Podcasts about medicaid services

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Best podcasts about medicaid services

Latest podcast episodes about medicaid services

The FOX News Rundown
Dr. Oz Pushes Back Against Democrats' Medicaid Claims

The FOX News Rundown

Play Episode Listen Later Jul 15, 2025 35:19


While the Congressional Budget Office says as many as twelve million people could lose health insurance due to Medicaid cuts in the President's "big, beautiful bill," the Trump administration defends work requirements and cuts for cost savings. Their goal is to reform the system, removing non-disabled recipients from Medicaid. Despite Democrats' concerns, these cuts won't take effect until the end of next year. Director of the Centers for Medicare & Medicaid Services, Dr. Mehmet Oz joins the Rundown to explain the need to address waste, fraud, and abuse in Medicaid to ensure those who need it most receive health care. Last week, the largest illegal immigration raid of President Donald Trump's second term occurred, resulting in the detention of over 360 individuals at two marijuana farms in California. Among those detained were several convicted felons and 14 children. Former acting ICE Director and former federal prosecutor Jonathan Fahey joins us to discuss the raids and the ongoing legal issues surrounding immigration. Plus, commentary from New York Post columnist and co-author of "Stolen Youth," Karol Markowicz. Photo Credit: AP Learn more about your ad choices. Visit podcastchoices.com/adchoices

From Washington – FOX News Radio
Dr. Oz Pushes Back Against Democrats' Medicaid Claims

From Washington – FOX News Radio

Play Episode Listen Later Jul 15, 2025 35:19


While the Congressional Budget Office says as many as twelve million people could lose health insurance due to Medicaid cuts in the President's "big, beautiful bill," the Trump administration defends work requirements and cuts for cost savings. Their goal is to reform the system, removing non-disabled recipients from Medicaid. Despite Democrats' concerns, these cuts won't take effect until the end of next year. Director of the Centers for Medicare & Medicaid Services, Dr. Mehmet Oz joins the Rundown to explain the need to address waste, fraud, and abuse in Medicaid to ensure those who need it most receive health care. Last week, the largest illegal immigration raid of President Donald Trump's second term occurred, resulting in the detention of over 360 individuals at two marijuana farms in California. Among those detained were several convicted felons and 14 children. Former acting ICE Director and former federal prosecutor Jonathan Fahey joins us to discuss the raids and the ongoing legal issues surrounding immigration. Plus, commentary from New York Post columnist and co-author of "Stolen Youth," Karol Markowicz. Photo Credit: AP Learn more about your ad choices. Visit podcastchoices.com/adchoices

Fox News Rundown Evening Edition
Dr. Oz Pushes Back Against Democrats' Medicaid Claims

Fox News Rundown Evening Edition

Play Episode Listen Later Jul 15, 2025 35:19


While the Congressional Budget Office says as many as twelve million people could lose health insurance due to Medicaid cuts in the President's "big, beautiful bill," the Trump administration defends work requirements and cuts for cost savings. Their goal is to reform the system, removing non-disabled recipients from Medicaid. Despite Democrats' concerns, these cuts won't take effect until the end of next year. Director of the Centers for Medicare & Medicaid Services, Dr. Mehmet Oz joins the Rundown to explain the need to address waste, fraud, and abuse in Medicaid to ensure those who need it most receive health care. Last week, the largest illegal immigration raid of President Donald Trump's second term occurred, resulting in the detention of over 360 individuals at two marijuana farms in California. Among those detained were several convicted felons and 14 children. Former acting ICE Director and former federal prosecutor Jonathan Fahey joins us to discuss the raids and the ongoing legal issues surrounding immigration. Plus, commentary from New York Post columnist and co-author of "Stolen Youth," Karol Markowicz. Photo Credit: AP Learn more about your ad choices. Visit podcastchoices.com/adchoices

Agent Survival Guide Podcast
Field Notes on Commission Trackers

Agent Survival Guide Podcast

Play Episode Listen Later Jul 12, 2025 15:13


Ready for a better commission tracking solution? Don't miss our episode featuring suggestions on tracking your hard-earned commissions.   Register for your FREE RitterIM.com Account   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Resources: AHIP Test Tips and Tricks for Medicare Certification Building the Foundation for Success ft. Roy Snarr Four Reasons Why Ritter Should Be Your FMO Insurance Agency How to Avoid Using Elderspeak Operating From a People-First Mentality ft. Scott Zimmerman The Best Appointment Schedulers for Insurance Agents The Difference Between Medicare & Medicaid: What That Means for Insurance Agents The Ultimate Agent Resource List Pt. 3: Staying Organized What Are Agents Responsible for Under HIPAA?   References: “Agencybloc Commissions Management.” Agencybloc.Com, AgencyBloc, www.agencybloc.com/commissions-management/. Accessed 10 June 2025. “AgencyComp Commissions Tracker.” Agencycomp.Com, AgencyComp, agencycomp.com/. Accessed 10 June 2025. “Commissionly Sales Commission Software.” Commissionly.Io, Commissionly, www.commissionly.io/. Accessed 10 June 2025. “Excel Help & Learning.” Support.Microsoft.Com, Microsoft Support, support.microsoft.com/en-us/excel. Accessed 23 June 2025. “Excel Quick and Simple Charts Tutorial.” YouTube.Com, YouTube, www.youtube.com/watch?v=TfkNkrKMF5c. Accessed 23 June 2025. “How to Create a Chart in Microsoft Excel: Step-by-Step Guide.” wikiHow.Com, wikiHow, 31 Dec. 2024, www.wikihow.com/Create-a-Graph-in-Excel. “How to Create Excel Charts and Graphs.” Blog.Hubspot.Com, HubSpot Blog, blog.hubspot.com/marketing/how-to-build-excel-graph. Accessed 23 June 2025. “Medicare Marketing Guidelines.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/medicare/health-drug-plans/managed-care-marketing/medicare-guidelines. Accessed 23 June 2025. “Medicare PRO CRM.” Medicareproapp.Com, Medicare PRO, www.medicareproapp.com/. Accessed 10 June 2025. “Radius Agency Management System.” Radiusbob.Com, Radius, www.radiusbob.com/. Accessed 10 June 2025.   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance       Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel    Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/    Not affiliated with or endorsed by Medicare or any government agency. 

Conversations on Health Care
Dr. Oz's Second-in-Command Explains Need for Medicaid Reimbursement Cuts as “Big Beautiful Bill” Passes

Conversations on Health Care

Play Episode Listen Later Jul 10, 2025 35:11


President Trump signed the “One Big Beautiful Bill Act” into law on July 4 and now leaders such as Stephanie Carlton are in charge of implementing it. She's the deputy administrator and chief of staff at the Centers for Medicare & Medicaid Services.Carlton and the administration see the law's benefits because Medicaid reimbursement rates “were allowed to go up to commercial rates and states are at varying levels towards that cap. But as we sat back and looked at it and said well, ‘these are providers who are committing to society to vulnerable Americans that they're going to help with their healthcare needs'…. but paying up to commercial rates kind of changes the focus of the program, where it becomes more about facilities profiting more than making sure patients are taken good care of.” Carlton also answered questions from hosts Mark Masselli and Margaret Flinter shortly before Congress passed the bill. In addition, she discussed how they believe modern technology can help with new Medicaid work requirements, concerns about the National Health Service Corps and the administration's plans to lower prescription drug costs.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Agent Survival Guide Podcast
Medicare Enrollment Periods Explained

Agent Survival Guide Podcast

Play Episode Listen Later Jul 9, 2025 12:41


We've got the breakdown of all the Medicare and Medicare Advantage enrollment periods that beginner agents need to know.   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Resources: 10 Essential Tools for Beginner Insurance Agents: https://ritterim.com/blog/10-essential-tools-for-beginner-insurance-agents/ Apps for Comparing Healthcare & Prescriptions: https://lnk.to/ASGA85 Medicare Advantage Open Enrollment Do's and Don'ts: https://ritterim.com/blog/medicare-advantage-open-enrollment-dos-and-donts/ Self-Guided Training with Knight School: https://ritterim.com/knight-school/ The Difference Between Medicare & Medicaid: https://lnk.to/ASGAE01 What is AHIP Certification and How Do I Get It? https://lnk.to/asg672   References: Franchina, Chris. “AEP vs. OEP: Understanding the Differences for Medicare.” Policy Engineer, 11 Jan. 2025, https://policyengineer.com/aep-vs-oep-understanding-the-differences-for-medicare/. “Get Ready to Buy.” Medicare.Gov, https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy. Accessed 17 June 2025. “Joining a Plan.” Medicare, “Joining a Plan.” Medicare, www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan. Accessed 10 June 2025. Worstell, Christian. “Medicare AEP vs. OEP: Know Your Enrollment Periods.” Medicare AEP vs. OEP | How to Enroll or Change Your Medicare Plan | MedicareAdvantage.Com, MedicareAdvantage.com, 18 Mar. 2025, https://www.medicareadvantage.com/enrollment/medicare-aep-vs-oep. “Medicare Open Enrollment.” CMS.Gov, https://www.cms.gov/priorities/key-initiatives/medicare-open-enrollment-partner-resources. Accessed 10 June 2025. “Medicare Open Enrollment Fact Sheet 2025.” CMS.Gov, Centers for Medicare & Medicaid Services, https://www.cms.gov/files/document/2024-medicare-open-enrollment-fact-sheet.pdf. Accessed 10 June 2025. “Special Enrollment Periods.” Medicare, Medicare.gov, https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods. Accessed 10 June 2025. “What Is the Medicare Annual Enrollment Period? | News & Articles | UnitedHealthcare.” UHC.Com, UnitedHealthcare, https://www.uhc.com/news-articles/medicare-articles/what-is-the-medicare-annual-enrollment-period. Accessed 10 June 2025. “What If I Missed My Initial Enrollment Period? | News & Articles | UnitedHealthcare.” UHC.Com, UnitedHealthcare, https://www.uhc.com/news-articles/medicare-articles/what-if-i-missed-my-initial-enrollment-period. Accessed 10 June 2025. “What Is the Medicare General Enrollment Period?” NOCA.Org, National Counsel of Aging, https://www.ncoa.org/article/a-closer-look-at-the-medicare-general-enrollment-period/. Accessed 10 June 2025.   Follow Us on Social!  Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.

Conversations on Health Care
Dr. Oz's Second-in-Command Explains Need for Medicaid Reimbursement Cuts as “Big Beautiful Bill” Passes

Conversations on Health Care

Play Episode Listen Later Jul 9, 2025 35:12


President Trump signed the “One Big Beautiful Bill Act” into law on July 4 and now leaders such as Stephanie Carlton are in charge of implementing it. She's the deputy administrator and chief of staff at the Centers for Medicare & Medicaid Services. Carlton and the administration see the law's benefits because Medicaid reimbursement rates “were allowed to go up to commercial rates and states are at varying levels towards that cap. But as we sat back and looked at... Read More Read More The post Dr. Oz's Second-in-Command Explains Need for Medicaid Reimbursement Cuts as “Big Beautiful Bill” Passes appeared first on Healthy Communities Online.

Between the Bells
Morning Bell 10 July

Between the Bells

Play Episode Listen Later Jul 9, 2025 3:33


Wall Street recovered to close higher on Wednesday as investors shrugged off the latest tariff noise to buy into tech and other growth market areas again. The Nasdaq rose 0.94% boosted by Nvidia shares climbing 1.8%, the S&P500 added 0.61%, and the Dow Jones ended the day up 0.5%. On Wednesday, Trump sent a further 6 letters to countries outlining new tariffs on imports of goods bound for the U.S.In Europe overnight, markets closed at a four-week high boosted by the banks as investors await progress on trade talks between the U.S. and the EU. The STOXX600 rose 0.78%, Germany's DAX added 1.42%, the French CAC climbed 1.44%, and, in the UK, the FTSE100 ended the day up 0.15%.Across the Asia markets on Wednesday, it was a mixed session after President Trump ruled out any extension to the tariff deadline of August 1. Japan's Nikkei added 0.33%, Hong Kong's Hang Seng fell 1.06%, China's CSI index lost 0.18% and South Korea's Kospi index ended the day flat.The Australian share market dropped 0.61% on Wednesday following US President Donald Trump's escalation of his protectionist trade war, as he reiterated threats to impose higher tariffs on copper imports.Lifestyle Communities (ASX:LIC) saw a dramatic drop of over 40% following a landmark tribunal ruling that deemed its profitable deferred management fees, or exit fees, imposed on residents to be invalid under state tenancy laws.Telix Pharmaceuticals (ASX:TLX) surged 6% following the announcement that its prostate cancer imaging product, Gozellix, has been assigned a permanent code by the US Centres for Medicare & Medicaid Services, effective October 1.Most traded securities:Most traded stocks and ETFs of the day yesterday by our clients were led byBHP (ASX:BHP)Ampol (ASX:ALD)Global X Physical Gold ETF (ASX:GOLD)What to watch today:On the commodities front this morning oil is trading 0.21% higher at US$68.32/barrel, gold is up 0.36% at US$3313.36/ounce and iron ore is up 0.35% at US$95.55/tonne.The Aussie dollar has strengthened against the greenback to buy 65.34 U.S. cents, 95.61 Japanese yen, 48.05 British pence and 1 New Zealand dollar and 9 cents.Ahead of Thursday's trading session here in Australia the SPI futures are anticipating the ASX will open the day up 0.5%.Trading ideas:Bell Potter has decreased the 12-month price target on Lifestyle Communities (ASX:LIC) from $8.55 to $5.00 and maintain a hold rating on the company following the receipt of judgement from ongoing VCAT proceedings relating chiefly to its use of a deferred managed fee structure.And Trading Central has identified a bullish signal on Data3 (ASX:DTL) following the formation of a pattern over a period of 182 days which is roughly the same amount of time the share price may rise from the close of $7.79 to the range of $9.80 to $10.20 according to standard principles of technical analysis.

Agent Survival Guide Podcast
Field Notes on Digital Marketing Resources

Agent Survival Guide Podcast

Play Episode Listen Later Jul 8, 2025 22:26


Take your business into the modern world of digital marketing. We've compiled the ultimate guide to getting started, tips, resources, and more!   Read the text version   Register with Ritter Insurance Marketing   Full-Service Digital Marketing Services: $99 Social ConciergeBee Disruptive Advertising Firebelly MarketingHubstaff Talent Ignite Visibility KlientBoostLinkedIn Lyfe Marketing ReminderMedia SEO DiscoveryUpwork   Self-Service Digital Marketing Options: Buffer Constant Contact GoDaddy Google Ads HostGator HubSpot MailChimp Semrush SEO Meta in 1 Click Social Bee Squarespace Wix   Resources: 3 Insurance Business Tools You Absolutely Can't Live Without Ritter Insurance Marketing Agent Compliance Handbook How to Market Yourself Online Webinar Field Notes on Traditional Marketing Integrity Tools Insurance Agents as TPMOs: What CMS Compliance Regulations Mean for You Introducing The Content Library for Health Insurance Agents Modern Medicare Marketing for Today's Agents FREE eBook Download PlanEnroll Ritter's Content Library Ritter Insurance Marketing Registration Form Social Media Marketing for Insurance Agents FREE eBook Download   The Ultimate Agent Resource List Pt. 2: Keeping in Touch with Clients   References: Kumar, Naveen. “167 Digital Marketing Statistics 2025 [Facts & Growth].” DemandSage, 4 Mar. 2025, https://www.demandsage.com/digital-marketing-statistics/. “Digital Marketing: Everything You Need to Know to Get It Right.” HubSpot Blog, https://blog.hubspot.com/marketing/what-is-digital-marketing. Accessed 16 June 2025. “Medicare Marketing Guidelines.” CMS.Gov, Centers for Medicare & Medicaid Services, https://www.cms.gov/medicare/health-drug-plans/managed-care-marketing/medicare-guidelines. Accessed 16 June 2025. Nguyen, Stephanie T. “Can-SPAM Act: A Compliance Guide for Business.” Federal Trade Commission, 24 Jan. 2025, https://www.ftc.gov/business-guidance/resources/can-spam-act-compliance-guide-business/ . “Subpart V—Medicare Advantage Communication Requirements.” Code of Federal Regulations, eCFR.gov, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-422/subpart-V. Accessed 16 June 2025. “Writing Alt Text for Infographics: Quick Tips.” WCAG Audits, ADA Accessibility Audits & Section 508 Audits, Bureau of Internet Accessibility, 7 Nov. 2023, https://www.boia.org/blog/writing-alt-text-for-infographics-quick-tips.   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency. Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.

See You Now
123: Safer Together | The Architecture of a Movement

See You Now

Play Episode Listen Later Jun 27, 2025 53:47


Despite decades of effort and innovation since the groundbreaking To Err is Human report over 25 years ago, preventable harm in healthcare persists, and violence against healthcare workers continues to rise. With record understaffing, burnout, mandatory overtime, and mounting documentation demands, the pressure to provide safe care has never been higher nor the stakes more urgent. In this first episode of our new series focusing on safety in healthcare, we explore a bold shift toward "total systems safety" with two leaders at the forefront of this movement who know these challenges all too well. Patricia McGaffigan, RN, MS, CPPS, Senior Advisor for Patient and Workforce Safety at the Institute for Healthcare Improvement, and President of the Certification Board for Professionals in Patient Safety, and Donald Berwick, MD, MPP, FRCP, President Emeritus and Senior Fellow at the Institute for Healthcare Improvement, and former Administrator of the Centers for Medicare and Medicaid Services. Together, they continue to shape national safety efforts including IHI's Safer Together: National Action Plan to Advance Patient Safety the first public-private collaboration of its kind. Spearheaded by McGaffigan and bringing together 27 major organizations that had never collaborated before. The plan aims to restructure the very foundation of healthcare, building safety into every level of the system around four interlocking pillars. Leadership & Governance: Strong, visible leadership and policies that make safety a strategic priority. Workforce Safety & Well-Being: Protecting nurses and healthcare workers – physically and mentally – so they can care safely for others. Patient & Family Engagement: Partnering with patients and family caregivers as co-designers of safe care. Learning Systems: Creating feedback loops and continuous improvement so lessons from one hospital spread everywhere.   At the heart of this movement is a truth long understood by nurses: safety is not a checklist or a policy, it's a culture, a commitment, and a collective responsibility. As Patricia McGaffigan reminds us, “You can't have patient safety if you don't have a safe workforce.” And as Don Berwick warns, “The illusion that safety is a matter of individual effort is one of the most toxic notions in the whole safety enterprise. It is we, not me.” Nurses have always led by example, holding space for healing while navigating broken systems. Now, their leadership is essential in building the future of healthcare safety: one that protects not only patients, but the people who care for them. Where healthcare is not only safer, but also is a culture that ensures we're all Safer Together.

Agent Survival Guide Podcast
Takeaways from the 2025 ACA Marketplace Integrity and Affordability Final Rule

Agent Survival Guide Podcast

Play Episode Listen Later Jun 27, 2025 18:23


Join Sarah for a rundown of this week's updates for insurance agents, featuring her deep dive into the CMS 2025 ACA Marketplace Integrity and Affordability Final Rule.   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Connect With Us On Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Resources: 5 Things About the Insurance License Exam, 1 Year Later: https://lnk.to/asgf20250620 Are You Self-Sabotaging Your Insurance Sales Success? https://ritterim.com/blog/are-you-self-sabotaging-your-insurance-sales-success/ Four Reasons Why Ritter Should Be Your FMO Insurance Agency: https://ritterim.com/blog/four-reasons-why-ritter-should-be-your-fmo-insurance-agency/ How to Build Intentional Value ft. Neil Reich: https://lnk.to/reich2025 Leveling Up: From Chill Mode to Growth Mode ft. Christian Brindle: https://lnk.to/brindle2025 Seven Figures or Bust Episode 79 - What Is CMS Doing? w/ Special Guest Sarah Rueppel! https://lnk.to/qzTwIw Summer 2025 Survival Guide: https://lnk.to/asgf20250606   References: “2025 Marketplace Integrity and Affordability Final Rule.” CMS.Gov, CMS, 20 June 2025, www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-final-rule. “2025 Marketplace Integrity and Affordability Proposed Rule.” CMS.Gov, Centers for Medicare and Medicaid Services, 10 Mar. 2025, www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-proposed-rule. “CMS Finalizes Major Rule to Lower Individual Health Insurance Premiums for Americans.” CMS.Gov, Centers for Medicare & Medicaid Services, 20 June 2025, www.cms.gov/newsroom/press-releases/cms-finalizes-major-rule-lower-individual-health-insurance-premiums-americans. Minemyer, Paige. “CMS Finalizes Rule Aimed at ‘improper' Sign-Ups on the ACA Exchanges.” Fiercehealthcare.Com, Fierce Healthcare, 20 June 2025, www.fiercehealthcare.com/regulatory/cms-finalizes-rule-aimed-improper-sign-ups-aca-exchanges. Minemyer, Paige. “Democrats Introduce Bill to Establish a Medicare ‘part E' Public Option.” Fiercehealthcare.Com, Fierce Healthcare, 16 June 2025, www.fiercehealthcare.com/regulatory/democrats-introduce-bill-establish-medicare-part-e-public-option. Mercado, Darla. “Fed Decision Recap: Central Bank Signals Stagflation Fears, Powell Says Fed ‘Well Positioned to Wait' on Rates.” CNBC.Com, CNBC, 18 June 2025, www.cnbc.com/2025/06/18/fed-meeting-live-updates-feds-interest-rate-projections-loom.html. “HHS Secretary Kennedy, CMS Administrator Oz Secure Industry Pledge to Fix Broken Prior Authorization System.” HHS.Gov, Department of Health & Human Services, 23 June 2025, www.hhs.gov/press-room/kennedy-oz-cms-secure-healthcare-industry-pledge-to-fix-prior-authorization-system.html. Minemyer, Paige. “Mehmet Oz: Insurers' Prior Auth Pledge ‘an Opportunity for the Industry to Show Itself.'” Fiercehealthcare.Com, Fierce Healthcare, 23 June 2025, www.fiercehealthcare.com/regulatory/oz-insurers-prior-auth-pledge-opportunity-industry-show-itself. “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability.” Federalregister.Gov, Federal Register, www.federalregister.gov/documents/2025/06/25/2025-11606/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability. Accessed 25 June 2025. Schneider, Howard. “Powell Repeats Rate Cuts Can Wait as Fed Studies Tariff Impacts.” Reuters.Com, Reuters, 24 June 2025, www.reuters.com/business/powell-repeats-rate-cuts-can-wait-fed-studies-tariff-impacts-2025-06-24/. Simmons-Duffin, Selena. “RFK Jr. and Dr. Oz Say Health Insurers Will Cut Red Tape on ‘Prior Authorizations.'” NPR.Org, NPR, 24 June 2025, www.npr.org/sections/shots-health-news/2025/06/24/nx-s1-5442713/rfk-jr-dr-oz-health-insurance-prior-authorization.   Not affiliated with or endorsed by Medicare or any government agency.

The Dom Giordano Program
E-I-E-I-Oh Boy... (Full Show)

The Dom Giordano Program

Play Episode Listen Later Jun 25, 2025 131:16


12 - NYC has a new mayor! And he's a self-proclaimed socialist? How much do cigarettes cost in NYC? Do we think the city will be more affordable now? 1205 - A New Jersey town is upset about ICE raids and a deportation. Why is Dom happy a socialist won the NYC Mayoral primary? 1215 - Side - all time farmer 1220 - Are the slashes to Medicaid warranted? Why are Republicans hesitant to cut funding for those that shouldn't qualify? Why is CNN leaking that the US really didn't annihilate Iran's nuclear facilities? 1230 - Dr. Mehmet Oz joins us today. What is he seeking to do in his role as Administrator of the Centers for Medicare and Medicaid Services? Why is eliminating people who shouldn't qualify for Medicaid so important? What has Dr. Oz learned so far in his role with the White House? What is to be done about drug use here in Philadelphia and nationwide? Will the “prior-authorization” catastrophe be fixed? 1240 - Former UConn and WNBA star Rebecca Lobo is in hot water with ESPN after a “slip” on air. Why have sports become so politicized? 1250 - Your calls. 1 - What does it take to get the death penalty in Philadelphia? 105 - Pastor Bill Devlin joins us from the justice center and paints us a picture of what it's like inside the courtroom of the Officer Christopher Fitzgerald. What is Christopher's wife, Marissa, wearing to show support for her late husband? What does Pastor Bill think of the death penalty? Some breaking news regarding Mark Houck and his case. 120 - Revisiting Mulligan's on Friday after a listener missed the festivities Friday. Who will catch the pass from Jaws? Your calls. 135 - How much money will Mark Houck get from our justice department with his case settlement? Well, Mark joins us today to discuss how life has been since his trial concluded. How are the kids doing after these last few years? How much collusion was there with law enforcement in storming his house early in the morning? What's next for Mark Houck? What is it like being treated like a felon? What is Mark's field of expertise? 150 - Your calls. 2 - NJ Assemblywoman Dawn Fantasia joins the program today to discuss the state going after a mom and pop farm. Why did the government go after this farm? Why have policies made things harder for farmers when they were created to make organic farming easier? Is the rural outrage over this as loud as it should be? How will this issue affect the gubernatorial race? How will abortion and murder laws play a factor? 215 - Dom's Money Melody! 220 - Can anyone get the Money Melody? Your calls. 225 - You might not be stopped for crimes in Philadelphia, but you will in Bucks County! 235 - Bill O'Reilly has gifted Dom an early copy of his new book. Dom gives Bill feedback? How scary is that? Do you read Shakespeare? Henry reveals something. 240 - Your calls. 250 - The Lightning Round!

The Dom Giordano Program
Socialites for Socialism

The Dom Giordano Program

Play Episode Listen Later Jun 25, 2025 44:53


12 - NYC has a new mayor! And he's a self-proclaimed socialist? How much do cigarettes cost in NYC? Do we think the city will be more affordable now? 1205 - A New Jersey town is upset about ICE raids and a deportation. Why is Dom happy a socialist won the NYC Mayoral primary? 1215 - Side - all time farmer 1220 - Are the slashes to Medicaid warranted? Why are Republicans hesitant to cut funding for those that shouldn't qualify? Why is CNN leaking that the US really didn't annihilate Iran's nuclear facilities? 1230 - Dr. Mehmet Oz joins us today. What is he seeking to do in his role as Administrator of the Centers for Medicare and Medicaid Services? Why is eliminating people who shouldn't qualify for Medicaid so important? What has Dr. Oz learned so far in his role with the White House? What is to be done about drug use here in Philadelphia and nationwide? Will the “prior-authorization” catastrophe be fixed? 1240 - Former UConn and WNBA star Rebecca Lobo is in hot water with ESPN after a “slip” on air. Why have sports become so politicized? 1250 - Your calls.

WFYI News Now
Student Tobacco Use Continues to Decline, Two-Year Freeze on College Tuition Rates, Indiana Economy Holds Steady, Some Indiana Children May No Longer Qualify for Medicaid Services

WFYI News Now

Play Episode Listen Later Jun 25, 2025 5:28


Tobacco use among middle and high school students in Indiana continues to decline. College tuition rates for Indiana's undergraduate students will be paused for two years. One measure of the strength of Indiana's economy held steady for a third month according to new preliminary data. Indiana is introducing new tools on July 1st to evaluate if children and infants qualify for home and community-based services through Medicaid – some children may no longer qualify because of it. Want to go deeper on the stories you hear on WFYI News Now? Visit wfyi.org/news and follow us on social media to get comprehensive analysis and local news daily. Subscribe to WFYI News Now wherever you get your podcasts. WFYI News Now is produced by Drew Daudelin, Zach Bundy and Abriana Herron, with support from News Director Sarah Neal-Estes.

Fading Memories: Alzheimer's Caregiver Support
The Future of Dementia Support: Beyond Clinic Walls

Fading Memories: Alzheimer's Caregiver Support

Play Episode Listen Later Jun 24, 2025 59:54


Navigating dementia care can be overwhelming. Traditional healthcare systems often fall short, leaving families without adequate support. However, a significant shift is underway. The federal government has launched GUIDE, a program acknowledging nationwide gaps in dementia care. This innovative initiative sets new standards, urging healthcare systems to adopt a different approach. We delve into the future of dementia care, exploring scalable, specialized solutions. Furthermore, we uncover how expert teams, like Remo Health's, provide comprehensive support for both patients and caregivers. This includes virtual clinical care, evidence-based education, and a vital community network. Additionally, proactive risk identification and on-demand access are becoming crucial. This model offers cost-effective, deeply personalized support. Moreover, it aligns perfectly with GUIDE's call for fundamental change. Tune in to discover how this new era promises better outcomes and essential assistance. Our Guest: Sabrina Chugani Sabrina is a co-founder and Chief Growth Officer at Remo Health, where she oversees partnerships, marketing, and account management. Sabrina has deep expertise in value-based care and has spent her career working at the forefront of innovative payment models, including MSSP, CKCC, and Direct Contracting, that change the way care is delivered nationwide. About Remo Health Remo Health is a virtual dementia care company. Our world-class neurologists diagnose and manage all types of dementia. Remo provides peer support, comprehensive and personalized care plans, and 24/7 access to experts for people living with dementia and those who care for them. Remo Health is a trusted participant in the Centers for Medicare & Medicaid Services' Guiding an Improved Dementia Experience (GUIDE) Model. ++++++++++++++++++++++++++++++++++++++++ Related Episodes: Brain Rejuvenation: Stem Cell Therapy and Alzheimer's Disease The Brain's Fountain of Youth: Innovative Paths to Dementia Prevention ++++++++++++++++++++++++++++++++++++++++ Sign Up for more Advice & Wisdom - email newsletter. Please help us keep our show going by supporting our sponsors. Thank you. ++++++++++++++++++++++++++++++++++++++++ Make Your Brain Span Match Your LifeSpan Relevate from NeuroReserve With Relevate nutritional supplement, you get science-backed nutrition to help protect your brain power today and for years to come. You deserve a brain span that lasts as long as your lifespan. ++++++++++++++++++++++++++++++++++++++++ Feeling overwhelmed? HelpTexts can be your pocket therapist. Going through a tough time? HelpTexts offers confidential support delivered straight to your phone via text message. Whether you're dealing with grief, caregiving stress, or just need a mental health boost, their expert-guided texts provide personalized tips and advice. Sign up for a year of support and get: Daily or twice-weekly texts tailored to your situation Actionable strategies to cope and move forward Support for those who care about you (optional) HelpTexts makes getting help easy and convenient. ++++++++++++++++++++++++++++++++++++++++ List of the Top 20 Alzheimer's Podcasts via FeedSpot! See where we rank. Join Fading Memories On Social Media! If you've enjoyed this episode, please share this podcast with other caregivers! You'll find us on social media at the following links. Instagram LinkedIn  Facebook Contact Jen at hello@fadingmemoriespodcast.com Or learn more at Our Website

Good Morning Orlando
The latest on the BBB.

Good Morning Orlando

Play Episode Listen Later Jun 24, 2025 40:29


Megabus shares list of items left behind on their buses. Ryan Schmelz has the latest on the BBB. The View hammers Trump for Iran bombing. Dr Oz, Administrator for the Centers for Medicare & Medicaid Services, joins Good Morning Orlando. Recap of Dr Oz interview.

Good Morning Orlando
Dr. Oz joins Good Morning Orlando.

Good Morning Orlando

Play Episode Listen Later Jun 24, 2025 9:33


Dr .Oz, Administrator for the Centers for Medicare & Medicaid Services, joins Good Morning Orlando.

Agent Survival Guide Podcast
The Pros and Cons of Selling Insurance

Agent Survival Guide Podcast

Play Episode Listen Later Jun 16, 2025 13:19


Thinking about becoming an insurance agent? In this episode, we weigh the pros and cons of selling insurance, so you'll have the information you need before you make that big decision!   Read the text version   Get Started by Registering with Ritter Insurance Marketing: https://app.ritterim.com/public/registration/   Learn More with These Resources: 2025 Maximum Broker Commissions for Medicare Advantage & Medicare Part D Update: https://lnk.to/dFX1s1 2025 State of the Senior Market Address: In Review: https://ritterim.com/blog/2025-state-of-the-senior-market-address-in-review/ 5 Perks of Being a Part-Time Insurance Agent: https://lnk.to/YGJ3KX Agent Survival Guide Podcast: https://lnk.to/asgpodcast Building Client Loyalty: More than Just a Plan: https://ritterim.com/blog/building-client-loyalty-more-than-just-a-plan/  Contact the Ritter Sales Team: https://ritterim.com/contact/ Four Reasons Why Ritter Should Be Your FMO Insurance Agency: https://ritterim.com/blog/four-reasons-why-ritter-should-be-your-fmo-insurance-agency/ Get Access to Exclusive Leads When You Become a PlanEnroll Network Agent: https://lnk.to/3pKJsF   How Insurance FMOs Work: https://ritterim.com/how-insurance-fmos-work/?utm_source=asg_podcast_link How Much Can Agents Make Selling Under-65 Insurance? https://lnk.to/TlGBGH How Much Can Insurance Agents Make Selling Medicare? https://ritterim.com/blog/how-much-can-insurance-agents-make-selling-medicare/ How Professional Organizations Make You a Better Agent: https://ritterim.com/blog/how-professional-organizations-make-you-a-better-agent/  REWIND: 8 Relationship Marketing Strategies for Insurance Agents: https://lnk.to/9b3cTl Ritter Insurance Marketing eBooks & Guides: https://ritterim.com/guides/ Ritter Insurance Marketing Events: https://ritterim.com/events/ The Advantages of Being a Field vs. Call Center Insurance Agent: https://ritterim.com/blog/the-advantages-of-being-a-field-vs-call-center-insurance-agent/  The Guide to Earning a Living Selling Health Insurance: https://ritterim.com/earning-a-living-selling-insurance/?utm_source=asg_podcast_link Your Step-By-Step Guide to Getting Started in Insurance Sales: https://ritterim.com/free-guide/?utm_source=asg_podcast_link   References: Cubanski, Juleette. “A Current Snapshot of the Medicare Part D Prescription Drug Benefit.” KFF.Org, KFF, 9 Oct. 2024, www.kff.org/medicare/issue-brief/a-current-snapshot-of-the-medicare-part-d-prescription-drug-benefit/. “Marketplace 2025 Open Enrollment Period Report: National Snapshot.” CMS.Gov, Centers for Medicare & Medicaid Services, 17 Jan. 2025, www.cms.gov/newsroom/fact-sheets/marketplace-2025-open-enrollment-period-report-national-snapshot-2. Rosanes, Mark. “Want to Build a Career Selling Insurance? Here Are the Pros and Cons.” Insurance Business America, Insurance Business, 22 Jan. 2024, www.insurancebusinessmag.com/us/guides/want-to-build-a-career-selling-insurance-here-are-the-pros-and-cons-473774.aspx.   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency. Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.

ASCO eLearning Weekly Podcasts
Addressing Barriers and Leveraging New Technologies in Lung Cancer Screening

ASCO eLearning Weekly Podcasts

Play Episode Listen Later Jun 9, 2025 26:09


Dr. Nathan Pennell and Dr. Cheryl Czerlanis discuss challenges in lung cancer screening and potential solutions to increase screening rates, including the use of AI to enhance risk prediction and screening processes. Transcript Dr. Nate Pennell: Hello, and welcome to By the Book, a monthly podcast series for ASCO Education that features engaging discussions between editors and authors from the ASCO Educational Book. I'm Dr. Nate Pennell, the co-director of the Cleveland Clinic Lung Cancer Program and vice chair of clinical research for the Taussig Cancer Center. I'm also the editor-in-chief for the ASCO Educational Book.  Lung cancer is one of the leading causes of cancer-related mortality worldwide, and most cases are diagnosed at advanced stages where curative treatment options are limited. On the opposite end, early-stage lung cancers are very curable. If only we could find more patients at that early stage, an approach that has revolutionized survival for other cancer types such as colorectal and breast cancer.  On today's episode, I'm delighted to be joined by Dr. Cheryl Czerlanis, a professor of medicine and thoracic medical oncologist at the University of Wisconsin Carbone Cancer Center, to discuss her article titled, "Broadening the Net: Overcoming Challenges and Embracing Novel Technologies in Lung Cancer Screening." The article was recently published in the ASCO Educational Book and featured in an Education Session at the 2025 ASCO Annual Meeting. Our full disclosures are available in the transcript of this episode.  Cheryl, it's great to have you on the podcast today. Thanks for being here. Dr. Cheryl Czerlanis: Thanks, Nate. It's great to be here with you. Dr. Nate Pennell: So, I'd like to just start by asking you a little bit about the importance of lung cancer screening and what evidence is there that lung cancer screening is beneficial. Dr. Cheryl Czerlanis: Thank you. Lung cancer screening is extremely important because we know that lung cancer survival is closely tied to stage at diagnosis. We have made significant progress in the treatment of lung cancer, especially over the past decade, with the introduction of immunotherapies and targeted therapies based on personalized evaluation of genomic alterations. But the reality is that outside of a lung screening program, most patients with lung cancer present with symptoms related to advanced cancer, where our ability to cure the disease is more limited.  While lung cancer screening has been studied for years, the National Lung Screening Trial, or the NLST, first reported in 2011 a significant reduction in lung cancer deaths through screening. Annual low-dose CT scans were performed in a high-risk population for lung cancer in comparison to chest X-ray. The study population was comprised of asymptomatic persons aged 55 to 74 with a 30-pack-year history of smoking who were either active smokers or had quit within 15 years. The low-dose CT screening was associated with a 20% relative risk reduction in lung cancer-related mortality. A similar magnitude of benefit was also reported in the NELSON trial, which was a large European randomized trial comparing low-dose CT with a control group receiving no screening. Dr. Nate Pennell: So, this led, of course, to approval from CMS (Centers for Medicare and Medicaid Services) for lung cancer screening in the Medicare population, probably about 10 years ago now, I think. And there are now two major trials showing an unequivocal reduction in lung cancer-related mortality and even evidence that it reduces overall mortality with lung cancer screening. But despite this, lung cancer screening rates are very low in the United States. So, first of all, what's going on? Why are we not seeing the kinds of screening rates that we see with mammography and colonoscopy? And what are the barriers to that here? Dr. Cheryl Czerlanis: That's a great question. Thank you, Nate. In the United States, recruitment for lung cancer screening programs has faced numerous challenges, including those related to socioeconomic, cultural, logistical, and even racial disparities. Our current lung cancer screening guidelines are somewhat imprecise and often fail to address differences that we know exist in sex, smoking history, socioeconomic status, and ethnicity. We also see underrepresentation in certain groups, including African Americans and other minorities, and special populations, including individuals with HIV. And even where lung cancer screening is readily available and we have evidence of its efficacy, uptake can be low due to both provider and patient factors. On the provider side, barriers include having insufficient time in a clinic visit for shared decision-making, fear of missed test results, lack of awareness about current guidelines, concerns about cost, potential harms, and evaluating both true and false-positive test results.  And then on the patient side, barriers include concerns about cost, fear of getting a cancer diagnosis, stigma associated with tobacco smoking, and misconceptions about the treatability of lung cancer. Dr. Nate Pennell: I think those last two are really what make lung cancer unique compared to, say, for example, breast cancer, where there really is a public acceptance of the value of mammography and that breast cancer is no one's fault and that it really is embraced as an active way you can take care of yourself by getting your breast cancer screening. Whereas in lung cancer, between the stigma of smoking and the concern that, you know, it's a death sentence, I think we really have some work to be made up, which we'll talk about in a minute about what we can do to help improve this.  Now, that's in the U.S. I think things are probably, I would imagine, even worse when we leave the U.S. and look outside, especially at low- and middle-income countries. Dr. Cheryl Czerlanis: Yes, globally, this issue is even more complex than it is in the United States. Widespread implementation of low-dose CT imaging for lung cancer screening is limited by manpower, infrastructure, and economic constraints. Many low- and middle-income countries even lack sufficient CT machines, trained personnel, and specialized facilities for accurate and timely screenings. Even in urban centers with advanced diagnostic facilities, the high screening and follow-up care costs can limit access. Rural populations face additional barriers, such as geographic inaccessibility of urban centers, transportation costs, language barriers, and mistrust of healthcare systems. In addition, healthcare systems in these regions often prioritize infectious diseases and maternal health, leaving limited room for investments in noncommunicable disease prevention like lung cancer screening. Policymakers often struggle to justify allocating resources to lung cancer screening when immediate healthcare needs remain unmet. Urban-rural disparities exacerbate these challenges, with rural regions frequently lacking the infrastructure and resources to sustain screening programs. Dr. Nate Pennell: Well, it's certainly an intimidating problem to try to reduce these disparities, especially between the U.S. and low- and middle-income countries. So, what are some of the potential solutions, both here in the U.S. and internationally, that we can do to try to increase the rates of lung cancer screening? Dr. Cheryl Czerlanis: The good news is that we can take steps to address these challenges, but a multifaceted approach is needed. Public awareness campaigns focused on the benefits of early detection and dispelling myths about lung cancer screening are essential to improving participation rates. Using risk-prediction models to identify high-risk individuals can increase the efficiency of lung cancer screening programs. Automated follow-up reminders and screening navigators can also ensure timely referrals and reduce delays in diagnosis and treatment. Reducing or subsidizing the cost of low-dose CT scans, especially in low- or middle-income countries, can improve accessibility. Deploying mobile CT scanners can expand access to rural and underserved areas.  On a global scale, integrating lung cancer screening with existing healthcare programs, such as TB or noncommunicable disease initiatives, can enhance resource utilization and program scalability. Implementing lung cancer screening in resource-limited settings requires strategic investment, capacity building, and policy interventions that prioritize equity. Addressing financial constraints, infrastructure gaps, and sociocultural barriers can help overcome existing challenges. By focusing on cost-effective strategies, public awareness, and risk-based eligibility criteria, global efforts can promote equitable access to lung cancer screening and improve outcomes.  Lastly, as part of the medical community, we play an important role in a patient's decision to pursue lung cancer screening. Being up to date with current lung cancer screening recommendations, identifying eligible patients, and encouraging a patient to undergo screening often is the difference-maker. Electronic medical record (EMR) systems and reminders are helpful in this regard, but relationship building and a recommendation from a trusted provider are really essential here. Dr. Nate Pennell: I think that makes a lot of sense. I mean, there are technology improvements. For example, our lung cancer screening program at The Cleveland Clinic, a few years back, we finally started an automated best practice alert in our EMR for patients who met the age and smoking requirements, and it led to a six-fold increase in people referred for screening. But at the same time, there's a difference between just getting this alert and putting in an order for lung cancer screening and actually getting those patients to go and actually do the screening and then follow up on it. And that, of course, requires having that relationship and discussion with the patient so that they trust that you have their best interests. Dr. Cheryl Czerlanis: Exactly. I think that's important. You know, certainly, while technology can aid in bringing patients in, there really is no substitute for trust-building and a personal relationship with a provider. Dr. Nate Pennell: I know that there are probably multiple examples within the U.S. where health systems or programs have put together, I would say, quality improvement projects to try to increase lung cancer screening and working with their community. There's one in particular that you discuss in your paper called the "End Lung Cancer Now" initiative. I wonder if you could take us through that. Dr. Cheryl Czerlanis: Absolutely. "End Lung Cancer Now" is an initiative at the Indiana University Simon Comprehensive Cancer Center that has the vision to end suffering and death from lung cancer in Indiana through education and community empowerment. We discuss this as a paradigm for how community engagement is important in building and scaling a lung cancer screening program.  In 2023, the "End Lung Cancer Now" team decided to focus its efforts on scaling and transforming lung cancer screening rates in Indiana. They developed a task force with 26 experts in various fields, including radiology, pulmonary medicine, thoracic surgery, public health, and advocacy groups. The result of this work is an 85-page blueprint with key recommendations that any system and community can use to scale lung cancer screening efforts. After building strong infrastructure for lung cancer screening at Indiana University, they sought to understand what the priorities, resources, and challenges in their communities were. To do this, they forged strong partnerships with both local and national organizations, including the American Lung Association, American Cancer Society, and others. In the first year, they actually tripled the number of screening low-dose CTs performed in their academic center and saw a 40% increase system-wide. One thing that I think is the most striking is that through their community outreach, they learned that most people prefer to get medical care close to home within their own communities. Establishing a way to support the local infrastructure to provide care became far more important than recruiting patients to their larger system.  In exciting news, "End Lung Cancer Now" has partnered with the IU Simon Comprehensive Cancer Center and IU Health to launch Indiana's first and only mobile lung screening program in March of 2025. This mobile program travels around the state to counties where the highest incidence of lung cancer exists and there is limited access to screening. The mobile unit parks at trusted sites within communities and works in partnership, not competition, with local health clinics and facilities to screen high-risk populations. Dr. Nate Pennell: I think that sounds like a great idea. Screening is such an important thing that it doesn't necessarily have to be owned by any one particular health system for their patients. I think. And I love the idea of bringing the screening to patients where they are. I can speak to working in a regional healthcare system with a main campus in the downtown that patients absolutely hate having to come here from even 30 or 40 minutes away, and they'd much rather get their care locally. So that makes perfect sense.  So, under the current guidelines, there are certainly things that we can do to try to improve capturing the people that meet those. But are those guidelines actually capturing enough patients with lung cancer to make a difference? There certainly are proposals within patient advocacy communities and even other countries where there's a large percentage of non-smokers who perhaps get lung cancer. Can we expand beyond just older, current and heavy smokers to identify at-risk populations who could benefit from screening? Dr. Cheryl Czerlanis: Yes, I think we can, and it's certainly an active area of research interest. We know that tobacco is the leading cause of lung cancer worldwide. However, other risk factors include secondhand smoke, family history, exposure to environmental carcinogens, and pulmonary diseases like COPD and interstitial lung disease. Despite these known associations, the benefit of lung cancer screening is less well elucidated in never-smokers and those at risk of developing lung cancer because of family history or other risk factors. We know that the eligibility criteria associated with our current screening guidelines focus on age and smoking history and may miss more than 50% of lung cancers. Globally, 10% to 25% of lung cancer cases occur in never-smokers. And in certain parts of the world, like you mentioned, Nate, such as East Asia, many lung cancers are diagnosed in never-smokers, especially in women. Risk-prediction models use specific risk factors for lung cancer to enhance individual selection for screening, although they have historically focused on current or former smokers.  We know that individuals with family members affected by lung cancer have an increased risk of developing the disease. To this end, several large-scale, single-arm prospective studies in Asia have evaluated broadening screening criteria to never-smokers, with or without additional risk factors. One such study, the Taiwan Lung Cancer Screening in Never-Smoker Trial, was a multicenter prospective cohort study at 17 medical centers in Taiwan. The primary outcome of the TALENT trial was lung cancer detection rate. Eligible patients aged 55 to 75 had either never smoked or had a light and remote smoking history. In addition, inclusion required one or more of the following risk factors: family history of lung cancer, passive smoke exposure, history of TB or COPD, a high cooking index, which is a metric that quantifies exposure to cooking fumes, or a history of cooking without ventilation. Participants underwent low-dose CT screening at baseline, then annually for 2 years, and then every 2 years for up to 6 years. The lung cancer detection rate was 2.6%, which was higher than that reported in the NLST and NELSON trials, and most were stage 0 or I cancers. Subsequently, this led to the Taiwan Early Detection Program for Lung Cancer, a national screening program that was launched in 2022, targeting 2 screening populations: individuals with a heavy history of smoking and individuals with a family history of lung cancer.  We really need randomized controlled trials to determine the true rates of overdiagnosis or finding cancers that would not lead to morbidity or mortality in persons who are diagnosed, and to establish whether the high lung detection rates are associated with a decrease in lung cancer-related mortality in these populations. However, the implementation of randomized controlled low-dose CT screening trials in never-smokers has been limited by the need for large sample sizes, lengthy follow-up, and cost.  In another group potentially at higher risk for developing lung cancer, the role of lung cancer screening in individuals who harbor germline pathogenic variants associated with lung cancer also needs to be explored further. Dr. Nate Pennell: We had this discussion when the first criteria came out because there have always been risk-based calculators for lung cancer that certainly incorporate smoking but other factors as well and have discussion about whether we should be screening people based on their risk and not just based on discrete criteria such as smoking. But of course, the insurance coverage for screening, you have to fit the actual criteria, which is very constrained by age and smoking history. Do you think in the U.S. there's hope for broadening our screening beyond NLST and NELSON criteria? Dr. Cheryl Czerlanis: I do think at some point there is hope for broadening the criteria beyond smoking history and age, beyond the criteria that we have typically used and that is covered by insurance. I do think it will take some work to perhaps make the prediction models more precise or to really understand who can benefit. We certainly know that there are many patients who develop lung cancer without a history of smoking or without family history, and it would be great if we could diagnose more patients with lung cancer at an earlier stage. I think this will really count on there being some work towards trying to figure out what would be the best population for screening, what risk factors to look for, perhaps using some new technologies that may help us to predict who is at risk for developing lung cancer, and trying to increase the group that we study to try and find these early-stage lung cancers that can be cured. Dr. Nate Pennell: Part of the reason we, of course, try to enrich our population is screening works better when you have a higher pretest probability of actually having cancer. And part of that also is that our technology is not that great. You know, even in high-risk patients who have CT scans that are positive for a screen, we know that the vast majority of those patients with lung nodules actually don't have lung cancer. And so you have to follow them, you have to use various models to see, you know, what the risk, even in the setting of a positive screen, is of having lung cancer.  So, why don't we talk about some newer tools that we might use to help improve lung cancer screening? And one of the things that everyone is super excited about, of course, is artificial intelligence. Are there AI technologies that are helping out in early detection in lung cancer screening? Dr. Cheryl Czerlanis: Yes, that's a great question. We know that predicting who's at risk for lung cancer is challenging for the reasons that we talked about, knowing that there are many risk factors beyond smoking and age that are hard to quantify. Artificial intelligence is a tool that can help refine screening criteria and really expand screening access. Machine learning is a form of AI technology that is adept at recognizing patterns in large datasets and then applying the learning to new datasets. Several machine learning models have been developed for risk stratification and early detection of lung cancer on imaging, both with and without blood-based biomarkers. This type of technology is very promising and can serve as a tool that helps to select individuals for screening by predicting who is likely to develop lung cancer in the future.  A group at Massachusetts General Hospital, represented in our group for this paper by my co-authors, Drs. Fintelmann and Chang, developed Sybil, which is an open-access 3D convolutional neural network that predicts an individual's future risk of lung cancer based on the analysis of a single low-dose CT without the need for human annotation or other clinical inputs. Sybil and other machine learning models have tremendous potential for precision lung cancer screening, even, and perhaps especially, in settings where expert image interpretation is unavailable. They could support risk-adapted screening schedules, such as varying the frequency and interval of low-dose CT scans according to individual risk and potentially expand lung cancer screening eligibility beyond age and smoking history. Their group predicts that AI tools like Sybil will play a major role in decoding the complex landscape of lung cancer risk factors, enabling us to extend life-saving lung cancer screening to all who are at risk. Dr. Nate Pennell: I think that that would certainly be welcome. And as AI is working its way into pretty much every aspect of life, including medical care, I think it's certainly promising that it can improve on our existing technology.  We don't have to spend a lot of time on this because I know it's a little out of scope for what you covered in your paper, but I'm sure our listeners are curious about your thoughts on the use of other types of testing beyond CT screening for detecting lung cancer. I know that there are a number of investigational and even commercially available blood tests, for example, for detection of lung cancer, or even the so-called multi-cancer detection blood tests that are now being offered, although not necessarily being covered by insurance, for multiple types of cancer, but lung cancer being a common cancer is included in that. So, what do you think? Dr. Cheryl Czerlanis: Yes, like you mentioned, there are novel bioassays such as blood-based biomarker testing that evaluate for DNA, RNA, and circulating tumor cells that are both promising and under active investigation for lung cancer and multi-cancer detection. We know that such biomarker assays may be useful in both identifying lung cancers but also in identifying patients with a high-risk result who should undergo lung cancer screening by conventional methods. Dr. Nate Pennell: Anything that will improve on our rate of screening, I think, will be welcome. I think probably in the future, it will be some combination of better risk prediction and better interpretation of screening results, whether those be imaging or some combination of imaging and biomarkers, breath-based, blood-based. There's so much going on that it is pretty exciting, but we're still going to have to overcome the stigma and lack of public support for lung cancer screening if we're going to move the needle. Dr. Cheryl Czerlanis: Yes, I think moving the needle is so important because we know lung cancer is still a very morbid disease, and our ability to cure patients is not where we would like it to be. But I do believe there's hope. There are a lot of motivated individuals and groups who are passionate about lung cancer screening, like myself and my co-authors, and we're just happy to be able to share some ways that we can overcome the challenges and really try and make an impact in the lives of our patients. Dr. Nate Pennell: Well, thank you, Dr. Czerlanis, for joining me on the By the Book Podcast today and for all of your work to advance care for patients with lung cancer. Dr. Cheryl Czerlanis: Thank you, Dr. Pennell. It's such a pleasure to be with you today. Thank you. Dr. Nate Pennell: And thank you to our listeners for joining us today. You'll find a link to Dr. Czerlanis' article in the transcript of this episode.  Please join us again next month for By the Book's next episode and more insightful views on topics you'll be hearing at the education sessions from ASCO meetings throughout the year, and our deep dives on approaches that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:     Dr. Nathan Pennell    @n8pennell   @n8pennell.bsky.social Dr. Cheryl Czerlanis Follow ASCO on social media:     @ASCO on X (formerly Twitter)     ASCO on Bluesky    ASCO on Facebook     ASCO on LinkedIn     Disclosures:    Dr. Nate Pennell:        Consulting or Advisory Role: AstraZeneca, Lilly, Cota Healthcare, Merck, Bristol-Myers Squibb, Genentech, Amgen, G1 Therapeutics, Pfizer, Boehringer Ingelheim, Viosera, Xencor, Mirati Therapeutics, Janssen Oncology, Sanofi/Regeneron       Research Funding (Institution): Genentech, AstraZeneca, Merck, Loxo, Altor BioScience, Spectrum Pharmaceuticals, Bristol-Myers Squibb, Jounce Therapeutics, Mirati Therapeutics, Heat Biologics, WindMIL, Sanofi    Dr. Cheryl Czerlanis: Research Funding (Institution): LungLife AI, AstraZeneca, Summit Therapeutics

Connected With Latham
Episode 98 – Drug Pricing: Takeaways from the MDMA Annual Meeting

Connected With Latham

Play Episode Listen Later Jun 6, 2025 40:21 Transcription Available


Stakeholders from across the healthcare industry, including members of Congress, the US Food and Drug Administration, and the Center for Medicare and Medicaid Services, recently convened in Washington D.C. for the Medical Device Manufacturers Association (MDMA) Annual Meeting. In this episode of Connected With Latham, Washington, D.C. partners Chris Schott, Nate Beaton, and Bill McConagha, and associate Danny Machado share their key takeaways from the meeting, including compliance hot topics and what the industry can expect in terms of regulatory enforcement in 2025.   This podcast is provided as a service of Latham & Watkins LLP. Listening to this podcast does not create an attorney client relationship between you and Latham & Watkins LLP, and you should not send confidential information to Latham & Watkins LLP. While we make every effort to assure that the content of this podcast is accurate, comprehensive, and current, we do not warrant or guarantee any of those things and you may not rely on this podcast as a substitute for legal research and/or consulting a qualified attorney. Listening to this podcast is not a substitute for engaging a lawyer to advise on your individual needs. Should you require legal advice on the issues covered in this podcast, please consult a qualified attorney. Under New York's Code of Professional Responsibility, portions of this communication contain attorney advertising. Prior results do not guarantee a similar outcome. Results depend upon a variety of factors unique to each representation. Please direct all inquiries regarding the conduct of Latham and Watkins attorneys under New York's Disciplinary Rules to Latham & Watkins LLP, 1271 Avenue of the Americas, New York, NY 10020, Phone: 1.212.906.1200

POLITICO's Nerdcast
Dr. Oz on the future of Medicaid, Trump's megabill and AI avatar health care

POLITICO's Nerdcast

Play Episode Listen Later Jun 1, 2025 46:35


Dr. Mehmet Oz, former TV host and Pennsylvania Senate candidate, is one of America's most famous physicians. Now he's running the Centers for Medicare and Medicaid Services, which means he's in charge of programs that provide health care for about half of all Americans. He sits down with White House Bureau Chief Dasha Burns to discuss potential Medicaid cuts, his big plans to lower drug pricing, why he's fielding early morning phone calls from President Trump, and his advice to patients to “be curious” about their health.  Plus, Burns is joined by senior political columnist and politics bureau chief Jonathan Martin to discuss his juicy column about the Ohio governor's race featuring Elon Musk, Vivek Ramaswamy and former Ohio State football coach Jim Tressel. And senior legal affairs reporter Kyle Cheney joins to discuss the showdown between Trump and the courts over his “Liberation Day” tariffs.  Learn more about your ad choices. Visit megaphone.fm/adchoices

POLITICO Playbook Audio Briefing
New from Politico: The Conversation with Dasha Burns

POLITICO Playbook Audio Briefing

Play Episode Listen Later Jun 1, 2025 45:36


Listen to the first episode of Politico's new podcast, The Conversation with Dasha Burns. Dr. Mehmet Oz, former TV host and Pennsylvania Senate candidate, is one of America's most famous physicians. Now he's running the Centers for Medicare and Medicaid Services, which means he's in charge of programs that provide health care for about half of all Americans. He sits down with White House Bureau Chief Dasha Burns to discuss potential Medicaid cuts, his big plans to lower drug pricing, why he's fielding early morning phone calls from President Trump, and his advice to patients to “be curious” about their health.  Plus, Burns is joined by senior political columnist and politics bureau chief Jonathan Martin to discuss his juicy column about the Ohio governor's race featuring Elon Musk, Vivek Ramaswamy and former Ohio State football coach Jim Tressel. And senior legal affairs reporter Kyle Cheney joins to discuss the showdown between Trump and the courts over his “Liberation Day” tariffs. 

BioSpace
COVID-19 Vaccine Overhaul, Rocket Grounded, ‘One Tough Hombre' on MFN

BioSpace

Play Episode Listen Later May 28, 2025 20:13


The name of the biopharma game this season is vaccines—and RFK Jr. wasted no time returning from Memorial Day Weekend before making news on this front, removing the COVID-19 vaccine from the list of recommended immunizations for healthy kids and pregnant women on Tuesday. This follows a rash of recent moves, including a new risk-based strategy for the approval of new COVID vaccines focused on adults over 65 and high-risk individuals six months to 64 years of age and a request that Moderna and partners Pfizer and BioNTech update the myocarditis risk on their vaccines' labels.This increased vaccine scrutiny by the FDA and Department of Health and Human Services is having a significant impact on biopharma companies, several of whom have received stop-work orders on next-gen COVID vaccines. Meanwhile, Moderna last week pulled the biological license application for its combination COVID-19/flu vaccine, anticipating a request for additional data on flu shot efficacy from the FDA, as mRNA technology continues to be scrutinized after playing the hero during the pandemic. Also last week, the White House released its Make America Healthy Again (MAHA) report, which took aim at vaccines, along with pharma lobbying and GLP-1s.Also on the policy front, a California judge issued an order Thursday that indefinitely stops HHS' goal of reducing its divisions from 28 to 15 and firing upwards of 10,000 employees, among other reorganization and mass layoff plans. And speaking of government plays that could receive judicial pushback, we received a couple of new updates on the Most Favored Nation (MFN) front: first, President Donald Trump appointed his CMS chief Mehmet Oz as the leader of drug pricing negotiations, calling him “one tough hombre,” and second, HHS provided new guidance for streamlining the process for states to import drugs from Canada.In the obesity realm, Eli Lilly is calling out the Centers for Medicare and Medicaid Services. In an open letter last week, Lilly voiced its displeasure with the agency for a final ruling that left its Zepbound and Novo Nordisk's Wegovy out of Medicare Advantage and Part D coverage in 2026.And in the R&D realm, we returned from the long weekend to sad news from Rocket Pharmaceuticals, as the company reported that its pivotal Danon disease trial is on hold after the death of a young patient. The death—extremely sad on a human level—is also a setback for the gene therapy space, which had been buoyed earlier this month by the success of a personalized CRISPR treatment received by baby KJ.Finally, BioSpace looks ahead to ASCO#25 where Dan Samorodnitsky will be on the ground in Chicago.

NewsWare‘s Trade Talk
NewsWare's Trade Talk: Thursday, May 22

NewsWare‘s Trade Talk

Play Episode Listen Later May 22, 2025 18:25


S&P Futures are trading slightly higher this morning after Wednesday's sell-off, which was triggered by a spike in Treasury yields amid concerns about a significant expansion in U.S. fiscal debt. The House is expected to pass Trump's tax and spending bill this morning; the vote is currently underway. Robert F. Kennedy Jr.'s “Make America Health Again” report is expected to be released today. Health insurer stocks are under pressure this morning following the Centers for Medicare & Medicaid Services' announcement of expanded audits of Medicare Advantage plans. AT&T has agreed to acquire substantially all of Lumen Technologies' mass markets fiber business for $5.75 billion in cash.  Reports on Jobless Claims and the flash PMI report for May will be released today. On the earning front SNOW, URBN, ZM & AAP are higher after their releases. After the bell today earnings reports from INTU, WDAY, ADSK, CPRT, ROST and DECK are set to report.

The Heart of Healthcare with Halle Tecco
A New Era at Optum | Optum Chief Executive Officer Dr. Patrick Conway

The Heart of Healthcare with Halle Tecco

Play Episode Listen Later May 19, 2025 42:51


Over 160 million Americans are served by Optum, yet many still don't fully understand what it actually does—or why it matters.Dr. Patrick Conway, newly appointed CEO of Optum and former head of CMS Innovation Center and Blue Cross NC, joins Steve for a wide-ranging discussion on the state of healthcare delivery, affordability, and the potential of value-based care at a national scale. With experience spanning the frontlines of medicine to top government and corporate leadership, Conway breaks down how Optum aims to improve care while controlling costs—and why he continues to practice as a pediatric hospitalist on weekends.We cover:

Agent Survival Guide Podcast
AHIP 2026 Certification Dates

Agent Survival Guide Podcast

Play Episode Listen Later May 16, 2025 16:56


The Friday Five for May 16th, 2025: Dunkin' and Starbucks Summer 2025 Menus Viral Music Charts for Content Creation Potential Heart Benefit in Shingles Vaccine Possible Hints at ACA Subsidy Direction for 2026 AHIP 2026 Certification Dates   Dunkin' and Starbucks Summer 2025 Menus: “Dunkin' Summer Menu.” Dunkindonuts.Com, Dunkin', www.dunkindonuts.com/en/summer-menu. Accessed 13 May 2025. Fink, Bailey. “Starbucks Is Bringing Back Customers' ‘Favorite Drink Ever' This Summer.” Allrecipes.Com, Allrecipes, 17 Apr. 2025, www.allrecipes.com/starbucks-summer-menu-2025-11717043. Baker, Nicolette. “Starbucks' Summer Menu Just Dropped — Including a Brand-New Iced Beverage.” Foodandwine.Com, Food & Wine, 15 Apr. 2025, www.foodandwine.com/starbucks-summer-menu-2025-11715175.   Viral Music Charts for Content Creation: “100 Top Trending Songs on TikTok.” Tokchart.Com, Tokchart, tokchart.com/. Accessed 14 May 2025. Bowe, Tucker. “Apple Quietly Gave Your Iphone a Simple yet Fun New Feature.” Gearpatrol.Com, Gear Patrol, 12 May 2025, www.gearpatrol.com/tech/apple-music-shazam-viral-chart/.   “Shazam Viral Global Chart .” Shazam.Com, Shazam, www.shazam.com/charts/viral/world. Accessed 14 May 2025. “Spotify Viral 50 - Global.” Spotify.Com, Spotify, open.spotify.com/playlist/37i9dQZEVXbLiRSasKsNU9?si=4zvmJR7bQnajf6_StIGfuw. Accessed 14 May 2025. “Viral Chart on Apple Music.” Music.Apple.Com, Apple Music, music.apple.com/us/playlist/viral-chart/pl.b127c05305ad413fb742e8585599ec84. Accessed 14 May 2025.   Potential Heart Health Benefit in Shingles Vaccine: McLendon, Russell. “Shingles Vaccine Can Reduce Risk of Stroke And Heart Attack, Study Finds.” Sciencealert.Com, ScienceAlert, 12 May 2025, www.sciencealert.com/shingles-vaccine-can-reduce-risk-of-stroke-and-heart-attack-study-finds. Rudy, Melissa. “Shingles Vaccine Has Unexpected Effect on Heart Health.” Foxnews.Com, FOX News Network, 9 May 2025, www.foxnews.com/health/shingles-vaccine-has-unexpected-effect-heart-health. “Shingles Vaccine Lowers the Risk of Heart Disease for up to Eight Years.” Escardio.Org, European Society of Cardiology, 6 May 2025, www.escardio.org/The-ESC/Press-Office/Press-releases/shingles-vaccine-lowers-the-risk-of-heart-disease-for-up-to-eight-years. Griesser, Kameryn. “Shingles Vaccine Reduces Risk of Heart Disease by 23%, Study of One Million People Finds.” Cnn.Com, Cable News Network, 12 May 2025, www.cnn.com/2025/05/09/health/shingles-heart-disease-vaccine-shots-wellness.   Possible Hints at ACA Subsidy Direction for 2026: Tong, Noah. “CMS Hints at Possible Cost-Sharing Reduction Payments for Insurers, Impacting ACA Enrollment.” Fiercehealthcare.Com, Fierce Healthcare, 7 May 2025, www.fiercehealthcare.com/payers/cms-hints-possible-cost-sharing-reduction-payments-insurers-impacting-aca-enrollment. “Explaining Health Care Reform: Questions About Health Insurance Subsidies.” Kff.Org, KFF, 25 Oct. 2024, www.kff.org/affordable-care-act/issue-brief/explaining-health-care-reform-questions-about-health-insurance-subsidies/. “Offering of Off-Exchange-Only Plans without ‘CSR Loading.'” Cms.Gov, Centers for Medicare & Medicaid Services, 2 May 2025, www.cms.gov/files/document/offering-exchange-only-plans-without-csr-loading.pdf. “Plan Year 2026 Individual Market Rate Filing Instructions.” Cms.Gov, Centers for Medicare & Medicaid Services, 2 May 2025, www.cms.gov/files/document/py-26-individual-market-rate-filing-instructions.pdf.   AHIP 2026 Certification Dates: “AHIP Medicare + Fraud, Waste, and Abuse Online Course.” Ahipmedicaretraining.Com, AHIP, www.ahipmedicaretraining.com/page/login. Accessed 13 May 2025.   Resources:   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency. Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.

The MeidasTouch Podcast
Meidas Health, Episode 6: Biden's Medicare Reformer on Why Trump's Health Plan Is Smoke and Mirrors

The MeidasTouch Podcast

Play Episode Listen Later May 15, 2025 33:16


Meidas Health is on a roll! Continuing its series of incisive interviews with the nation's top healthcare leaders, Chiquita Brooks-LaSure — head of the Centers for Medicare and Medicaid Services under President Biden — joins host Dr. Vin Gupta for a hard-hitting discussion on prescription drug pricing in the United States. In light of President Trump's executive order yesterday — which was light on specifics — what's actually having an impact on lowering costs for patients nationwide? Learn more about your ad choices. Visit megaphone.fm/adchoices

Agent Survival Guide Podcast
Recent ACA Coverage Changes Reversed with 2025 Marketplace Proposed Rule

Agent Survival Guide Podcast

Play Episode Listen Later May 14, 2025 10:58


We breakdown the 2025 Marketplace Proposed Rule and highlight what we think agents like you should know!    Read the text version    Contact our Under-65 Sales Team!   Resources: CMS Finalizes Improvements to Marketplace Plan Selection with 2026 Final Rule: https://ritterim.com/blog/cms-finalizes-improvements-to-marketplace-plan-selection-with-2026-final-rule/ Everything Agents Need to Know About Selling in State-Based Marketplaces: https://ritterim.com/blog/everything-agents-need-to-know-about-selling-in-state-based-marketplaces/ Everything You Need to Know About the ACA OEP: https://ritterim.com/blog/everything-you-need-to-know-about-the-aca-oep/ How to Help Clients Navigate ACA Marketplace Subsidies & Taxes: https://lnk.to/qzlRwV Lawsuit Changes DACA Recipients' Affordable Care Act Eligibility: https://ritterim.com/blog/lawsuit-changes-daca-recipients-affordable-care-act-eligibility/ Learn with Knight School: https://ritterim.com/knight-school/ Meet Ritter's Under-65 Sales Team: https://ritterim.com/meet-your-sales-team/ Steps to Get Ready for OEP: Federal Exchange States & State Based Exchanges: https://lnk.to/SyqM9T   References:   “2025 Marketplace Integrity and Affordability Proposed Rule.” CMS.Gov, Centers for Medicare & Medicaid Services, https://www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-proposed-rule Accessed 23 Apr. 2025.   Follow Us on Social!  Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.

BioSpace
Trump's Drug Pricing Policy, Prasad's CBER Nod, Bayer's Layoffs and Galapagos' Next Chapter

BioSpace

Play Episode Listen Later May 14, 2025 31:06


President Donald Trump unveiled a sweeping drug pricing policy this week, seeking to lower drug prices in the U.S. by up to 80% through a reprisal of the Most Favored Nation rule he attempted to introduce in his first term. The rule would essentially link U.S. prices to those paid in other nations where medications are cheaper. Biopharma reaction was one of tentative relief, with BMO Capital Markets analysts suggesting the executive order had “more bark than bite.” Meanwhile, the Centers for Medicare and Medicaid Services announced that among the next 15 drugs to undergo IRA-prescripted price negotiations could be drugs payable through Medicare Part B, and not just Part D, where the first two rounds have applied.  Into all of this action steps Vinay Prasad, the outspoken oncologist and hematologist who was named last week as the next director of the FDA's Center for Biologics Evaluation and Research. While the S&P Biotech ETF fell by more than 5% upon the news, overall reaction was fairly measured, with cell and gene therapy executive Audrey Greenberg summing up Prasad's selection as “anything but a status quo appointment.”  Over in the weight loss and obesity space, Eli Lilly can't seem to lose. This weekend, Lilly announced full data from a head-to-head trial showing a “superior benefit-to-risk ratio” for its Zepbound over Novo Nordisk's Wegovy. And last week, the Indiana-based pharma won a court battle against compounders when a judge sided with the FDA, stating that tirzepatide—the active ingredient in both Zepbound and diabetes sister drug Mounjaro—was no longer in shortage. Add on a presidential shoutout during Trump's Monday press conference for its U.S. manufacturing investments, and it really was Lilly's week.  Flying less high are some 2,000 Bayer employees who lost their jobs in the first quarter of 2025 as part of the company's new operating model, which is intended to make Bayer “much more agile.” On a less direct flight is Galapagos, which reversed course on plans to spin out a portion of the company and find a new CEO. Instead, CEO Paul Stoffels will make a quicker exit and the Belgian biotech could sell off its cell therapy assets as it looks to build up a new pipeline in house, having abandoned the spinout idea altogether. Stay tuned.  Finally, in ClinicaSpace this week, we took a deep dive into the HIV treatment space, where companies like Gilead and Immunocore are targeting a cure, while the Trump administration slashes funding for HIV research.  

340B Insight
Answers to Big 340B Rebate Questions Could Come Soon

340B Insight

Play Episode Listen Later May 12, 2025 22:58


Big potential changes to how 340B operates plus heightened interest in both new protections and new restrictions for covered entities means there is much to keep track of in the 340B world. 340B Health CEO Maureen Testoni joins us to make sense of recent developments in the nation's courts and beyond.Rebates Get Their Day in Court340B Health, two member hospitals, and the government met drug companies in court in late April to challenge drugmaker attempts to replace 340B discounts with rebates. Testoni says the judge cited potentially devastating consequences to hospitals if rebates proceeded but also had probing questions for the government on how it is working to address drugmaker compliance concerns. The Dept. of Health and Human Services is set to release guidance by early June on the rebate issue, and the court's decision could come out soon.The White House Proposes 340B Big Oversight Shift A leaked copy of the Trump administration's latest budget proposal includes a plan to move the Office of Pharmacy Affairs (OPA) from the Health Resources & Services Administration to the Centers for Medicare & Medicaid Services. Testoni says the oversight shift is concerning because of a stark difference between the purpose of 340B and the operations of Medicare and Medicaid. CMS also imposed years of Medicare payment cuts to 340B hospitals that the U.S. Supreme Court eventually overturned.340B Protections, Mandates Take Center StageStates continue enacting laws to protect hospital access to 340B pricing, but they also are moving forward with reporting mandates and proposals to define how hospitals should use their savings. Testoni said reporting and use-of-savings mandates lead to misdirected views on the purpose of 340B, which goes far beyond direct patient care and cost assistance. On Capitol Hill, a report from a long-running investigation of 340B recently came out, contributing to the debate over possible new restrictions.ResourcesFederal Government Signals Upcoming Guidance on 340B Rebate Models Amid Legal ChallengesBrief Your Leaders on White House Plans for Major 340B ChangesNebraska Is 12th State To Enact Contract Pharmacy ProtectionsIndiana Becomes Fifth State To Mandate 340B Reports From HospitalsKey Senator Concludes 340B Investigation, Calls for Major ReformsNew 340B Health Research340B Impact Profiles

The Sound of Ideas
NIH launches autism study using Medicare, Medicaid data, local experts react

The Sound of Ideas

Play Episode Listen Later May 8, 2025 51:12


The National Institutes of Health and the Centers for Medicare & Medicaid Services has announced a partnership that will focus on studying the root causes of autism spectrum disorder using Medicare and Medicaid enrollees' data.

The James Altucher Show
Dr. Mehmet Oz (Centers for Medicare and Medicaid Services) on Food, Medicine, and the Future of Healthcare

The James Altucher Show

Play Episode Listen Later May 7, 2025 42:36


A Note from James:So Dr. Oz—television personality turned government official—this is such an interesting thing. He's going to be the new administrator of the Center for Medicare and Medicaid Services, CMS. He's going to be in charge of all Medicare and Medicaid. What does he know or think about these parts of our government?Medicare and Medicaid, combined with Social Security, make up the biggest part of government spending. So it'd be interesting to know what he thinks. On his show, he'd talk about everything from medicine to alternative medicine to other healing methods. I want to know how he's going to handle things in the government.This is a republishing of a past podcast I did with Dr. Oz, but it still describes his approach to medicine. And I think, as a citizen, this is useful. That's why I wanted to share it again. He's going to be working closely with RFK Jr. and Marty Makary (who's also been on this podcast and is now head of the FDA).So here's Dr. Oz.Episode Description:In this re-released conversation, James speaks with Dr. Mehmet Oz about his philosophy on medicine, self-care, and the critical role nutrition plays in overall well-being. As Dr. Oz steps into a major government role as the head of CMS, this episode offers valuable insight into the beliefs and strategies he may bring to one of the most powerful positions in U.S. healthcare.Together, they cover the power of second opinions, why most people misunderstand sugar, how gut bacteria drive health, and what it means to choose yourself when it comes to well-being. They also unpack highlights from Dr. Oz's book Food Can Fix It, including practical strategies for brain health, stress, and weight loss.What You'll Learn:Why second opinions can drastically change your medical outcomes.The connection between stress, sugar, and your brain's coping mechanisms.What to eat (and avoid) for long-term brain health and energy.How gut bacteria influence digestion, immunity, and mood.Dr. Oz's personal routine for energy, sleep, and productivity.Timestamped Chapters:[00:00] Dr. Oz's New Role in Government[01:00] Dr. Oz's Philosophy: Empowering Patients[02:45] The Power of Second Opinions[04:00] Behind the Book: Food Can Fix It[06:00] Parenting, Health, and Self-Sacrifice[07:30] Why We Stress Eat—and What to Do Instead[09:30] Fixing the Root Cause with Food[12:00] Brain Food and Omega-3 Fats[15:30] Antioxidants, Alcohol, and Wheat Brain[17:30] Why Sugar Without Fiber Is Dangerous[18:30] Juicing vs. Smoothies[19:30] Food Traditions, Rituals, and Healing[20:15] Using Food as Medicine for Pain[21:00] The Role of Gut Bacteria[23:30] Smart Weight Loss Strategies[26:30] Rethinking Dairy, Gluten, and Processed Foods[28:00] Eating for All-Day Energy[30:30] Daily Routine: Sleep Hygiene and Focus[33:00] Final Thoughts and Dr. Oz's Upcoming PodcastAdditional Resources:

Agent Survival Guide Podcast
How Plan Crosswalks Work in the ACA Marketplace

Agent Survival Guide Podcast

Play Episode Listen Later May 5, 2025 11:38


What are plan crosswalks in the Affordable Care Act Marketplace? Find out what this means for your clients and how agents can help in the process.    Read the text version    Register with Ritter: https://app.ritterim.com/public/registration/   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Resources: Everything Agents Need to Know About Selling in Sate-Based Marketplaces: https://ritterim.com/blog/everything-agents-need-to-know-about-selling-in-state-based-marketplaces/   Everything You Need to Know About the ACA OEP: https://ritterim.com/blog/everything-you-need-to-know-about-the-aca-oep/    FAQs About Selling On-Exchange & Off-Exchange Under-65 Plans: https://ritterim.com/blog/faqs-about-selling-on-exchange-off-exchange-under-65-plans/ How to Help Clients Navigate ACA Marketplace Subsidies & Taxes: https://lnk.to/qzlRwV Knight School: https://ritterim.com/knight-school/ Steps to Get Ready for OEP: Federal Exchange States & State-Based Exchanges: https://lnk.to/SyqM9T The Ritter Blog: https://ritterim.com/blog/ Meet Your Sales Team: https://ritterim.com/meet-your-sales-team/  Under-65 Health: https://ritterim.com/products/under-65/ What the Inflation Reduction Act Means for Your Medicare & ACA Clients: https://ritterim.com/blog/what-the-inflation-reduction-act-means-for-your-medicare-aca-clients/   References: “2025 Marketplace Integrity and Affordability Proposed Rule.” CMS.Gov, Centers for Medicare & Medicaid Services, https://www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-proposed-rule. Accessed 10 Apr. 2025. “ECFR :: 45 CFR 164.512 -- Uses and Disclosures for Which an Authorization or Opportunity to Agree or Object Is Not Required.” Code of Federal Regulations, https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-B/part-155/subpart-D/section-155.335. Accessed 8 Apr. 2025. “Low Cost Marketplace Health Care, Qualifying Income Levels.” HealthCare.Gov, https://www.healthcare.gov/lower-costs/. Accessed 8 Apr. 2025.   Follow Us on Social!  Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.

Agent Survival Guide Podcast
5 Things from the CMS 2026 MA and Part D Final Rule

Agent Survival Guide Podcast

Play Episode Listen Later May 2, 2025 9:19


Join Sarah as she dives back into CMS regulations! This week, she highlights 5 regulations from the 2026 Medicare Advantage and Part D Final Rule.   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Resources: 5 Things About the 2026 CMS MA and Part D Rate Announcement: https://lnk.to/asgf20250411 CMS 2025 Marketplace Integrity & Affordability Proposed Rule: https://lnk.to/asgf20250314 CMS Updates to MA and Part D for CY 2026: https://lnk.to/asgf20250425 Expanded Medicare Telehealth Benefits Extended Through September 2025: https://ritterim.com/blog/expanded-medicare-telehealth-benefits-extended-through-september-2025/  Recent ACA Coverage Changes Reversed with 2025 Marketplace Proposed Rule: https://ritterim.com/blog/recent-aca-changes-reversed-with-2026-marketplace-proposed-rule/   References: “CMS Finalizes 2026 Payment Policy Updates for Medicare Advantage and Part D Programs.” CMS.Gov, Centers for Medicare and Medicaid Services, 7 Apr. 2025, www.cms.gov/newsroom/press-releases/cms-finalizes-2026-payment-policy-updates-medicare-advantage-and-part-d-programs. “Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F).” CMS.Gov, Centers for Medicare & Medicaid Services, 4 Apr. 2025, www.cms.gov/newsroom/fact-sheets/contract-year-2026-policy-and-technical-changes-medicare-advantage-program-medicare-prescription-final. “Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly.” Federalregister.Gov, Federal Register, 15 Apr. 2025, www.federalregister.gov/documents/2025/04/15/2025-06008/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare.     Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.

Medicare For The Lazy Man Podcast
Episode 801 - Are we about to get OZed? ...or will the enemies of Medicare Advantage prevail?

Medicare For The Lazy Man Podcast

Play Episode Listen Later May 2, 2025 34:59


Lots of chat about Dr. Oz and his plans for the future of the Centers for Medicare & Medicaid Services. Unfortunately, the articles I prepared fell into what might be a bottomless pit.  In the Medicare Advantage Minute, Democrats sent a nasty letter to Dr. Oz questioning his support for Medicare Advantage and criticizing his substantial holdings in the biggest MA slut: United HealthCare. From the pages of "Your Medicare Benefits 2024" we learn the short story of how Medicare covers flu shots. CMS (the Federal Government) in a magnificent return to sanity ordered that questions catering to Binary, non-Binary and other confused individuals be stricken from Medicare Advantage applications. Finally, a listener whose wife must have badgered him mercilessly, asked whether gym memberships were an included freebie with their Medicare supplement plan. My answer was that a competing product had the benefit they seek but there would be an endless amount of paperwork and insurance foolishness to deal with. He decided to shine it on and hope that his wife forgets the whole thing. We'll see! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.

The Tranquility Tribe Podcast
Ep. 341: From Policy to Practice: The State of Women's Healthcare with Natalie Davis from United States of Care

The Tranquility Tribe Podcast

Play Episode Listen Later Apr 30, 2025 55:37


In this episode of The Birth Lounge podcast, HeHe dives into what's happening in women's health and healthcare access, focusing on the postpartum landscape and recent budget cuts impacting Medicaid. Special guest Natalie Davis, founder of United States of Care, joins to discuss pivotal healthcare legislation, Medicaid's role in maternal and infant health, and the importance of universal access to quality healthcare. The discussion also touches on the power of virtual care and current legislative threats to preventive health services. We hope this episode will equip and inspire you to engage in local healthcare advocacy. 01:34 Current State of Women's Health in the US 02:23 Introducing Natalie Davis 05:51 Challenges in Postpartum Care 10:04 Impact of Budget Cuts on Medicaid 16:16 Supreme Court Case on Preventive Services 22:38 Advocacy for Better Healthcare 27:44 Universal Healthcare Debate 28:38 Debating Healthcare Access and Affordability 31:05 The 100 Weeks Project: Supporting Postpartum Women 32:57 Personalized and Comprehensive Postpartum Care 34:53 Navigating the Postpartum System 40:38 Resources for NICU Families and Mental Health Support 42:07 Legislation Impacting Women's Health 43:30 The Rise of Virtual Care 50:53 Getting Involved in Local Legislation 53:33 Final Thoughts and Encouragement   Guest Bio: For nearly two decades, Natalie Davis has worked shaping and implementing American health care policies to improve the lives of all people. In 2018, she and fellow national health care leaders, such as Andy Slavitt, launched United States of Care to ensure that everyone in the country has access to quality, affordable health care through a community-driven policy change. She is relentless in her person-centered approach to building health care solutions and has a history of building partnerships that work to create positive change in our country's health care system. From 2010-2016, Natalie served at the Centers for Medicare and Medicaid Services implementing the Affordable Care Act, with the final two years as Senior Advisor to former CMS Administrator, Andy Slavitt. A social entrepreneur, Natalie also helped found Town Hall Ventures which focuses on bringing the best of innovation and care delivery to diverse communities. Natalie also served as the Director of Strategic Engagement at the Bipartisan Policy Center. Natalie holds an M.A. in Philosophy from George Washington University and is an alumna of Salisbury University schools of Sociology and Art History. Natalie lives in Washington, DC with her amazing husband and four children. INSTAGRAM: Connect with HeHe on IG  Connect with HeHe on YouTube   Connect with United States of Care on IG    BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone!   LINKS MENTIONED: State of Postpartum Care (State Maps) Journey Map Preventive Services Resource Hub https://www.marchofdimes.org/our-work/nicu-family-support   https://postpartum.net/

Supreme Court Opinions
Advocate Christ Medical Center v. Kennedy

Supreme Court Opinions

Play Episode Listen Later Apr 30, 2025 45:10


In this case, the court considered this issue: Does the phrase “entitled… to benefits” include all who meet basic program eligibility criteria, whether or not benefits are actually received?The case was decided on April 29, 2025.In this case, a group of over 200 hospitals claimed that the Department of Health and Human Services (HHS) miscalculated their Disproportionate Share Hospital (DSH) adjustments, which provide additional funding to hospitals treating a high percentage of low-income patients. The dispute centered on the interpretation of the phrase "entitled to supplementary security income (SSI) benefits" under subchapter XVI. The hospitals argued that this phrase should include all patients enrolled in the SSI system at the time of hospitalization, even if they were not entitled to an SSI payment during that month. HHS, however, interpreted it to mean patients who were eligible to receive an SSI payment during the month of hospitalization.The Provider Reimbursement Review Board denied the hospitals' request for additional reimbursement on procedural grounds, and the Centers for Medicare & Medicaid Services denied relief on the merits. The District Court rejected the hospitals' claims and granted summary judgment to HHS. The D-C Circuit affirmed, concluding that SSI benefits are about cash payments for needy individuals and that it makes little sense to say individuals are entitled to the benefit in months when they are not eligible for a payment.The Supreme Court of the United States held that an individual is "entitled to SSI benefits" for purposes of the Medicare fraction when she is eligible to receive an SSI cash payment during the month of her hospitalization. The Court reasoned that SSI benefits are cash benefits determined on a monthly basis, and eligibility for such benefits is also determined monthly. The Court affirmed the judgment of the D-C Circuit, respecting the specific formula that Congress prescribed for calculating the Medicare fraction.The opinion is presented here in its entirety, but with citations omitted. If you appreciate this episode, please subscribe. Thank you. 

AHLA's Speaking of Health Law
HHS' Withdrawal of the Richardson Waiver and New Statement of Organization: What Does It Mean for the Health Care Industry?

AHLA's Speaking of Health Law

Play Episode Listen Later Apr 29, 2025 28:22 Transcription Available


In March, the Department of Health and Human Services (HHS) withdrew the Richardson Waiver, a policy under which HHS voluntarily undertook notice-and-comment rulemaking in circumstances where it wouldn't otherwise need to. HHS also issued a new Statement of Organization for the Office of the General Counsel (HHS-OGC), which, among other things, may signal an effort to consolidate and expand HHS-OGC's authority. Jaime Jones, Partner, Sidley Austin LLP, and Brenna Jenny, Partner, Sidley Austin LLP, discuss HHS' potential rationale for these changes and the implications for the health care industry. During the first Trump Administration, Brenna Jenny served as the Principal Deputy General Counsel at HHS and the Chief Legal Officer at the Centers for Medicare & Medicaid Services.AHLA's Health Law Daily Podcast Is Here! AHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Premium members. Get all your health law news from the major media outlets on this new podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.

Agent Survival Guide Podcast
Agent Requirements for ACA Sales

Agent Survival Guide Podcast

Play Episode Listen Later Apr 28, 2025 10:12


Discover the steps to get ready-to-sell in the Affordable Care Act Marketplace. We're talking certifications, client authorization, and more!   Read the text version   Register with Ritter   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   ACA Forms: ACA Consumer Authorization Live Call Script: https://ritterim.com/documents/aca-consumer-authorization-live-call-script.pdf Eligibility Application Attestation: https://ritterim.com/documents/aca-eligibility-application-attestation.pdf Eligibility Application Attestation Live Call Script: https://ritterim.com/documents/aca-consumer-eligibility-application-attestation-live-call-script.pdf Marketplace Consent Form: https://ritterim.com/documents/aca-consumer-marketplace-authorization-form.pdf   Resources: 2025 ACA Exchange & FFM Certification Info: https://lnk.to/ZvnhS8 Contract & Get Appointment to Sell with Health Insurance Companies: https://ritterim.com/blog/contract-get-appointed-to-sell-with-health-insurance-companies/ Everything Agents Need to Know About Selling in State-Based Marketplaces: https://ritterim.com/blog/everything-agents-need-to-know-about-selling-in-state-based-marketplaces/ (check podcast) Free eBooks & Guides: https://ritterim.com/guides/ How Agents Can Protect Clients from Unauthorized ACA Plan Switching: https://ritterim.com/blog/how-agents-can-protect-clients-from-unauthorized-aca-plan-switching/ How to Become Certified for Aca Marketplace Sales with Federally Facilitated Marketplace (FFM) Training) https://ritterim.com/blog/how-to-become-certified-for-aca-marketplace-sales-with-federally-facilitated-marketplace-ffm-training/ (check podcast version) How to Help Clients Navigate ACA Marketplace Subsidies & Taxes: https://lnk.to/qzlRwV Meet Your Sales Team: https://ritterim.com/meet-your-sales-team/ New Required Documents Agents Need for ACA Sales: https://ritterim.com/blog/new-required-documents-agents-need-for-aca-sales/ OEP Ready-to-Sell Checklist for New Agents: https://ritterim.com/documents/oep-ready-to-sell-checklist.pdf Recent ACA Coverage Changes Reversed with 2025 Marketplace Proposed Rule: https://ritterim.com/blog/recent-aca-changes-reversed-with-2026-marketplace-proposed-rule/ The Ritter Blog: https://ritterim.com/blog/ The Ritter Platform: https://ritterim.com/the-ritter-platform/ Under-65 Health: https://ritterim.com/products/under-65/   References: “CMS Update on Actions to Prevent Unauthorized Agent and Broker Marketplace Activity.” CMS.Gov, Centers for Medicare & Medicaid Services, https://www.cms.gov/newsroom/press-releases/cms-update-actions-prevent-unauthorized-agent-and-broker-marketplace-activity. Accessed 31 Mar. 2025. “Returning Agents' and Brokers' Guide to Plan Year 2025 ...” CMS.Gov, Centers for Medicare & Medicaid Services, https://www.cms.gov/files/document/returning-agents-and-brokers-guide-marketplace-registration-and-training.pdf. Accessed 31 Mar. 2025. “The Marketplace in Your State.” HealthCare.Gov, https://www.healthcare.gov/marketplace-in-your-state/. Accessed 31 Mar. 2025.   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.

Agent Survival Guide Podcast
CMS Updates to MA and Part D for CY 2026

Agent Survival Guide Podcast

Play Episode Listen Later Apr 25, 2025 16:36


  The Friday Five for April 25, 2025: Dr. Oz shares MAHA vision as CMS admin CY 2026 Part D Coverage Cost Breakdown CY 2026 Selected Drug Subsidy Cost Breakdown Provisions Not Finalized in 2026 MA and Part D Final Rule Impact of Non-Finalized Provisions on Agents   Dr. Oz shares MAHA vision as CMS admin: Simmons-Duffin, Selena. “5 Things to Know as Dr. Oz Prepares to Lead Medicare and Medicaid.” NPR.Org, NPR, 3 Apr. 2025, www.npr.org/sections/shots-health-news/2025/03/25/g-s1-55766/dr-mehmet-oz-medicare-medicaid-cms-trump. “Dr. Mehmet Oz Shares Vision for CMS.” CMS.Gov, Centers for Medicare & Medicaid Services, 25 Apr. 2025, www.cms.gov/newsroom/press-releases/dr-mehmet-oz-shares-vision-cms. Olsen, Emily. “Dr. Oz Sworn in as CMS Administrator.” Healthcaredive.Com, Healthcare Dive, 21 Apr. 2025, www.healthcaredive.com/news/dr-mehmet-oz-sworn-in-cms-administrator/745880/.   CY 2026 Part D Coverage Cost Breakdown: “Final CY 2026 Part D Redesign Program Instructions.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/newsroom/fact-sheets/final-cy-2026-part-d-redesign-program-instructions. Accessed 23 Apr. 2025. “Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly.” Federalregister.Gov, Federal Register, 15 Apr. 2025, www.federalregister.gov/documents/2025/04/15/2025-06008/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare.   CY 2026 Selected Drug Subsidy Cost Breakdown: John, Stephnie A., and Abdie Santiago. “The IRA in 2025: The Future of Medicare Part D.” Mintz.Com, Mintz, 13 Feb. 2025, www.mintz.com/insights-center/viewpoints/2146/2025-02-13-ira-2025-future-medicare-part-d. “Medicare Prescription Drug Benefit Manual – Chapter 5.” Cms.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/files/document/chapter-5-benefits-and-beneficiary-protection-v92011.pdf. Accessed 23 Apr. 2025. “Factsheet: Medicare Drug Price Negotiation Program.” Cms.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/files/document/fact-sheet-medicare-selected-drug-negotiation-list-ipay-2026.pdf. Accessed 23 Apr. 2025.   Provisions Not Finalized in 2026 MA and Part D Final Rule: “Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F).” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/newsroom/fact-sheets/contract-year-2026-policy-and-technical-changes-medicare-advantage-program-medicare-prescription-final. Accessed 24 Apr. 2025. Tong, Noah. “Medicare Advantage Final Rule Excludes Anti-Obesity Drug Coverage under Medicare, Medicaid.” Fiercehealthcare.Com, Fierce Healthcare, 4 Apr. 2025, www.fiercehealthcare.com/payers/medicare-advantage-final-rule-excludes-anti-obesity-drug-coverage-under-medicare-medicaid. “Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly.” Federalregister.Gov, Federal Register, www.federalregister.gov/documents/2025/04/15/2025-06008/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare. Accessed 24 Apr. 2025. “Medicare Coverage of Anti-Obesity Medications.” Aspe.Hhs.Gov, Assistant Secretary for Planning and Evaluation, 26 Nov. 2024, aspe.hhs.gov/sites/default/files/documents/127bd5b3347b34be31ac5c6b5ed30e6a/medicare-coverage-anti-obesity-meds.pdf.   Resources: 2025 Maximum Broker Commissions for Medicare Advantage & Medicare Part D: https://ritterim.com/blog/2025-maximum-broker-commissions-for-medicare-advantage-and-medicare-part-d/ 3 Additional Effective Techniques for Closing Insurance Sales: https://lnk.to/asg656 4 Effective Techniques for Closing Insurance Sales: https://lnk.to/asg655 5 Things About the 2026 CMS MA and Part D Rate Announcement: https://lnk.to/asgf20250411 CMS Updates, Content Library, & More! https://lnk.to/asgf20250328 Recent ACA Coverage Changes Reversed with 2025 Marketplace Proposed Rule: https://ritterim.com/blog/recent-aca-changes-reversed-with-2026-marketplace-proposed-rule/ Subscribe to the Ritter Blog: https://ritterim.com/blog/ The Best Appointment Schedulers for Insurance Agents: https://lnk.to/asg657   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency. Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.

Agent Survival Guide Podcast
5 Myths About Selling ACA Health Insurance Plans

Agent Survival Guide Podcast

Play Episode Listen Later Apr 21, 2025 11:18


Don't let fear hold you back from expanding your business! The under-65 market is brimming with opportunities. That's why we're debunking 5 common myths about the ACA market to help you get started.    Read the text version   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Resources: 6 Reasons Insurance Agencies Selling Medicare Products Should Sell ACA: https://ritterim.com/blog/6-reasons-insurance-agencies-selling-medicare-products-should-sell-aca/ 8 Reasons Why Insurance Agents Should Sell ACA Plans: https://lnk.to/SNNOSG ACA 101 Selling Under-65 Health Insurance: https://lnk.to/chQNkw FAQs About ACA Certification and Training: https://ritterim.com/blog/faqs-about-aca-certification-and-training/ FAQs About Selling On-Exchange & Off-Exchange Under-65 Plans: https://ritterim.com/blog/faqs-about-selling-on-exchange-off-exchange-under-65-plans/ How to Become Certified for ACA Marketplace Sales with Federally Facilitated Marketplace (FFM) Training: https://ritterim.com/blog/how-to-become-certified-for-aca-marketplace-sales-with-federally-facilitated-marketplace-ffm-training/ How Much Can Agents Make Selling Under-65 Insurance?: https://lnk.to/TlGBGH Key Changes for ACA Open Enrollment 2025 ft. Ross Baker from HealthSherpa: https://lnk.to/UXgO5Q Lawsuit Changes DACA Recipients' Affordable Care Act Eligibility: https://ritterim.com/blog/lawsuit-changes-daca-recipients-affordable-care-act-eligibility/ Meet Your Sales Team: https://ritterim.com/meet-your-sales-team/ Ritter Docs Site: https://docs.ritterim.com/ Simplify Marketplace Enrollments with HealthSherpa: https://lnk.to/2chDBN   References: “Eligibility for the Premium Tax Credit.” IRS, Internal Revenue Service, https://www.irs.gov/affordable-care-act/individuals-and-families/eligibility-for-the-premium-tax-credit/. Accessed 21 Mar. 2025 FAQs for Marketplace Agents and Brokers, CMS,  https://www.agentbrokerfaq.cms.gov/s/. Accessed 21 Mar. 2025. “Find out What Immigration Statuses Qualify for Coverage in the Marketplace.” HealthCare.Gov, https://www.healthcare.gov/immigrants/immigration-status/. Accessed 21 Mar. 2025. “General Resources.” CMS.Gov, Centers for Medicare & Medicaid Services, https://www.cms.gov/marketplace/agents-brokers/general-resources. Accessed 21 Mar. 2025. “Learn What to Do If You Already Have Medicare Health Coverage.” HealthCare.Gov, https://www.healthcare.gov/medicare/medicare-and-the-marketplace/. Accessed 21 Mar. 2025. “The Patient Protection and Affordable Care Act.” Democrats.Senate.Gov, https://www.dpc.senate.gov/healthreformbill/healthbill04.pdf. Accessed 21 Mar. 2025. “Welcome to the Health Insurance Marketplace®.” HealthCare.Gov, https://www.healthcare.gov/. Accessed 21 Mar. 2025.   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and Youtube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.

Gist Healthcare Daily
Wednesday, April 16, 2025

Gist Healthcare Daily

Play Episode Listen Later Apr 16, 2025 7:56


Medicare proposes a 2.4% pay increase for inpatient hospitals next year. The Centers for Medicare and Medicaid Services will end some federal Medicaid spending for state programs. And, the ongoing merger between UnitedHealth Group and home health company Amedisys heads to mediation with the Department of Justice. Those stories and more coming up on today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.

The Steve Gruber Show
Scot Bertram | TSA to Require a REAL ID in order to take Flight

The Steve Gruber Show

Play Episode Listen Later Apr 4, 2025 11:00


Here are 3 big things you need to know—   One — Ford Motor Company has announced that it would allow car shoppers to buy its 2024-25 vehicles at the discounted price the automaker offers to its employees. Called "From America, For America," the promotion was unveiled on the same day a new 25% U.S. tariff on foreign vehicles took effect.   Two ----  Former heart surgeon and TV star Dr. Mehmet Oz was confirmed Thursday to lead the Centers for Medicare and Medicaid Services. The 64-year-old will manage health insurance programs for roughly half the country, with oversight of Medicare, Medicaid or Affordable Care Act coverage.   And number three —   The TSA's deadline to have a REAL ID license is just over a month away.  Starting May 7th, Americans will need to have a REAL-ID compliant driver's license to take domestic and international flights.  If you don't have one, you'll need a passport or secondary ID to travel through security checkpoints. Unless, of course, they postpone this deadline yet again.

PBS NewsHour - Segments
News Wrap: Trump fires several National Security Council members

PBS NewsHour - Segments

Play Episode Listen Later Apr 3, 2025 7:02


In our news wrap Thursday, President Trump will fire several members of his National Security Council after he met in the Oval Office with conservative activist and conspiracy theorist Laura Loomer, the Senate confirmed Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services and a string of violent storms across the Midwest and South killed at least six people. PBS News is supported by - https://www.pbs.org/newshour/about/funders

The Electorette Podcast
Special Coverage: Is Dr. Oz Qualified to Lead the Centers for Medicare and Medicaid Services? A Conversation with Nourbese Flint

The Electorette Podcast

Play Episode Listen Later Mar 26, 2025 18:50


The Senate Finance Committee just advanced the nomination of Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS), bringing his confirmation one step closer to reality. In this bonus episode, Jen Taylor-Skinner is joined by Nourbese Flint, president of All* Above All, for a critical conversation about what's at stake. CMS oversees vital programs like Medicare, Medicaid, and the Affordable Care Act—making its leadership role one of the most powerful in shaping national healthcare policy. Dr. Oz, widely known for promoting unscientific treatments and holding controversial views, raises serious concerns—particularly for reproductive justice and the health of marginalized communities. Nourbese shares her perspective on the qualifications this role demands and reflects on the legacy of past CMS leaders, such as Chiquita Brooks-LaSure. We discuss the broader implications of Dr. Oz's potential confirmation, including its impact on maternal health and the risks posed to vulnerable populations. Our conversation also explores the importance of grassroots resistance and political engagement in holding policymakers accountable. Nourbese offers strategies for community action and underscores why staying informed and involved is more important than ever. Learn more about your ad choices. Visit megaphone.fm/adchoices

The Highwire with Del Bigtree
DR. OZ FACES CONFIRMATION HEARING TO LEAD MEDICARE, MEDICAID

The Highwire with Del Bigtree

Play Episode Listen Later Mar 20, 2025 202:35


The Senate confirmation hearing for Dr. Mehmet Oz, the nominee for Administrator of the Centers for Medicare and Medicaid Services.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-highwire-with-del-bigtree--3620606/support.

Rich Zeoli
Schumer Said He Wants to Avoid Gov Shutdown, Dems Threatened to Primary Him

Rich Zeoli

Play Episode Listen Later Mar 14, 2025 186:38


The Rich Zeoli Show- Full Episode (03/14/2025): 3:05pm- Earlier this week, the House of Representatives passed a continuing resolution to fund the government through September. The Senate will consider the CR Friday afternoon. After initially telling reporters that Democrats would not help Republicans overcome the 60-vote filibuster threshold, Senate Minority Leader Chuck Schumer (D-NY) said he will vote in favor of cloture to prevent the government from shutting down at midnight on Friday. House Democrats are decrying Sen. Schumer's decision—with rumors swirling that Rep. Alexandria Ocasio-Cortez may be considering a primary challenge. Sen. Schumer is up for re-election in 2028. 3:10pm- Will the Senate vote in favor of funding the government through September? According to Politico, a government shutdown may be in the Trump Administration's best interest—as the Attorney General and Office of Management of Budget will determine what federal activities are essential based on guidance that dates back to the Carter Administration. This would allow for DOGE to slash the size of government with even greater ease. 3:30pm- Speaking from the Justice Department in Washington, D.C., President Donald Trump condemned the DOJ's past weaponization—which he noted targeted him and other individuals deemed to be political rivals by the law enforcement agency. Trump stated, “we must be honest about the lies and abuses that have occurred within these walls. Unfortunately, in recent years, a corrupt group of hacks and radicals within the ranks of the American government obliterated the trust and goodwill built up over generations.” 4:00pm- This week, several conservative commentators were “swatted”—which occurs when someone purposefully deceives an emergency response operator, reporting a serious crime and ultimately causing police units to storm another person's address. Relatedly, Supreme Court Justice Amy Cooney Barrett's sister was recently the victim of a bomb threat—with the suspect explicitly citing his disdain for the Justice's judicial philosophy. 4:10pm- Speaking from the Justice Department in Washington, D.C., President Donald Trump condemned the DOJ's past weaponization—which he noted targeted him and other individuals deemed to be political rivals by the law enforcement agency. Trump stated, “we must be honest about the lies and abuses that have occurred within these walls. Unfortunately, in recent years, a corrupt group of hacks and radicals within the ranks of the American government obliterated the trust and goodwill built up over generations.” 4:40pm- While speaking with Jake Tapper on CNN, Congresswoman Alexandria Ocasio Cortez (D-NY) expressed frustration with Senate Minority Leader Chuck Schumer's (D-NY) decision to break the filibuster and allow for the Republican continuing resolution bill to pass, averting a government shutdown. Does AOC plan to primary Schumer in 2028? 5:05pm- Dr. Victoria Coates— Former Deputy National Security Advisor & the Vice President of the Davis Institute for National Security and Foreign Policy at The Heritage Foundation—joins The Rich Zeoli Show to discuss the Trump Administration's continued efforts to end the war in Ukraine. She's the author of the book: “The Battle for the Jewish State: How Israel—and America—Can Win” which features a forward from Senator Ted Cruz. 5:20pm- The Senate voted 62-38 to end the filibuster and proceed to amendment votes on the House's continuing resolution bill. None of the amendments are expected to pass and the Senate is expected to pass the bill as is later today. 5:25pm- While appearing on The Breakfast Club with Charlamagne tha God, comedian Bill Burr compared billionaire Elon Musk to Adolf Hitler—accusing Musk of doing a Nazi salute and wondering why progressives aren't doing more to try to stop him. 5:40pm During his confirmation hearing, President Donald Trump's nominee to serve as Administrator of Center for Medicare and Medicaid Services ...

What the Health?
The Dr. Oz Show

What the Health?

Play Episode Listen Later Mar 14, 2025 24:59


The Senate Finance Committee got its chance March 14 to question Mehmet Oz, President Donald Trump's nominee to lead the vast Centers for Medicare & Medicaid Services, the largest agency within the Department of Health and Human Services. Oz, with his long history in television, was as polished as one would expect, brushing off even some more controversial parts of his past with apparent ease. In this special bonus episode of “What the Health?,” KFF Health News' Rachana Pradhan and Stephanie Armour join Julie Rovner to recap the Oz hearing. They also provide an update on the progress of nominees to lead the National Institutes of Health, the Food and Drug Administration, and the Centers for Disease Control and Prevention. Hosted on Acast. See acast.com/privacy for more information.

Post Reports
Dr. Oz goes to Washington

Post Reports

Play Episode Listen Later Mar 13, 2025 18:51


Mehmet Oz is President Donald Trump's pick to lead the Centers for Medicare and Medicaid Services, a massive agency that oversees health coverage for more than 100 million Americans, including older adults, those with low incomes and children. Oz is a cardiothoracic surgeon and former professor at Columbia University who became a household name when he started appearing on “The Oprah Winfrey Show” in 2004 and then hosted his own show, “The Dr. Oz Show,” from 2009 to 2022. On Friday, Oz will face federal lawmakers in a Senate hearing as he seeks confirmation to run CMS, an agency that has a more than trillion-dollar budget and could face spending cuts in the budget year ahead. Today on “Post Reports,” health accountability reporter Lauren Weber explains why he may face questions about his past, his investments and possible conflicts of interest.Today's show was produced by Elana Gordon. It was edited by Peter Bresnan with help from Maggie Penman and Lynh Bui. It was mixed by Sam Bair. Subscribe to The Washington Post here.

What the Health?
The Cutting Continues

What the Health?

Play Episode Listen Later Mar 13, 2025 44:15


The Trump administration's efforts to downsize the federal government continue, with both personnel and programs being cut at the Department of Health and Human Services, the Department of Veterans Affairs, and the Social Security Administration. Meanwhile, the fight over cuts to the Medicaid program for those with low incomes heats up, as Republicans worry that more of their voters than ever before are Medicaid beneficiaries. Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Anna Edney of Bloomberg News join KFF Health News' Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Jeff Grant, who recently retired from the Centers for Medicare and Medicaid Services after 41 years in government service. Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too: Julie Rovner: NBC News' “‘You Lose All Hope': Federal Workers Gripped by Mental Health Distress Amid Trump Cuts,” by Natasha Korecki. Shefali Luthra: The New York Times' “15 Lessons Scientists Learned About Us When the World Stood Still,” by Claire Cain Miller and Irineo Cabreros. Alice Miranda Ollstein: The Atlantic's “His Daughter Was America's First Measles Death in a Decade,” by Tom Bartlett. Anna Edney: Bloomberg News' “India Trade Group Blasts Study Linking Drugs to Safety Risks,” by Satviki Sanjay. Hosted on Acast. See acast.com/privacy for more information.