Podcasts about medicare medicaid services

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Play Episode Listen Later Feb 4, 2025 22:41

The Biden administration over the last three years spearheaded efforts to rein in Medicare Advantage plans' use of prior authorizations to deny care and cut short coverage for nursing homes. But at the end, it also left some pretty substantial decisions on the table for the incoming Trump team — seen by many as pro-Medicare Advantage. In this episode, Nicole Fallon, vice president of integrated services and managed care for LeadingAge, breaks down what we know about the future of MA. First up: What happens to updated rules for MA plans proposed by the Centers for Medicare & Medicaid Services in November? They called for more limits on artificial tools and automated denials of care, strategies that a 2024 Senate report found were being employed frequently to cut off access to post-acute services, particularly in nursing homes. What happens next with those proposals is unknown, says Fallon, noting that such policy updates are not required annually, although payment updates (also still pending approval for 2026) are. Trump's new team at CMS could allow them to flounder and issue its own proposal (or not) for 2027. Of broader concern, however, is whether members of Congress and patients will be able to keep pressure on the federal government to adopt further improvements as some Trump appointees embrace the idea of growing MA even faster. “Our hope is that both Congress and the administration really recognize that, first we need to kind of shore up those foundational issues — like access to care, enforcement of the rules, some greater transparency and data collection and really being good stewards of those Medicare trust fund dollars — before we engage in that debate about whether MA for all is really the right strategic direction,” Fallon says in this episode hosted by McKnight's Long-Term Care News Senior Editor Kimberly Marselas. Listen in to hear Fallon's current expectations and more about what the change in administration could mean for addressing more challenging MA reimbursement concerns.

WA Considers Paying Parents for Caring for Disabled Kids Amid In-Home Shortages

Washington in Focus

Play Episode Listen Later Jan 29, 2025 6:50

(The Center Square) – Washington may soon join Illinois, California and other states in compensating the parents of developmentally disabled children under legislation considered by the Senate on Monday. State lawmakers proposed something similar last year but failed to get it out of the Legislature. If approved, Senate Bill 5211 would allow parents to receive payments for providing what qualifies as “extraordinary care.” However, there is a stipulation attached. The bipartisan proposal would require the Centers for Medicare & Medicaid Services to amend certain waivers to allow for the payments.Support this podcast: https://secure.anedot.com/franklin-news-foundation/ce052532-b1e4-41c4-945c-d7ce2f52c38a?source_code=xxxxxxFull story: https://www.thecentersquare.com/washington/article_8c6bfd46-ddae-11ef-acfa-671326e94d47.html

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Vanessa Villaverde, MPA, MHSA: Senior Program Investor, California Health Care Foundation

HealthCare UnTold

Play Episode Listen Later Nov 28, 2024 27:31

Our guest today is Vanessa Villaverde, the senior program investment officer at the CHCF Innovation Fund, which invests in technology and service companies with the potential to significantly lower the cost of care or to improve access to care for Californians with low incomes. Vanessa is an exceptional health leader with her eye on expanding the contributions of Latina/o/x innovators in health technologies,Before joining CHCF, Vanessa worked at health tech companies Caresyntax and Remedy Partners, where she developed value-based care programs and products. She worked at the Centers for Medicare & Medicaid Services for 10 years advising on innovative payment models, state Medicaid policy, and 1115 waivers. She has invested into health care companies through special purpose vehicles and Angel networks, created a nonprofit to further readiness for Black and Latino/x founders looking to fundraise, and served as a venture scout for Vamos Ventures, an LA-based and Latino/x-led VC fund providing capital to Latino/x and diverse teams in health care, wellness, workforce, fintech, and sustainability.HealthCare UnTold expresses its gratitude to Vanessa for her dedication and hard work in enhancing the health and prosperity for our communities.#VaneesaVillaverde#CAHealthCareFoundation#HealthCareInnovation#LatinoTechnologyStartups

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‘Enormous' MDS implications, the next version, and more

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Play Episode Listen Later Oct 22, 2024 24:08

All team members at skilled nursing facilities have a stake in getting the ever-evolving MDS stipulations right. The Centers for Medicare & Medicaid Services is collecting more information than ever before, and they're studying it for patterns more rigorously than ever. Consider MDS processes another example of high-risk management, and it shouldn't be taken lightly. That's the view of Leah Klusch, the executive director of The Alliance Training Center, who sat down with McKnight's Long-Term Care News Executive Editor James M. Berklan recently to discuss all things MDS. She re-emphasizes the importance of making the data reproducible. She discusses the latest coding changes in version 1.19.1 of the MDS. She warns that not filling out the section on the mood interview could cost providers $40 to $50 per patient day. She dotes over providers' needs like any 57-year nursing veteran might. Beyond that, Klusch already has had a peek at a next iteration of the MDS and comments how she thinks it will bring even more crystallization to the nursing home assessment and admissions process.

779 - The Centers for Medicare & Medicaid Services Takes A Step On Climate

Public Health On Call

Play Episode Listen Later Jul 19, 2024 14:51

About this episode: The CMS Innovation Center at the Centers for Medicare & Medicaid is tasked with research and development to improve health care costs and delivery. It's also grappling with a challenging reality: The health care sector is a major contributor to greenhouse gas emissions which, in turn, are changing the climate in ways that impact our health. This is especially true of Medicaid/Medicare recipients such as children, older adults, and low income communities who bear the brunt of health issues from climate change. The Center's new Decarbonization and Resilience Initiative aims to understand the scope of the problem and identify creative solutions by collecting, monitoring, assessing, and addressing hospital carbon emissions and their effects on health outcomes, costs, and quality. Guest: Purva Rawal is the chief strategy officer at the CMS Innovation Center at the Centers for Medicare & Medicaid Services. Host: Dr. Josh Sharfstein is vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health, a faculty member in health policy, a pediatrician, and former secretary of Maryland's Health Department. Show links and related content: TEAM Decarbonization and Resilience Initiative Fact Sheet—The Centers for Medicare & Medicaid Services @‌CMSinnovates on X Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on X @‌JohnsHopkinsSPH on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed

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As CMS prepares to cut off coverage for advanced wound care products, providers worry about worsening outcomes

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Play Episode Listen Later Jul 16, 2024 13:26

A pending decision on whether Medicare will cover skin substitute grafts could put effective wound care tools out of the reach of too many seniors, an expert in wound care and health economics is warning. Bill Padula, former president of the National Pressure Injury Advisory Panel and an assistant professor with the Department of pharmaceutical and health economics at the school at the University of Southern California, notes the products in the crosshairs are used to treat DFUs and venous leg ulcers, both common in nursing homes patients. Medicare Administrative Contractors could remove dozens of options from the Centers for Medicare & Medicaid Services coverage list. And without coverage, doctors likely won't have a full range of products to reach for — or the ability to offer them as frequently as needed. “Of course, that doesn't mean that it's impossible to get these skin substitutes to the patient, but they are expensive,” Padula says in this episode hosted by McKnight's Long-Term Care News Senior Editor Kimbelry Marselas. “If Medicare is not paying for it — and we all know the story of seniors on fixed incomes that most are unlikely to be able to afford the of-pocket payments for skin substitutes on their own — this could amount to thousands of dollars every visit.” As a health economist, Padula acknowledges CMS must monitor spending on evolving products to ensure appropriate use. But this is a coverage decision that could well deliver a literal lesson in an ounce of prevention being better than a pound of cure. Chronic wounds that don't heal, notes Padula and a wealth of other researchers, often lead to amputations and increased mortality. Listen in to learn more about the debate fueled by the MACs' decision and how providers still hope to shape the ultimate call.

Misconceptions about palliative care still abound, two experts assert

Play Episode Listen Later Jun 13, 2024 25:05

There remains confusion about palliative care, which differs from hospice care in that recipients do not have to give up curative care. It focuses on providing relief from the symptoms and stresses of the illness for the patient and the family, and it is appropriate at any age and any stage of illness. Also, an interprofessional team delivers it. While Medicare Part B pays for it, the fee-for-service payment remains inadequate, many argue, because it fails to adequately cover the comprehensive team approach. There actually is a strong value proposition under value-based payment, Bowman noted, and many Medicare Advantage plans are contracting with palliative care providers based on this value proposition. There are other bright spots surrounding palliative care, Bowman and Silvers said. One of these is the Centers for Medicare & Medicaid Services' request for comment in the hospice proposed rule for fiscal year 2025 about higher-cost palliative care treatments. This opens the door to a new payment system that covers the services of an interdisciplinary specialty care team, Silvers noted. Another positive development is Hawaii recently became the first state to cover palliative care through Medicaid.Follow us on social media:X (formerly Twitter): @McKHomeCareFacebook: McKnight's Home CareLinkedIn: McKnight's Home CareInstagram: mcknights_homecareFollow Center to Advance Palliative Care on social media:X (formerly Twitter): @CAPCpalliativeFacebook: Center to Advance Palliative Care (CAPC)LinkedIn: Center to Advance Palliative Care (CAPC)Show contributors:McKnight's Home Care Editor Liza Berger; and Brynn Bowman, CEO, and Allison Silvers, Chief Health Care Transformation Officer, of the Center to Advance Palliative Care

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‘Hell yes!' Why one nursing home company jumped to join the staffing mandate lawsuit

Play Episode Listen Later Jun 11, 2024 13:25

Months before the Centers for Medicare & Medicaid Services proposed federal staffing minimums for nursing homes, the American Health Care Association said it would sue over the rule should it offer providers little hope of compliance. But when that rule was finalized in May — requiring nursing homes to have RNs on site 24 hours a day and increasing hourly direct care requirements from an earlier proposal — finding providers to carry the legal torch wasn't necessarily a given. Many providers might shy away from the possible scrutiny lawsuit involvement would bring, the chance to be pilloried in the mainstream media and have their motives questioned by families. But Derek Prince, CEO and Managing Partner of HMG Healthcare, knew he wanted his company play a major role in the case many now see as a last line of defense for the sector. When AHCA leaders approached him seeking a Texas provider to share their concerns, Prince told them ‘Hell yes!” “We instill in all of our folks, ‘Take care of people and we can always defend if you're doing what's right and trying to make stuff better and you're trying to take care of our population,' ” Prince said. “So in this particular instance, we believe that the lawsuit is what's right.” The CMS rule is too rigid for the many different kinds of nursing homes in the country and the different patient types they serve, Prince argues. “It was a fairly easy decision to go, ‘If it's not us, who,?' and this is the time to step up. We always tell all of our team members, ‘You've got to get out there and execute, and you've got to be effective.' And we just thought, ‘We have to walk the walk.'” In this episode hosted by McKnight's Long-Term Care News Senior Editor Kimberly Marselas, Prince explains his reasoning on the lawsuit, why his company puts quality achievement ahead of staffing stars and what he sees as the best outcome for his patients and the sector.

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CEO of SCAN: There is room for improvement, but Medicare Advantage beats traditional Medicare

Play Episode Listen Later May 16, 2024 18:46

The SCAN Group, which offers Medicare Advantage plans along with primary care and other services to older adults, recently released its first-ever Environmental, Social and Governance report. The purpose was to showcase the ways in which the organization is supporting employees, members, patients and communities, and advancing social aims for the company. Among the company's points of pride is its work to address homelessness among older adults, according to Jain. It offers many clinical programs for the older population, including an Independence at Home program. With the release of the MA rate for 2025, the Centers for Medicare & Medicaid Services is sending a message that it would like to cut payment to MA plans. The SCAN Group's MA model is different than other MA companies in that it enables providers to actually own the risk themselves. Jain's interest in social justice originated, in part, from his parents who grew up at the time of Indian independence and his early exposure to inequality and racism, he said.Follow us on social media:X (formerly Twitter): @McKHomeCareFacebook: McKnight's Home CareLinkedIn: McKnight's Home CareInstagram: mcknights_homecareFollow SCAN Group on social media:X (formerly Twitter): @SCANHealthPlanLinkedIn: SCANShow contributors:McKnight's Home Care Editor Liza Berger and Sachin Jain, MD, CEO, SCAN Group

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Live at ViVE: How CMS Is Changing with ‘Jetson's Era' Technologies—featuring Andrea Fletcher

HLTH Matters

Play Episode Listen Later May 15, 2024 30:57

Did you know that there is a team of techies who serve the Centers for Medicare & Medicaid Services or CMS?What is their role in this federal agency? How is CMS changing with emerging technologies? And how might software engineers, project managers and other tech professionals help innovate from the inside to reform the complicated healthcare system in the US?Andrea Fletcher is the first Chief Digital Strategy Officer and Executive Director of Digital Services at CMS, where she is responsible for leading digital modernization efforts and promoting interoperability and public access to health data.On this episode of The Beat, Andrea joins hosts Dr. Jessica Shepherd and Dr. Gautam Gulati to explain how her team responds to tech emergencies and plans big strategic plays for CMS.Andrea discusses the potential for the federal government to be a leader in AI adoption and shares her open-source software initiative to reuse tech stacks within and across federal departments and agencies.Listen in for Andrea's insight on leveraging data to rethink how we pay for and deliver care and learn how CMS is looking to evolve with ‘Jetson's era' technologies and improve the experience of healthcare for individual Americans.Topics CoveredWhat Andrea's team of techies does as the Digital Service at CMSHow Andrea's team responds to tech emergencies and plans big strategic plays for the agencyHow Andrea's team collaborates with other federal departments and agenciesAndrea's hope that the federal government will be a leader in the adoption AI (and what that might look like)What differentiates leading in government from the private sectorOpportunities to innovate within the complicated Medicare and Medicaid systemsAndrea's open-source software initiative to reuse tech stacks across federal departments and agenciesAndrea's human-centered approach to leveraging AI in healthcare Rethinking how we pay for and deliver care in a world of advanced technologyWhat we can learn from the VA's diabetes prevention research and outcomes-based care modelAndrea's predictions re: how clinics will change in the future and what roles AI might replaceHow to participate in shaping Americans' healthcare experienceConnect with Andrea FletcherThe Digital Service at CMSAndrea at CMSAndrea on LinkedInConnect with Dr. Gautam Gulati & Dr. Jessica ShepherdViVEHLTHDr. Shepherd on TwitterDr. Shepherd on LinkedInDr. Gulati on TwitterDr. Gulati on LinkedInResourcesUS Digital ServiceFindSupport.govWhite House Initiative on Women's Health ResearchCybersecurity & Infrastructure Security AgencyVA Research on DiabetesDigitalVA

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Legal News for Fri 5/3 - DACA Recipients Gain ACA Access, Zantac Cancer Trial, and Trump's Trial Where He Calls Stormy an Extorter and Cohen Disgruntled

Minimum Competence

Play Episode Listen Later May 3, 2024 14:49

This Day in Legal History: Racist Restrictive Covenants Struck DownOn May 3, 1948, a significant legal decision was rendered by the United States Supreme Court, fundamentally altering the landscape of civil rights and property law. The case, Shelley v. Kraemer, addressed the pernicious practice of racially-restrictive covenants in real estate. These covenants were agreements embedded in the deeds of properties that prohibited the sale of these properties to individuals of certain races, most commonly African Americans.The Supreme Court's decision in Shelley v. Kraemer struck down the legal enforcement of these covenants, ruling that while private parties may enter into whatever agreements they choose, they cannot seek judicial enforcement of covenants that violated constitutional principles of equality. The Court held that such enforcement by state courts constituted state action and therefore was subject to the Equal Protection Clause of the Fourteenth Amendment.The background of the case involved an African American family, the Shelleys, who purchased a home in a neighborhood in St. Louis, Missouri. This neighborhood had an existing covenant that barred African Americans from owning property. When the Shelleys moved in, several of their white neighbors sought to enforce the covenant to prevent them from taking ownership.The Missouri Supreme Court had originally sided with the neighbors, ruling that the covenant was enforceable. However, the U.S. Supreme Court's decision reversed this ruling. Justice Fred M. Vinson, writing for the majority, emphasized that the enforcement of racially restrictive covenants by state courts amounted to a state action that denied equal protection of the laws.This landmark decision was a crucial step forward in the fight against institutionalized racism, particularly in housing. It reflected the growing judicial recognition of civil rights issues and set a precedent for future rulings related to racial discrimination. Moreover, Shelley v. Kraemer highlighted the judiciary's role in upholding constitutional rights against socially entrenched racial discrimination.The ruling did not, however, eliminate racially restrictive covenants overnight. Many neighborhoods continued to observe such agreements informally, and it wasn't until later legislative efforts, such as the Fair Housing Act of 1968, that such practices were comprehensively outlawed. Nevertheless, the Shelley v. Kraemer decision remains a pivotal moment in American legal history, celebrated for its affirmation of the principles of equality and justice enshrined in the U.S. Constitution.The Biden administration is set to implement a rule that will allow undocumented immigrants who arrived in the U.S. as children and are covered under the Deferred Action for Childhood Arrivals (DACA) program to receive subsidized health insurance through Obamacare. This rule, scheduled for release by the Department of Health and Human Services (HHS), will redefine "lawfully present" individuals to include DACA recipients, enabling them to access premium tax credits and cost-sharing reductions when purchasing plans from federal and state marketplaces beginning November 1, 2024.HHS Secretary Xavier Becerra emphasized the importance of this change, noting that over a third of DACA recipients currently lack health insurance. The inclusion of DACA recipients is expected to improve not only their health and wellbeing but also contribute positively to the overall economy. Additionally, the rule will permit these individuals to enroll in basic health programs similar to Medicaid in certain states, provided they earn no more than 200% of the poverty level.The Centers for Medicare & Medicaid Services anticipate that this adjustment could result in 100,000 previously uninsured DACA recipients gaining health coverage. This decision marks a significant shift from previous policies where DACA recipients were excluded from being considered "lawfully present" for insurance purposes due to the original rationale behind the DACA policy, which did not address eligibility for insurance affordability programs.The significant development in this story is the modification of the definition of "lawfully present" by the HHS to include DACA recipients. This change is crucial as it directly impacts the eligibility of these individuals for health insurance subsidies under Obamacare, a shift in policy that broadens access to healthcare for a previously marginalized group.DACA Immigrants Win Access to Obamacare Subsidies in HHS RuleIn a groundbreaking trial in Chicago, attorneys for Angela Valadez, an 89-year-old woman who developed colon cancer, argued that pharmaceutical companies GSK and Boehringer Ingelheim were aware that the heartburn medication Zantac could become carcinogenic under certain conditions but failed to alert the public. The lawyers contended that Zantac's active ingredient, ranitidine, could transform into a cancer-causing substance called NDMA if it aged or was subjected to high temperatures, and accused the companies of covering up the degradation of the pills by altering their appearance.GSK and Boehringer Ingelheim, the only defendants in this trial after other companies reached settlements, defended their product. They insisted that Zantac has been proven safe and effective through numerous studies and that no direct evidence links Zantac to Valadez's cancer, citing her other risk factors for the disease. The U.S. Food and Drug Administration had removed Zantac and its generic versions from the market in 2020 after detecting NDMA in some samples. Despite this, a significant legal victory came for the companies in 2022 when a judge dismissed about 50,000 claims, questioning the scientific backing of the assertion that Zantac could cause cancer. However, with more than 70,000 cases still pending, largely in Delaware, the issue remains a significant legal and public health concern. A newer version of Zantac with a different active ingredient is currently on the market, which does not contain ranitidine.GSK knew about Zantac cancer risk, attorneys tell jury in first trial | ReutersIn the ongoing criminal trial of former U.S. President Donald Trump in New York, a new defensive angle emerged as Trump's lawyer portrayed the hush money payment at the center of the trial as potentially extortive. The payment in question involved Stormy Daniels, real name Stephanie Clifford, who was reportedly paid to keep quiet about an alleged encounter with Trump prior to the 2016 presidential election.During the proceedings, defense attorney Emil Bove questioned Keith Davidson, Daniels' former lawyer, about his history with negotiating cash-for-dirt agreements with celebrities, hinting that Davidson's actions bordered on extortion. Trump's legal team appears to be focusing on undermining the credibility of prosecution witnesses like Daniels and Michael Cohen, Trump's former lawyer and fixer, who arranged the controversial $130,000 payment. Trump has denied any encounter with Daniels and pleaded not guilty to the charges of falsifying business records to conceal the payment.This trial aspect dovetails with previous testimony regarding Cohen's disappointment over not receiving a major governmental post after Trump's election victory. Cohen, who later disassociated from Trump and criticized him publicly, is expected to be a key witness. He has already served prison time for his role in the payment scheme.Moreover, the trial has seen further complications due to Trump's conduct outside the courtroom. Justice Juan Merchan has had to address violations of a gag order by Trump, who has been fined and could potentially face jail for continuing infractions. Trump has criticized the trial publicly, claiming it is an attempt to prevent his political comeback and alleging conflicts of interest by those involved in the trial.Trump's various legal troubles include other serious charges, such as attempting to overturn the 2020 election results and mishandling classified documents, adding layers of complexity to his current legal battles as he campaigns for the 2024 presidential election. These developments suggest a trial fraught with legal and political ramifications, with Trump's defense pushing back against what they suggest are questionable prosecutorial tactics and witness credibility.Trump trial hears Michael Cohen was 'despondent' he was denied a government post | ReutersTrump lawyer suggests hush money payment was extortion | ReutersThis week's closing theme is by Johannes Brahms.Johannes Brahms, born on May 7, 1833, in Hamburg, Germany, is one of the most revered figures in the history of classical music. His compositions span a wide range of genres, including chamber works, symphonies, and choral compositions. Brahms was known for his perfectionist approach, often taking years to refine his works to his satisfaction.Among his most celebrated creations is Symphony No. 1 in C minor, Op. 68. This symphony, which took Brahms about 14 years to complete, is frequently dubbed "Beethoven's Tenth" due to its stylistic similarities to Ludwig van Beethoven's symphonic work, especially the Ninth Symphony. Brahms's dedication to living up to Beethoven's legacy is evident in the meticulous structure and emotional depth of the piece.Symphony No. 1 was first performed in 1876, and since then, it has become a staple in the orchestral repertoire. It is particularly noted for its profound depth and complexity. The symphony unfolds over four movements, beginning with a dramatic and tense first movement that features a memorable timpani motif, which sets a somber and introspective mood. This is followed by a gentle and lyrical second movement, offering a stark contrast to the dramatic opening. The third movement, often considered the heart of the symphony, showcases Brahms's skill in thematic development and orchestral color. The finale is a triumphant resolution to the symphony's earlier tensions, culminating in a powerful and uplifting theme that echoes Beethoven's own symphonic climaxes.This week's closing theme features this masterful work by Brahms, inviting listeners to explore the depths of his musical genius. Symphony No. 1 stands not just as a nod to Beethoven's influence but as a significant original contribution to the symphonic form, marking Brahms's triumphant emergence as a composer of the first order in the orchestral domain.Without further ado, Brahm's Symphony No. 1 in C Minor, Op. 68 - III. Un poco allegretto e grazioso, enjoy. Get full access to Minimum Competence - Daily Legal News Podcast at www.minimumcomp.com/subscribe

EP429: Following the Dollar Through Pharmacy Acronyms Like WAC, AWP, and NADAC, With Luke Slindee, PharmD

Play Episode Listen Later Mar 7, 2024 38:20

For a full transcript of this episode, click here. In this healthcare podcast we're talking about pharmacy acronyms or terms like AWP and WAC, and, not really an acronym, but we'll also talk pharmacy list prices, rebates, discounts. We also have NADAC, but that's slightly off to the side for reasons we'll get to in a sec. Most of these acronyms refer to a number with a dollar sign in front of it, and it's hell on wheels to figure out if and/or to what extent that number reflects what is going on in the real world, especially if you are a patient or a plan sponsor and all you see is the list price that Pharma puts out on one side of the storyboard, and then what the patient pays or (if you're lucky) what the plan pays for the drug on the way other side of the whole chain of events. What's a black box a lot of times for patients and plan sponsors is what goes on in the middle, wherein many middle people get their mitts on the transaction. Real quick here, let's run through the Mister Rogers' neighborhood of all of these middle people right now; and we're gonna do this really briefly. Most of you are already going to know most of this, but I just want to remind you so that when my guest today, Luke Slindee, and I kick into the conversation about the acronyms and the terms and we try to follow the dollar … yeah, you can put a name to a face. Alright, so first we have pharma manufacturers. The pharma manufacturer—and this is largely gonna be true whether it's a branded drug or a generic pharma manufacturer—but the manufacturer sets a list price. This list price is gonna be called an AWP or a WAC price, and we're gonna get into the differences and what those terms actually mean in the show that follows. But Pharma decides their price point. They go to wholesalers with that price. Wholesalers say they want a discount to purchase the product. Some kind of rebate or discount is negotiated. Now the wholesalers have the drug, and they get calls from pharmacies. Pharmacies have patients who have scripts for that, so the pharmacies need to buy the drug. What price does the pharmacy now pay the wholesaler for the drug? Short answer: It's nuts. It's nuts how the wholesalers decide what to charge the pharmacies for the drug. We talk about that in the interview that follows, but suffice to say that now we have the list price turning into whatever price the pharmacies wound up paying to get the drug from the wholesalers for. Any way you cut it, the wholesalers are making some money. Okay … now we get to the part where we're figuring out how much the patient or the plan sponsor will pay to pick up that drug that started at the pharma manufacturers and went to the wholesalers and now is at the pharmacy. How much are the patients gonna pay? How much are the plan sponsors gonna pay? If you spend any time in the real world (not the drug supply chain world), what you'd expect to happen next is that the patient would go into the pharmacy and the pharmacist would charge a markup and/or a dispensing fee on the price that they bought the drug from the wholesaler for. That'd be normal. And this can be the case when patients pay cash. Listen to the show with Mark Cuban (EP418, along with Ferrin Williams, PharmD, MBA), who started a pharmacy called Cost Plus Drugs. Get it? Their prices are cost plus. You have had other pharmacies for years doing similar things, like Blueberry in Pittsburgh. They get the drug. They buy it from a wholesaler or etc. But they buy the drug for some price, and then they sell it to their customers (ie, patients) at their cost plus. But most of the time in pharmacy supply chain world, things don't work that way because many patients have insurance. When a patient walks into the pharmacy, someone has to figure out how much the patient owes and how much their insurance will cover, right? So, enter PBMs (pharmacy benefit managers). They originally started out doing this math (ie, adjudicating claims), figuring out what the out-of-pocket will be for the patient and then what the insurance will cover. Then drugs started to get really expensive and a few other developments, and then, all of a sudden, we have PBMs negotiating with Pharma for how much of a rebate the PBM is going to demand for the PBM to put the manufacturer drug on formulary. The PBM also is determining how much they will pay the pharmacy for said drug on behalf of plan sponsors, in addition to doing the math for how much the patient will pay. So, let me say that again because it kind of begs a “what now?” with eyebrows sky-high as the appropriate response to what I just said, especially if you think through the ramifications here, ramifications which I discuss at length with Vinay Patel (EP241); Benjamin Jolley, PharmD (EP422); Scott Haas (EP365); Paul Holmes (EP397); and others. So, again, the PBM is not just adjudicating claims. They are also negotiating rebates from Pharma so plan sponsors do not have to pay the full amount that the wholesalers paid Pharma and that the pharmacies paid the wholesalers, which maybe is a lot of money. The PBMs are like, “Hey, Pharma. You need to give me a piece of your action because we, the PBM, have big market power. I serve 100 million patients or something. So, if you want access to my 100 million lives, you gotta shell it out. You gotta shell me out some rebates.” So, fine, Pharma gives the PBM some amount of money in the form of a rebate. And it has to work that way, if you think about it, because the drug was originally sold to the wholesaler. You see what I'm saying? So, the pharma company has to give the PBMs a separate rebate amount. This is in addition to how much the PBM told the plan sponsor the plan sponsor owes for the drug, which is also paid to the PBM. But now, PBM is also still in charge of adjudicating the claim. So, they're telling the pharmacy how much to charge the patient. Somehow or another also, the PBM also got itself in charge of deciding how much money the pharmacy itself would be reimbursed by that PBM. In the rest of the world, the pharmacy might tell the PBM, “Hey, this is the price.” But not in pharmacy supply chain world. In pharmacy supply chain world, the PBM tells the pharmacy how much it's gonna pay. The end. And this, my friends, is how so often pharmacies get themselves in the pickle of having to pay the wholesaler one price to get the drug while they get reimbursed a totally different price to dispense the drug. And because independents have very little negotiating leverage on actually either side of that equation, they so very often buy high and sell low. Please listen to the shows with Benjamin Jolley (EP422) and Vinay Patel (EP241), where we get into this in a lot of detail. But I just want to emphasize this point: All of that whole drug supply chain I just went through, where the manufacturer sells to the wholesaler who sells to the pharmacy and the PBM pays the pharmacy and the patient is paying something and the plan sponsor is paying something—many of the middleman transactions in there happen under the cover of darkness a lot of times. If I'm a plan sponsor, do I have any idea how much the PBM paid the pharmacy for any particular drug? Unless you're good at looking at the NADAC numbers (more on this coming up), no. I do not have any idea what a fair price for that drug actually is and how much people are making on the back of that drug as it goes through the supply chain. And this, my friends, is how come spread pricing can exist. Because spread pricing is when the PBM charges the plan sponsor more than they are paying the pharmacy, pocketing the difference, and then calling what they pocket a trade secret—even if it's the plan sponsor whose butt is on the line to make sure that what the PBM is pocketing is fair and reasonable compensation. I mean, if only J&J had listened to this show (EP428). Here's a link to the lawsuit, which is about J&J paying ridiculous amounts in spread pricing. If what I just said is really confusing, I'm gonna validate that and say, “Yeah, it is really confusing.” And to a certain extent, that might be the main point. Where there's mystery, there's margin and all of that. Here's what Dawn Cornelis said on LinkedIn in response to an article about the lawsuit: “Data accessibility lies at the heart of mitigating a fiduciary lawsuit. It all begins with gaining access to your data. But let's be clear—it's not an easy feat. The major hurdle? Procuring accurate data from your TPA [third-party administrator]. And that's just the first step. The subsequent challenge involves analyzing this data, a task best handled by a skilled healthcare data analyst—yet another formidable undertaking.” The one acronym in this whole stew that is not questionable at all is the NADAC. So, let's talk about the NADAC for a moment, the National Average Drug Acquisition Cost Price Benchmark. I was really thrilled to get Luke Slindee to be my guest today—or one reason I was so thrilled—is because Luke works for the accounting firm who, on behalf of CMS (Centers for Medicare & Medicaid Services) and the federal government, administers this NADAC, the National Average Drug Acquisition Cost. (Here's a good NADAC explainer if you're interested.) In brief, NADAC was jointly developed by the Centers for Medicare & Medicaid Services, and it calculates the average price that pharmacies pay for prescription drugs. NADAC is based on a retail price survey. My guest today, as aforementioned, is Luke Slindee. He is a second-generation pharmacist. His family owned a pharmacy in Minnesota when he was growing up. Now he is a senior pharmacy consultant for Myers and Stauffer, which is the accounting firm that calculates the NADAC Price Benchmark on behalf of CMS and the federal government. Also mentioned in this episode are Mark Cuban; Ferrin Williams, PharmD, MBA; Blueberry Pharmacy; Vinay Patel; Benjamin Jolley, PharmD; Scott Haas; Paul Holmes; Dawn Cornelis; Capital Rx; Myers and Stauffer LC; Adam Fein; Joey Dizenhouse; Steven Quimby, MD; and Antonio Ciaccia. For additional information, go to data.medicaid.gov. You can also follow Luke on LinkedIn. Luke Slindee, PharmD, is a second-generation pharmacist with a background in independent pharmacy, chain pharmacy, data analytics, and prescription drug pricing. He currently supports public drug pricing transparency benchmarks and is an advocate for pharmacy reimbursement reform and antitrust enforcement in healthcare. 09:52 Why is it important for plan sponsors to understand the going rate for every point in the supply chain? 10:21 How do manufacturers come up with a list price? 10:40 What does AWP stand for? 10:59 What does WAC stand for? 11:06 How are AWP and WAC numbers chosen by the manufacturer? 13:22 What is the difference between AWP and WAC? 14:54 How much are wholesalers paying to manufacturers? 16:43 How much is the pharmacy paying for branded drugs from a wholesaler? 17:34 Why might pharmacies be buying drugs for less than what wholesalers are paying? 18:17 Substack article by Benjamin Jolley, PharmD, on this topic. 19:22 EP423 with Joey Dizenhouse. 20:33 Why do things get weird when a PBM gets involved? 21:58 How does all of this work for generic manufacturers? 25:20 EP344 with Steven Quimby, MD. 26:15 How did Civica Rx come about? 32:21 What's the difference between the NADAC and the AWP value? 36:04 Luke discusses the downstream effects to pharmacies. For additional information, go to data.medicaid.gov. You can also follow Luke on LinkedIn. Luke Slindee discusses #followingthedollar through #WAC, #AWP & #NADAC on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Julie Selesnick, Rik Renard, AJ Loiacono (Encore! EP379), Nina Lathia, Marshall Allen, Stacey Richter (INBW39), Peter Hayes, Joey Dizenhouse, Benjamin Jolley, Emily Kagan Trenchard (Encore! EP392)

CMS must do more to improve MA prior authorization, payment issues, policy experts say

policy payments medicare centers cms medicare advantage prior authorization medicare medicaid services gurian leadingage

Play Episode Listen Later Feb 8, 2024 20:58

The rule issued last month from the Centers for Medicare & Medicaid Services reduces wait times to within one week for many standard Medicare Advantage prior authorization decisions. It does not go far enough, said Nicole Fallon, VP of managed care public policy or LeadingAge, noting that prior authorization decisions should only take a couple of hours. She and her colleague, Mollie Gurian, VP of home-based public policy for LeadingAge, pointed out that they also are pushing for MA prior authorizations to cover patients across their post-acute care journeys, including 30-day home health episodes. They also are striving for payment adequacy, as many MA plans pay only 60% or 80% of Medicare fee-for-service rates. Among other changes, they are hoping for the shedding of the statutory noninterference clause that prohibits CMS from telling plans how to pay. Despite the challenges ahead in reforming MA, Fallon and Gurian believe MA has introduced positive healthcare reforms, such as supplemental benefits, and CMS and lawmakers are asking the right questions to continue to improve the private Medicare benefit.Follow us on social media:Twitter: @McKHomeCareFacebook: McKnight's Home CareLinkedIn: McKnight's Home CareInstagram: mcknights_homecareFollow LeadingAge on social media:Twitter: @LeadingAgeFacebook: LeadingAgeLinkedIn: LeadingAge

Add-On Code G2211: What You Need to Know

FrequENTcy — AAO–HNS/F Otolaryngology Podcasts

Play Episode Listen Later Jan 24, 2024 12:25

Join Gene Brown, MD, RPh, AAO-HNS/F At-Large Director and general otolaryngologist, and James Lin, MD, the Academy's CPT Advisor and a neurotologist, as they engage in a robust podcast discussion on the Centers for Medicare & Medicaid Services implementation of code G2211. This is a new code that went into effect on January 1, 2024. Dr. Brown and Dr. Lin provide clinical examples that indicate when code G2211 may be utilized in an otolaryngology practice.

academy code md centers rph medicare medicaid services

Nursing homes not planning for value-based care are falling behind

planning medicare centers fuller nursing homes mcknight valuebased falling behind value based care medicare medicaid services brian fuller aco reach

Play Episode Listen Later Jan 9, 2024 15:02

Does every nursing home need a value-based care strategy today? The answer, says Brian Fuller, ATI Advisory's new managing director of value-based care design and delivery, is “unequivocally yes.” The Centers for Medicare & Medicaid Services continues to promote a shift to have all Medicare beneficiaries engaged in some type of value-based care by 2030, with the goal to be at 60% by the end of 2024. That's bringing added pressure to skilled nursing providers, many of whom may still be confused about exactly what value-based care is, how they can participate, and how they might benefit under newer, more nuanced programs. The time to prepare is now, says Fuller. “The work is incredibly complex and difficult, and it simply doesn't happen overnight,” Fuller tells McKnight's Long-Term Care News Senior Editor Kimbelry Marselas in this episode.. “And so any strategy is a multi-year process. The longer an organization takes to make sure that they have a clear and actionable strategy, the more they risk that they fall further behind in their marketplace and being able to optimize their opportunities.” Listen in to learn about data tools and partnerships that can help any provider excel under a variety of models ranging from Institutional-Special Needs Plans to the year-old ACO Reach.

Health Equity: Behind the Buzzwords

joe biden benefits medicine healthcare medicare centers regulations medicaid stakeholders buzzwords health equity medical care biden admin dhc kevin malone medicare medicaid services accountable care epstein becker green

Play Episode Listen Later Dec 14, 2023 19:31

Under the Biden administration, the Centers for Medicare & Medicaid Services published a health equity framework that drastically changed the playing field for health plans and other risk-bearing entities. In the wake of these changes, how can health plans, accountable care organizations, and other similar stakeholders successfully create and administer social determinants of health interventions as a means to advance health equity? On this episode, Epstein Becker Green attorneys Jackie Selby, Kevin Malone, and Marjorie Scher discuss the recent national focus on health equity, the actionable interventions behind the concept, and the responsibility of stakeholders in making care delivery more equitable. Visit our site for more information and related resources: https://www.ebglaw.com/dhc74 Subscribe for email notifications: https://www.ebglaw.com/subscribe. Visit: http://diagnosinghealthcare.com. This podcast is presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.

Season 2, EP. 7: CMS' Special Focus Program, What We Know

NHPCO Podcast

Play Episode Listen Later Dec 6, 2023 41:17

On today's episode, Madison is joined once more by NHPCO's VP of Policy and Government Relations, Logan Hoover plus a new addition to the NHPCO team, Patrick Harrison, Senior Director of Regulatory and Compliance, to discuss one of the most pressing issues facing the hospice community in 2024: the U.S. Centers for Medicare & Medicaid Services' Special Focus Program (SFP). Enacted under the Consolidated Appropriations Act, 2021, the SFP aims to increase oversight of hospices which have substantially failed to meet Medicare program requirements. However, despite concerns raised by key stakeholders including members of Congress, technical expert panel participants, and hospice community leaders, CMS is moving forward with a program based on a flawed methodology which may not accurately identify poor performing hospices. Tune in to learn more about what's being done to attempt to change the current SFP algorithm and how providers can advocate for change.

congress policy senior director compliance medicare centers regulatory cms government relations enacted sfp consolidated appropriations act special focus medicare medicaid services patrick harrison nhpco

Coffee & Contracts - CMS changes and what it means

Financial Residency

Play Episode Listen Later Nov 29, 2023 8:14

This episode is sponsored by Eckard Enterprises. To start empowering your financial future, visit www.EckardEnterprises.com In this podcast segment, Jon discusses the recent announcements from CMS (Centers for Medicare & Medicaid Services) regarding new guidelines for 2024. He highlights a global reduction of 1.25 in overall payment rates, affecting various medical specialties. Despite the decrease, there are significant increases for primary care and direct patient care services. Jon emphasizes the importance of staying informed about CMS changes, as they can impact compensation structures and contract terms for healthcare professionals. He encourages listeners to reach out to Contract Diagnostics for assistance in understanding and navigating these shifts, ensuring that physicians have a voice in negotiations and are fully aware of the implications for their practice. Jon invites individuals to contact Contract Diagnostics through phone, chat, or email for personalized assistance, visit www.ContractDiagnostics.com

money coffee finance budget physicians contracts cms residency medical school medicare medicaid services cms centers contract diagnostics eckard enterprises

S4 Ep8: Unlocking Seamless Healthcare Experiences with Digital Identity —Featuring Jason Sherwin and Ryan Howells

HLTH Matters

Play Episode Listen Later Nov 28, 2023 14:47

About Jason Sherwin:Jason Sherwin is the Senior Director of Business Development at Clear. He is a passionate strategic thinker who is driven to challenge long-held healthcare standards. Jason has 13 years of expertise in the health technology field, focusing on product planning and commercial growth. In his role at Clear, Jason works cross-functionally with executives and other leaders in marketing, operations, and IT to maximize outcomes.Jason completed his MBA at the Stern School of Business, which enabled him to apply the principles he learned to his real-world work. His expertise in designing successful strategies for managing organizational change and gauging success was further boosted by his specialization in Leadership & Change Management. Jason also completed his Bachelor of Science at Skidmore College in 2009.About Ryan Howells:Ryan Howells is Principal at Leavitt Partners and Program Manager at CARIN Alliance. He focuses on healthcare policy and interoperability issues, working with key stakeholders, including the White House, Congress, HHS, and VHA. His role is instrumental in driving consumer access to healthcare data and enabling interoperability in the healthcare ecosystem.Ryan is also a Member of the Medicaid Information Technology Architecture (MITA) Governance Board at the Centers for Medicare & Medicaid Services, intending to provide strategic direction and tactic oversight. Ryan has earned his Master of Arts in Health Services Administration at the University of Southern California.Things You'll Learn:In healthcare, identity is critical. Getting the patient's identity wrong isn't an option.Streamlining healthcare through digital identity can significantly reduce provider costs and improve patient matching.The 21st Century Cures Act, Fire APIs, and identity-proof credentials are revolutionizing how consumers access their healthcare data.Individuals can prove their identity, for example, when checking in for an appointment with their doctor, through a unique digital identity, similar to taking a selfie.The goal is to place patients in control of their health information, providing a seamless experience.Trust is a crucial aspect, making the digital identity a reliable solution for healthcare data.Resources:Connect with and follow Jason on LinkedIn.Visit CLEAR on their website and follow them on LinkedIn.Connect with and follow Ryan on LinkedIn.Learn more about Leavitt Partners on this website and LinkedIn.Visit CARIN Alliance on their website and follow them on LinkedIn.

Medicare's Historic Prescription Drug Price Negotiations

JAMA Author Interviews: Covering research in medicine, science, & clinical practice. For physicians, researchers, & clinician

Play Episode Listen Later Nov 7, 2023 15:01

JAMA Senior Editor Kristin Walter, MD, MS, and Lawrence O. Gostin, JD, JAMA Legal and Global Health Correspondent and Faculty Director of the O'Neill Institute for National and Global Health Law at Georgetown University, discuss the Inflation Reduction Act, which for the first time allows the Centers for Medicare & Medicaid Services to negotiate prescription drug prices with drug manufacturers. Related Content: Medicare's Historic Prescription Drug Price Negotiations

ms price national md historic negotiation jd medicare centers georgetown university inflation reduction act prescription drugs faculty director medicare medicaid services global health law lawrence o gostin

Friday News Flyover - Nov 3, 2023 - medicaid, cannabis, 2023 elections

Heartland POD

Play Episode Listen Later Nov 3, 2023 15:10

Welcome to the Friday News Flyover for November 3, 2023. I'm Sean Diller. This week: Medicaid chaos in red states around the country | Cannabis legalization on the ballot in Ohio | Pennsylvania Democrats have returned triple the mail ballots compared with their Republican neighbors | Colorado voters consider two statewide ballot initiatives, and | It's Britneyhttps://missouriindependent.com/2023/11/02/medicaid-unwinding-breeds-chaos-in-states-as-millions-lose-coverage/Medicaid ‘unwinding' breeds chaos in states as millions lose coverageBY: PHIL GALEWITZ, KATHERYN HOUGHTON, BRETT KELMAN AND SAMANTHA LISS - NOVEMBER 2, 2023 11:34 AM More than two dozen people lined up outside a state public assistance office in Montana before it opened to ensure they didn't get cut off from Medicaid.Callers in Missouri and Florida reported waiting on hold for more than two hours on hotlines to renew their Medicaid coverage.The parents of a disabled man in Tennessee who had been on Medicaid for three decades fought with the state this summer to keep him enrolled as he lay dying from pneumonia in a hospital.Since the expiration of COVID-era protections earlier this year, states have reviewed the eligibility of more than 28 million people and terminated coverage for over 10 million of them. Millions more are expected to lose Medicaid in the coming months.The Medicaid disenrollment rates of people reviewed so far vary dramatically by state, largely along a blue-red political divide, from a low of 10% in Illinois to a high of 65% in Texas.“I feel like Illinois is doing everything in their power to ensure that as few people lose coverage as possible,” said Paula Campbell of the Illinois Primary Health Care Association, which represents dozens of community health centers.Camille Richoux, health policy director for the nonprofit Arkansas Advocates for Children and Families said, “It's not just bad, but worse than people can imagine. This has not been about determining who is eligible using all possible means, but how we can kick people off by all possible means.”The unprecedented enrollment drop comes after federal protections ended this spring that had prohibited states from removing people from Medicaid during the three pandemic years. Since March 2020, enrollment in Medicaid and the related Children's Health Insurance Program had surged by more than 22 million to reach 94 million people in the U.S.The process of reviewing recipients' eligibility has been anything but smooth for many Medicaid enrollees, and some suspect particular states have used the confusing system to discourage enrollment.But gaps in coverage can jeopardize people's access to health services - or their financial security - if they get medical bills for care they cannot postpone.Pam Shaw, a pediatrician in Kansas City, Kansas, who chairs the American Academy of Pediatrics' state government affairs committee said, “Any type of care that's put off — whether it's asthma, whether it's autism, whether it's something as simple as an earache — can just get worse if you wait,”Doctors and representatives of community health centers around the country said they have seen an uptick in cancellations and no-shows among patients without coverage — including children. Nationwide, states have already disenrolled at least 1.8 million children in the 20 states that provide the data by age. Children typically qualify more easily than adults, so child advocates believe many kids are being wrongly terminated based on their parents' being deemed no longer eligible. In Texas, 68% of those disenrolled from Medicaid were children, compared with 16% in Massachusetts, according to KFF. In September, President Joe Biden's administration said most states were conducting eligibility checks incorrectly and inappropriately disenrolling eligible children or household members. The administration ordered states to reinstate coverage for some 500,000 people.Idaho, one of a few states that completed the unwind in six months, said it disenrolled 121,000 people of the 153,000 recipients it reviewed as of September because it suspected they were no longer eligible. Of those kicked off, about 13,600 signed up for private coverage on the state's ACA marketplace, according to Pat Kelly, executive director of Your Health Idaho, the state's exchange. What happened to the rest, state officials say they don't know.Nationwide, about 71% of Medicaid enrollees terminated during the unwinding have been cut because of procedural issues - meaning they could actually still qualify for Medicaid, but lost it anyway. ‘People are not getting through'In many states, enrollees have faced long waits to get help with renewals. The worst phone waits were in Missouri, according to a KFF Health News review of letters the Centers for Medicare & Medicaid Services sent to states in August. In the letter to Missouri's Medicaid program, CMS said it was concerned that the average wait time of 48 minutes and the 44% rate of Missourians abandoning those calls in May was “impeding equitable access” to assistance and patients' ability to maintain coverage.Some people are waiting on hold more than three hours, said Sunni Johnson, an enrollment worker at Affinia Healthcare, which runs community health centers in the St. Louis area. That's a significant hurdle for people with inflexible jobs and other barriers.In Florida, which has removed over 730,000 people from the program since April, enrollees earlier this year were waiting almost 2½ hours on a Spanish-language call center, according to a report from UnidosUS, a civil rights advocacy group. The Spanish versions of the Medicaid application, renewal website, and other communications are also confusing, said Jared Nordlund, the Florida director for UnidosUS.Some Medicaid recipients are seeking help through the courts. In a 2020 class-action lawsuit against Tennessee that seeks to pause the Medicaid eligibility review, parents of recipients describe spending hours on the phone or online with the state Medicaid program, trying to ensure their children's insurance coverage is not lost.One of those parents, Donna Guyton, said in a court filing that Tennessee's Medicaid program, called TennCare, sent a June letter revoking the coverage of her 37-year-old son, Patrick, who had been eligible for Medicaid because of disabilities since he was 6. As Guyton made calls and filed appeals to protect her son's insurance, he was hospitalized with pneumonia, then spent weeks there before dying in late July.“While Patrick was fighting for his life, TennCare was threatening to take away his health insurance coverage and the services he relied on,” she said in a court filing. “Though we should have been able to focus on Patrick's care, our family was required to navigate a system that kept denying his eligibility and putting his health coverage at risk.”TennCare said in a court filing Patrick Guyton's Medicaid coverage was never actually revoked — the termination letter was sent to his family because of an “error.”Phil Galewitz in Washington, D.C., wrote this article. Daniel Chang in Hollywood, Florida; Katheryn Houghton in Missoula, Montana; Brett Kelman in Nashville, Tennessee; Samantha Liss and Bram Sable-Smith in St. Louis; and Bernard J. Wolfson in Los Angeles contributed to this report.KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.https://ohiocapitaljournal.com/2023/11/01/marijuana-legalization-would-add-260m-to-ohio-economy-study-predicts/Smoke ‘em if you got ‘em. Or when you get ‘em anyway.Issue 2, an initiative that would legalize recreational marijuana for people over 21 in Ohio, is on the ballot in next Tuesday's election. An economic analysis released last week found that the benefits of legalizing cannabis in Ohio would outweigh the costs by a quarter-billion dollars a year.A study by Columbus-based Scioto Analysis attempts to identify the pluses and minuses that would come with legalization.To do the analysis, the group used studies from states such as Washington and Colorado, where recreational weed has long been the law. To examine how the pros and cons identified in those states might play out in Ohio, the researchers looked at economic and census data, as well as crime statistics.with its 10% excise tax on top of Ohio's normal sales tax, passage of Issue 2 would produce $190 million a year, according to the report. Then there are the jobs the new industry would create.The report predicts that Ohio will add roughly 3,300 new jobs in the first year after legalization. Assuming these jobs are full time and pay matches the average wage across the state of Ohio, this will amount to about $190 million in wage benefits for workers across the state. And if weed is no longer illegal for adults over 21, it stands to reason that there will be fewer arrests.The report said using data from the FBI's Uniform Crime Report on the number of cannabis-related arrests in Ohio, they estimate there would be about 4,400 fewer arrests per year if recreational cannabis were legalized. Adding up the cost of those arrests, and assuming that 6% of those people would have been convicted of felonies, this amounts to over $38 million in savings for Ohio.”Overall, study estimated Ohioans would receive $260 million in annual benefits if Issue 2 passes this coming Tuesday. https://www.penncapital-star.com/blog/mail-in-ballot-returns-top-half-a-million-2023-election-mailbag/Dems far outpacing Republicans in mail and absentee ballots returnedMail-in ballot returns top half a million | 2023 Election MailbagBY: CASSIE MILLER - NOVEMBER 1, 2023 2:00 PM Here are the numbers: As of Nov. 1, Pennsylvania voters requested a total of 1,026,227 absentee and mail-in ballots.Of that number, 90% requested a mail-in ballot and 10% requested an absentee ballot ahead of the municipal election.Registered Democrats requested 723,746 mail-in and absentee ballots compared to 215,286 Republicans and 87,195 requests from “other” registered voters. So about 3 of every 4Of the 570,000 ballots returned so far statewide, 417,829 - or about 3 of every 4 - were ballots from registered Democrats and 114,149 were from those registered as Republicans. https://coloradonewsline.com/2023/10/01/proposition-hh-proposition-ii/Colorado voters will decide on two statewide measures this election, both of which were referred to the ballot by the state Legislature.First, Proposition HHIf approved, Proposition HH would lower property tax rates over the next 10 years and allow the state to keep more money than it would otherwise be obligated to return to taxpayers. If Proposition HH passes, the residential assessment rate would be reduced to 6.7% from 6.765% until 2032. Proposition HH would also raise the amount of tax revenue the state can keep — set by the Taxpayer's Bill of Rights — by 1%. The new revenue allowed would be used to backfill property tax revenue that local governments would miss out on, for things like public education. $20MM would also be set aside for a rental assistance program.The proposition is backed by the Democratic lawmakers who voted to put it on the ballot and by Demoratic Gov. Jared Polis, as well as by other liberal groups, unions, AARP and the League of Women Voters. They say the proposal is a responsible solution to rising property taxes while still keeping schools funded. https://variety.com/2023/music/news/britney-spears-memoir-the-woman-in-me-sales-publisher-1235768414/It's BritneyBritney Spears‘ long-awaited memoir “The Woman in Me” — which details her fight for freedom and tumultuous relationships with the men in her life — has sold 1.1 million copies in its first week across print, pre-sales, e-books and audiobooks in the United States.“The Woman in Me” was released on Oct. 24 and has officially been out for just over a week. The memoir is 275 pages long and the audiobook is read by actress Michelle Williams. The book featured a wild assortment of revelations that touched on Spears' career, family, conservatorship and high profile relationships. Among them, Spears revealed that she and her ex-beau Justin Timberlake had gotten an abortion and she also claims Timberlake cheated on her with unnamed celebrities. Spears landed the publishing deal for a tell-all last February, just a few months after her conservatorship was terminated. Simon & Schuster acquired the rights to Spears' book last year after a bidding war that involved multiple publishers, though the financial terms of the transaction have not been revealed. That's it for me, from Denver I'm Sean Diller. Stories featured in today's show were originally reported in the Missouri Independent, Ohio Capital Journal, Pennsylvania Capital Star, Colorado Newsline, and Variety. Thanks for listening, see you next time.

covid-19 united states texas children stories hollywood los angeles washington woman politics doctors colorado joe biden elections ohio spanish tennessee pennsylvania nashville illinois fbi league massachusetts missouri families republicans kansas rights democrats kansas city millions montana cannabis columbus idaho smoke democratic britney spears variety centers justin timberlake american academy medicaid pediatrics dems nationwide assuming cms spears legislature callers aarp aca taxpayers michelle williams missoula timberlake women voters simon schuster in florida ohioans flyover jared polis missourians 20mm absentee ballots kff friday news pat kelly medicare medicaid services unidosus 2023 elections health insurance program kff health news colorado politics ohio politics progressive podcast daniel chang uniform crime report missouri independent proposition hh ohio capital journal paula campbell pennsylvania capital star

Friday News Flyover - Nov 3, 2023 - Ohio voters decide on abortion rights and cannabis - Red states kicking millions off Medicaid - Pennsylvania Dems outpacing GOP mail ballots - Britney Spears memoir sells 1MM copies in a week

The Heartland POD

Play Episode Listen Later Nov 3, 2023 15:10

Welcome to the Friday News Flyover for November 3, 2023. I'm Sean Diller. This week: Medicaid chaos in red states around the country | Cannabis legalization on the ballot in Ohio | Pennsylvania Democrats have returned triple the mail ballots compared with their Republican neighbors | Colorado voters consider two statewide ballot initiatives, and | It's Britneyhttps://missouriindependent.com/2023/11/02/medicaid-unwinding-breeds-chaos-in-states-as-millions-lose-coverage/Medicaid ‘unwinding' breeds chaos in states as millions lose coverageBY: PHIL GALEWITZ, KATHERYN HOUGHTON, BRETT KELMAN AND SAMANTHA LISS - NOVEMBER 2, 2023 11:34 AM More than two dozen people lined up outside a state public assistance office in Montana before it opened to ensure they didn't get cut off from Medicaid.Callers in Missouri and Florida reported waiting on hold for more than two hours on hotlines to renew their Medicaid coverage.The parents of a disabled man in Tennessee who had been on Medicaid for three decades fought with the state this summer to keep him enrolled as he lay dying from pneumonia in a hospital.Since the expiration of COVID-era protections earlier this year, states have reviewed the eligibility of more than 28 million people and terminated coverage for over 10 million of them. Millions more are expected to lose Medicaid in the coming months.The Medicaid disenrollment rates of people reviewed so far vary dramatically by state, largely along a blue-red political divide, from a low of 10% in Illinois to a high of 65% in Texas.“I feel like Illinois is doing everything in their power to ensure that as few people lose coverage as possible,” said Paula Campbell of the Illinois Primary Health Care Association, which represents dozens of community health centers.Camille Richoux, health policy director for the nonprofit Arkansas Advocates for Children and Families said, “It's not just bad, but worse than people can imagine. This has not been about determining who is eligible using all possible means, but how we can kick people off by all possible means.”The unprecedented enrollment drop comes after federal protections ended this spring that had prohibited states from removing people from Medicaid during the three pandemic years. Since March 2020, enrollment in Medicaid and the related Children's Health Insurance Program had surged by more than 22 million to reach 94 million people in the U.S.The process of reviewing recipients' eligibility has been anything but smooth for many Medicaid enrollees, and some suspect particular states have used the confusing system to discourage enrollment.But gaps in coverage can jeopardize people's access to health services - or their financial security - if they get medical bills for care they cannot postpone.Pam Shaw, a pediatrician in Kansas City, Kansas, who chairs the American Academy of Pediatrics' state government affairs committee said, “Any type of care that's put off — whether it's asthma, whether it's autism, whether it's something as simple as an earache — can just get worse if you wait,”Doctors and representatives of community health centers around the country said they have seen an uptick in cancellations and no-shows among patients without coverage — including children. Nationwide, states have already disenrolled at least 1.8 million children in the 20 states that provide the data by age. Children typically qualify more easily than adults, so child advocates believe many kids are being wrongly terminated based on their parents' being deemed no longer eligible. In Texas, 68% of those disenrolled from Medicaid were children, compared with 16% in Massachusetts, according to KFF. In September, President Joe Biden's administration said most states were conducting eligibility checks incorrectly and inappropriately disenrolling eligible children or household members. The administration ordered states to reinstate coverage for some 500,000 people.Idaho, one of a few states that completed the unwind in six months, said it disenrolled 121,000 people of the 153,000 recipients it reviewed as of September because it suspected they were no longer eligible. Of those kicked off, about 13,600 signed up for private coverage on the state's ACA marketplace, according to Pat Kelly, executive director of Your Health Idaho, the state's exchange. What happened to the rest, state officials say they don't know.Nationwide, about 71% of Medicaid enrollees terminated during the unwinding have been cut because of procedural issues - meaning they could actually still qualify for Medicaid, but lost it anyway. ‘People are not getting through'In many states, enrollees have faced long waits to get help with renewals. The worst phone waits were in Missouri, according to a KFF Health News review of letters the Centers for Medicare & Medicaid Services sent to states in August. In the letter to Missouri's Medicaid program, CMS said it was concerned that the average wait time of 48 minutes and the 44% rate of Missourians abandoning those calls in May was “impeding equitable access” to assistance and patients' ability to maintain coverage.Some people are waiting on hold more than three hours, said Sunni Johnson, an enrollment worker at Affinia Healthcare, which runs community health centers in the St. Louis area. That's a significant hurdle for people with inflexible jobs and other barriers.In Florida, which has removed over 730,000 people from the program since April, enrollees earlier this year were waiting almost 2½ hours on a Spanish-language call center, according to a report from UnidosUS, a civil rights advocacy group. The Spanish versions of the Medicaid application, renewal website, and other communications are also confusing, said Jared Nordlund, the Florida director for UnidosUS.Some Medicaid recipients are seeking help through the courts. In a 2020 class-action lawsuit against Tennessee that seeks to pause the Medicaid eligibility review, parents of recipients describe spending hours on the phone or online with the state Medicaid program, trying to ensure their children's insurance coverage is not lost.One of those parents, Donna Guyton, said in a court filing that Tennessee's Medicaid program, called TennCare, sent a June letter revoking the coverage of her 37-year-old son, Patrick, who had been eligible for Medicaid because of disabilities since he was 6. As Guyton made calls and filed appeals to protect her son's insurance, he was hospitalized with pneumonia, then spent weeks there before dying in late July.“While Patrick was fighting for his life, TennCare was threatening to take away his health insurance coverage and the services he relied on,” she said in a court filing. “Though we should have been able to focus on Patrick's care, our family was required to navigate a system that kept denying his eligibility and putting his health coverage at risk.”TennCare said in a court filing Patrick Guyton's Medicaid coverage was never actually revoked — the termination letter was sent to his family because of an “error.”Phil Galewitz in Washington, D.C., wrote this article. Daniel Chang in Hollywood, Florida; Katheryn Houghton in Missoula, Montana; Brett Kelman in Nashville, Tennessee; Samantha Liss and Bram Sable-Smith in St. Louis; and Bernard J. Wolfson in Los Angeles contributed to this report.KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.https://ohiocapitaljournal.com/2023/11/01/marijuana-legalization-would-add-260m-to-ohio-economy-study-predicts/Smoke ‘em if you got ‘em. Or when you get ‘em anyway.Issue 2, an initiative that would legalize recreational marijuana for people over 21 in Ohio, is on the ballot in next Tuesday's election. An economic analysis released last week found that the benefits of legalizing cannabis in Ohio would outweigh the costs by a quarter-billion dollars a year.A study by Columbus-based Scioto Analysis attempts to identify the pluses and minuses that would come with legalization.To do the analysis, the group used studies from states such as Washington and Colorado, where recreational weed has long been the law. To examine how the pros and cons identified in those states might play out in Ohio, the researchers looked at economic and census data, as well as crime statistics.with its 10% excise tax on top of Ohio's normal sales tax, passage of Issue 2 would produce $190 million a year, according to the report. Then there are the jobs the new industry would create.The report predicts that Ohio will add roughly 3,300 new jobs in the first year after legalization. Assuming these jobs are full time and pay matches the average wage across the state of Ohio, this will amount to about $190 million in wage benefits for workers across the state. And if weed is no longer illegal for adults over 21, it stands to reason that there will be fewer arrests.The report said using data from the FBI's Uniform Crime Report on the number of cannabis-related arrests in Ohio, they estimate there would be about 4,400 fewer arrests per year if recreational cannabis were legalized. Adding up the cost of those arrests, and assuming that 6% of those people would have been convicted of felonies, this amounts to over $38 million in savings for Ohio.”Overall, study estimated Ohioans would receive $260 million in annual benefits if Issue 2 passes this coming Tuesday. https://www.penncapital-star.com/blog/mail-in-ballot-returns-top-half-a-million-2023-election-mailbag/Dems far outpacing Republicans in mail and absentee ballots returnedMail-in ballot returns top half a million | 2023 Election MailbagBY: CASSIE MILLER - NOVEMBER 1, 2023 2:00 PM Here are the numbers: As of Nov. 1, Pennsylvania voters requested a total of 1,026,227 absentee and mail-in ballots.Of that number, 90% requested a mail-in ballot and 10% requested an absentee ballot ahead of the municipal election.Registered Democrats requested 723,746 mail-in and absentee ballots compared to 215,286 Republicans and 87,195 requests from “other” registered voters. So about 3 of every 4Of the 570,000 ballots returned so far statewide, 417,829 - or about 3 of every 4 - were ballots from registered Democrats and 114,149 were from those registered as Republicans. https://coloradonewsline.com/2023/10/01/proposition-hh-proposition-ii/Colorado voters will decide on two statewide measures this election, both of which were referred to the ballot by the state Legislature.First, Proposition HHIf approved, Proposition HH would lower property tax rates over the next 10 years and allow the state to keep more money than it would otherwise be obligated to return to taxpayers. If Proposition HH passes, the residential assessment rate would be reduced to 6.7% from 6.765% until 2032. Proposition HH would also raise the amount of tax revenue the state can keep — set by the Taxpayer's Bill of Rights — by 1%. The new revenue allowed would be used to backfill property tax revenue that local governments would miss out on, for things like public education. $20MM would also be set aside for a rental assistance program.The proposition is backed by the Democratic lawmakers who voted to put it on the ballot and by Demoratic Gov. Jared Polis, as well as by other liberal groups, unions, AARP and the League of Women Voters. They say the proposal is a responsible solution to rising property taxes while still keeping schools funded. https://variety.com/2023/music/news/britney-spears-memoir-the-woman-in-me-sales-publisher-1235768414/It's BritneyBritney Spears‘ long-awaited memoir “The Woman in Me” — which details her fight for freedom and tumultuous relationships with the men in her life — has sold 1.1 million copies in its first week across print, pre-sales, e-books and audiobooks in the United States.“The Woman in Me” was released on Oct. 24 and has officially been out for just over a week. The memoir is 275 pages long and the audiobook is read by actress Michelle Williams. The book featured a wild assortment of revelations that touched on Spears' career, family, conservatorship and high profile relationships. Among them, Spears revealed that she and her ex-beau Justin Timberlake had gotten an abortion and she also claims Timberlake cheated on her with unnamed celebrities. Spears landed the publishing deal for a tell-all last February, just a few months after her conservatorship was terminated. Simon & Schuster acquired the rights to Spears' book last year after a bidding war that involved multiple publishers, though the financial terms of the transaction have not been revealed. That's it for me, from Denver I'm Sean Diller. Stories featured in today's show were originally reported in the Missouri Independent, Ohio Capital Journal, Pennsylvania Capital Star, Colorado Newsline, and Variety. Thanks for listening, see you next time.

covid-19 united states texas children stories hollywood los angeles washington woman politics doctors colorado joe biden ohio spanish tennessee pennsylvania nashville illinois fbi league massachusetts missouri families states republicans kansas rights mail democrats kansas city millions montana cannabis decide columbus idaho kicking smoke democratic britney spears memoir voters variety centers justin timberlake sells american academy medicaid pediatrics dems nationwide assuming cms spears legislature callers aarp aca taxpayers ballots michelle williams red state abortion rights copies missoula timberlake women voters simon schuster in florida ohioans flyover jared polis missourians 20mm absentee ballots kff friday news pat kelly medicare medicaid services unidosus 2023 elections health insurance program kff health news colorado politics ohio politics progressive podcast daniel chang uniform crime report proposition hh missouri independent ohio capital journal paula campbell pennsylvania capital star

EP417: 5 Kinds of Payer and Provider Collaborations and 5 Must-Haves for Said Collaborations to Work, With Josh Berlin, JD

america chip wondering physicians jd cuts medicare determine centers ama mips macra federal affairs medicare medicaid services apms tell congress alternative payment models

Play Episode Listen Later Nov 2, 2023 33:43

Yeah, it's a fact that the vast majority of past and present provider and payer relationships are not exactly collaborative. They may better be described as fairly adversarial, actually—especially when viewed through the lens of provider organizations trying really hard to find a payment model that will enable them to do better by their patients and deliver better outcomes. We've had Justina Lehman (EP414), Ali Ucar (EP362), Dan O'Neill (EP359) talking about this from the provider organization standpoint. We also had Dan Serrano (EP410) and Will Shrank, MD (EP413) corroborating here. But after each of these earlier episodes, many comments and conversations ensued about said potential (or not) payer/provider collaborations. And there was a theme of many of these online exchanges. The theme was wondering if we'd all get laughed at for even talking about these rare and elusive Shangri-la scenarios. Like expending words and energy thinking about payers and providers working together was as crazy as being seen earnestly discussing, I don't know, whether mermaids know about pants or something. And that's why I wanted to get Josh Berlin on the podcast today: to talk about the why, the what, and the how of collaboration. I wanted to know if there really is a solid why here for the why collaborate, especially from a payer point of view. And when I say payer, I mean a payer kind of payer like a Blue Cross, United, Cigna, Aetna plan kind of payer. And I'm calling that out because payers are intermediaries in all cases except for their fully insured members. Except for that one book of business, entities actually taking the risk are taxpayers or self-insured employers. So, saving money on its face is not a super compelling value proposition. Listen to the show with David Contorno (EP339) for the why there. As we talk about in the interview that follows, though, what might be compelling is predictable spend, possibly—or even more compelling could be a competitive differentiation for that payer that leads to higher market share. Payer/provider collaborations can also lead to a more resilient market foothold that can stand up to threats from upstart competitors or big tech and big retail swooping in looking for a tasty slice of this $3 trillion industry. There's also the potential for a higher profit margin. And, oh, one additional reason to collaborate if you're a payer that we don't get into super heavily but I'd be remiss to not mention is the whole Star Ratings thing for Medicare Advantage plans, because stars equal big money. But a payer is not gonna get that Star Rating shekel if providers aren't delivering high enough quality care. Also, of course, we have HEDIS (Healthcare Effectiveness Data and Information Set) and other quality measures that have financial value ascribed to them. In the conversation that follows, Josh talks about different types of collaborations. Collaboration is a really very vague term, so what exactly is this collaboration, what does it entail, and how do you do it? Josh told me that there are five kinds of collaboration, and here they are in order of their depth of entanglement, I guess you could call it. 1. Sharing data back and forth 2. Use that data to identify areas of need and then do something programmatic together, like create clinical pathways or work on one very specific type of quality program. 3. A joint venture (JV)—you JV and work together on some sort of narrow network kind of product 4. Become capital partners in some way. 5. Having a risk-bearing kind of relationship—the provider gets a piece of the premium dollar So, that's the five types of collaboration. But here's the things you've got to tick through, that you have to really go through and make sure you've got all these things before you start. Otherwise, it'll be a monumental waste of time. 1. Complementary capabilities that enable scalability 2. A desire for sustainability in a market, and both have common goals and objectives and an agreed-upon time horizon 3. Both parties need to be pretty flexible. Rigid products have a shelf life. You've got to be willing to advance with market dynamics flexibly—know how to iterate around whatever it is you're doing. 4. Excel at collaboration. If you're going to collaborate, you have to know how to collaborate. And that's a cultural thing. 5. Compatible risk profiles—this means not just “taking risk” but knowing how to do it in a way that will work and navigating around things that could cause trouble when moving from fee for service to a more capitated way of going about things. Josh talks about some of them. Just to loop back around on #4 there, because … yeah, to collaborate, you need to collaborate. I call Josh out on this one, and he reiterates that … yeah, nothing to take for granted here. It might seem obvious, but it's so frequently an internal unknown unknown—at a lot of payers especially. I mean, if I'm a provider organization and you force me to only communicate with you through snail mail (ie, postage stamp, letter box, the whole nine), I don't know, I'd kind of get the vibe that I'm being enthusiastically ignored, which I just cannot square with a collaborative spirit of any kind. Josh Berlin is a founding partner of Rule of Three, which is a consulting firm. Rule of Three has clients that are physician practices, hospitals, health systems on the traditional side; and they also work with nontraditional organizations like Walmart Health and Wellness. They also work with payers, like regional blues and employer plans. You can learn more at Rule of Three and by connecting with them on LinkedIn. Josh M. Berlin, JD, is CEO of Rule of Three, LLC, with more than 25 years of experience, most of which has been in healthcare advisory in service to his clients. Most recently, he has served as principal and co-practice leader of Citrin Cooperman's Healthcare Practice and managing partner for IBM Watson Health's Strategic Advisory Practice, leading a unique group of consultants in each instance to serve clients across the full healthcare ecosystem (providers, payers, employers, governments, advocacy, etc). Prior to those roles, Josh served as a principal in the healthcare consulting practice at Dixon Hughes Goodman (now FORVIS), helping to lead their strategy consulting business, and served as a leader in all versions of KPMG (KPMG Consulting/BearingPoint and KPMG). Currently, he serves on the Boards of the Validation Institute, Population Health Management journal, and HealthTrackRx. Josh's expertise spans both the consulting and healthcare industries. Some of his clients have included the Hospital Corporation of America, the Department of Health and Human Services (including the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services), various pediatric health systems, the National Association for Healthcare Quality, Nebraska Medicine, Penn Medicine, the Ochsner Health System/Network, the BJC Collaborative, and The Leapfrog Group, as well as a variety of other healthcare organizations. Josh has developed long-standing client relationships at all levels of organizations, notably including some of the most prestigious C-suite executives in healthcare today. 06:06 Why should payers want to collaborate with providers? 09:46 “Collaboration … is bilateral. … Both sides, plan and provider, should be equally as interactive with the individual populations they work with.” 12:37 What are the must-haves for collaboration between providers and payers? 13:10 What are the five different types of collaboration? 16:03 What are the five characteristics you want to be focused on in partnership? 21:35 EP359 with Dan O'Neill. 22:16 In order to collaborate, do you have to be collaborative? 26:11 Ochsner as a great example of collaboration. 27:46 Episodes with David Carmouche, MD, and Eric Gallagher. 28:51 A collaboration failure in Haven. You can learn more at Rule of Three and by connecting with them on LinkedIn. Josh M. Berlin of Rule of Three, LLC, discusses #payer and #provider #collaboration on our #healthcarepodcast. #podcast #digitalhealth #valuebasedcare #healthcare Recent past interviews: Click a guest's name for their latest RHV episode! Dr Adam Brown, Rob Andrews, Justina Lehman, Dr Will Shrank, Dr Carly Eckert (Encore! EP361), Dr Robert Pearl, Larry Bauer (Summer Shorts 8), Secretary Dr David Shulkin and Erin Mistry, Keith Passwater and JR Clark (Summer Shorts 7), Lauren Vela (Summer Shorts 6)

Medicare pay cuts coming in 2024 with Jennifer Hananoki, JD

AMA COVID-19 Update

Play Episode Listen Later Oct 5, 2023 10:38

The Centers for Medicare & Medicaid Services is trying to cut physician Medicare payment yet again. Jennifer Hananoki, JD, assistant director on the AMA Federal Affairs team, joins to address the proposed 2024 Medicare physician pay schedule. She breaks down the 3.36% cut to physician reimbursement, plus what the MIPS scores for 2022 and Oct. 9 deadline to file an appeal mean for physicians. American Medical Association CXO Todd Unger hosts.

Fri 8/22 - Racist Juror Removed in District Court, Big Pharma Prepares to Negotiate with CMS, Anti-DEI Comes for Scholarships, Cisco Acquisition and Trump Fraud Trial Drama

Minimum Competence

Play Episode Listen Later Sep 22, 2023 9:47

On this day in legal history, September 22, 1692, eight people were executed for witchcraft in Salem, Massachusetts during the so-called “Salem Witch Trials.”The Salem Witch Trials were a series of witchcraft cases brought before local magistrates in a settlement called Salem, which was a part of the Massachusetts Bay Colony in the 17th century. The trials took place between February 1692 and May 1693 and are one of the most notorious episodes in early American history. It all began when a group of young girls claimed to be possessed by the devil and accused several local women of witchcraft. As mass hysteria spread through the community, a special court convened in Salem to hear the cases.The first convicted witch, Bridget Bishop, was hanged in June 1692. As the trials proceeded, accusations spread to individuals from surrounding villages. At the height of the witch hunt, more than 150 people were found guilty and 19 were hanged. Another man, Giles Corey, was pressed to death with large stones for refusing to enter a plea. Many others languished in jail for months without trials until the hysteria that swept through Puritan Massachusetts subsided.The Salem Witch Trials have long fascinated historians and psychologists as a cautionary tale about the dangers of isolationism, religious extremism, false accusations, and lapses in due process. It wasn't until 1711 that the colony passed a bill to exonerate the accused and provide financial restitution to their heirs. However, the damage had been done, and the events in Salem have since become synonymous with paranoia and injustice, serving as a vivid cautionary tale for more than three centuries.In a highly unusual move, U.S. District Judge Timothy Batten removed a white juror from a tax trial involving wealthy developer Jack Fisher, citing the juror's "racist behavior." Fisher is accused of arranging $1.3 billion in fraudulent tax deductions through syndicated conservation easements. The juror, known as Juror 26, had told the judge that she was "standing up for White people," leading to her removal and replacement with an alternate juror. The defense has indicated that they will appeal if Fisher is convicted, citing the rare step of juror replacement during deliberations.The trial has been fraught with racial tensions and discord among jurors. Judge Batten had to warn jurors against using profanity with each other and interviewed several members of the predominantly Black jury about their disagreements. Juror 26 had falsely accused another juror, a Black man, of saying the defendants should be jailed "because they are rich, White and entitled."Prosecutors had urged for the removal of Juror 26 due to her comments, lying to the judge, and refusal to deliberate. Defense lawyers argued that her statements were misconstrued and that she had resumed deliberations. Batten eventually decided to remove her, stating that he could not in good conscience allow her to continue on the jury.Fisher's lawyers have filed a motion requesting the removal of five other jurors or a declaration of a mistrial, which the judge has denied. The trial is set to resume with an alternate juror, and the jury will return on Friday after failing to reach a verdict.White Juror Tossed at Trial as Judge Cites ‘Racist Behavior' (1)Pharmaceutical companies like Boehringer Ingelheim Pharmaceuticals, Inc. and Novartis AG are gearing up to negotiate drug prices with Medicare in compliance with the Biden administration's Inflation Reduction Act. Companies have until October 1 to agree to enter these negotiations. Those who refuse will face a starting tax of 65% on the U.S. sales of the product in question, with the tax rate increasing by 10% each quarter up to a maximum of 95%. The Internal Revenue Service is yet to issue a proposed rule on how this tax will be reported and paid.Pharmaceutical companies argue that this tax violates the Eighth Amendment's prohibition on excessive fines. However, they are not waiting for further guidance from the Biden administration, as the Congressional Budget Office estimates that the tax could exceed a manufacturer's profits when combined with corporate income taxes. The primary focus for manufacturers is to collect data for the Centers for Medicare & Medicaid Services by October 2, which will help in determining each drug's maximum fair price.The Congressional Budget Office has not provided a clear estimate on the revenue from the tax penalty but predicts that drug manufacturers will comply due to the high costs of non-compliance. Companies have the option to withdraw their products from Medicare and other federal health programs to avoid the tax, but this would mean losing access to a vast customer base. Industry experts believe that non-compliance is not a feasible option and expect companies to accept whatever price the government dictates. The general consensus is that the tax is not designed to be paid but to force compliance with Medicare's drug pricing program.Drugmakers Aren't Waiting Around for Details on Medicare TaxA non-profit group opposing race-based education policies has filed multiple civil rights complaints against U.S. universities. These complaints challenge the legality of minority scholarships and other programs aimed at promoting racial diversity. The actions follow a U.S. Supreme Court ruling in June that banned the use of race in college admissions, commonly known as affirmative action. The group, called the Equal Protection Project of the Legal Insurrection Foundation, argues that the Supreme Court's decision should extend to all educational programs.The latest complaint accuses Western Kentucky University of violating civil rights law by offering scholarships exclusively to minority students. Other universities targeted include Kansas State University and the University of Nebraska-Lincoln. The U.S. Department of Education has not yet indicated whether it will launch formal investigations into these complaints.Advocates of race-conscious programs argue that they are essential for combating societal disadvantages faced by minority students. They warn that removing race as a factor in admissions and scholarships will result in fewer minority students at top schools. Some schools, like the University of Missouri, have already announced the elimination of race as a factor in awarding scholarships.Legal experts note that it's unclear whether the Supreme Court's ruling will extend to other race-conscious programs beyond admissions. The Department of Education's civil rights office is expected to become a key battleground for these issues. Meanwhile, some schools are exploring alternative methods to improve racial diversity, such as recruiting from underprivileged schools.Anti-affirmative action group, emboldened by US Supreme Court, targets scholarships | ReutersCisco Systems Inc. has announced its largest acquisition to date, buying cybersecurity company Splunk Inc. for approximately $28 billion. The deal is significant, accounting for about 10% of Cisco's market value. Cisco plans to pay $157 per share in cash for the acquisition. Once the deal is finalized, Splunk's CEO, Gary Steele, will report to Cisco's CEO, Chuck Robbins, and join Cisco's executive leadership team.Legal counsel for the deal involves several major law firms. Simpson Thacher & Bartlett is serving as legal counsel to Cisco, while Cravath, Swaine & Moore is acting as Cisco's regulatory counsel. On the other side, Skadden, Arps, Slate, Meagher & Flom is providing legal counsel to Splunk, and Cooley is advising Qatalyst, the financial advisor to Splunk.The acquisition aims to strengthen Cisco's cybersecurity defenses and enhance its artificial intelligence capabilities. The deal is expected to close by the end of the third quarter of next year, pending approval from Splunk's shareholders. Private equity firm Hellman & Friedman, which owns 7.5% of Splunk stock valued at $1.4 billion, was advised by Kirkland & Ellis on their voting and support agreement as part of this acquisition.Simpson Thacher Advises Cisco on $28 Billion Splunk Acquisition (1)Just 10 days before a scheduled trial, lawyers for Donald Trump will attempt to convince a New York judge to dismiss most or all of a lawsuit filed by state Attorney General Letitia James. The lawsuit accuses the former U.S. President of "staggering" fraud. On the other hand, James' legal team will argue that Trump and other defendants, including his adult sons and the Trump Organization, should be found liable for fraud even before the trial begins.The case is being reviewed by Justice Arthur Engoron and focuses on allegations that Trump inflated the value of more than 20 properties between 2011 and 2021 to obtain better loan and insurance terms. James claims that Trump inflated his own fortune by as much as $3.6 billion. Trump's lawyers argue that James has no authority to sue over what they claim are non-fraudulent private transactions and that most of her claims are beyond the statute of limitations.The trial comes at a time when Trump is leading in the race for the 2024 Republican presidential nomination, despite facing multiple legal challenges. Last week, Trump accused James of ignoring a court decision and called for a delay in the trial. This led an appeals court judge to temporarily stay the trial, with a decision on whether it should proceed expected next week.James' lawsuit aims to prevent Trump and his sons from running businesses in New York and seeks at least $250 million in penalties. James has called Trump's request for a delay a "brazen and meritless" attempt to undermine the court's authority and warned that even a brief delay could disrupt this and other trials that Trump faces.Trump, NY attorney general to argue over scope of looming fraud trial | Reuters Get full access to Minimum Competence - Daily Legal News Podcast at www.minimumcomp.com/subscribe

Eliminating Inequities with Interpretation: Effective Communication for Improving Health Outcomes

Charting Pediatrics

Play Episode Listen Later Sep 19, 2023 22:29

In the United States, nearly 68 million people speak a language other than English at home. That number has virtually tripled over the last three decades. As our country continues to experience this soaring growth, qualified medical interpreters are becoming more essential to improving health outcomes and achieving health equity goals. Patients with hearing loss or limited health literacy may also require interpretation services. “Effective communication through interpreter utilization is one of the most important things we can do to help our patients with that,” Anna Ruman, MD, says. Dr. Ruman is one of our guests on today's episode. She is an assistant professor of pediatrics at the University of Colorado School of Medicine and a hospitalist at Children's Hospital Colorado. Her passion for this work started before attending medical school. After minoring in Spanish in college, she lived and worked in Mexico. From there, she made her way to Chicago to work as an English-Spanish health educator. She is joined by Nancy Casillas, a medical interpreter and program coordinator for the Medical Interpretation and Translation Department here at Children's Colorado. Casillas, a first-generation Mexican American, has been with Children's Colorado for 16 years and understands the challenges of having English as a second language. “I feel that through this work, I'm helping those families who may be newly arrived immigrants to the country, and they may feel a little lost, and with my skills I'm helping them feel not so lost in this country,” Casillas says. These experts explain how the Centers for Medicare & Medicaid Services has specifically identified language access as one of the five priority areas for the next year, aligning with the shared goal to reduce or eliminate healthcare disparities. Some highlights from this episode include: How medical interpreters enhance health equity Advantages and disadvantages of different types of interpreting Qualifications for interpretation practice versus being bilingual Advancements happening at Children's Colorado For more information on Children's Colorado, visit: childrenscolorado.org

Inflation Reduction Act's Drug Price Negotiation Provisions – What Now?

Play Episode Listen Later Aug 1, 2023 32:40

In July, the Centers for Medicare & Medicaid Services made significant headway in its implementation of the drug pricing provisions of the Inflation Reduction Act (IRA). How can stakeholders respond to, implement, and comply with all these new provisions? On this episode, hear from special guest Sylvia Yu, Vice President and Senior Counsel of Federal Programs at PhRMA. Sylvia and Epstein Becker Green attorneys Connie Wilkinson and Alexis Boaz discuss the recent updates on the quickly moving implementation of the drug pricing provisions under the IRA and the industry's response. Visit our site for related resources and email contact information: https://www.ebglaw.com/dhc68. Subscribe for email notifications: https://www.ebglaw.com/subscribe. Visit: http://diagnosinghealthcare.com. This podcast is presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.

Healthcare vaccine mandate will be gone, not forgotten come Aug. 1

covid-19 americans healthcare vaccines supreme court forgotten centers mclaughlin vaccine mandate mcknight disabilities act medicare medicaid services

Play Episode Listen Later Jul 11, 2023 8:00

While federal regulators are officially revoking a nationwide mandate for healthcare workers, including those in nursing homes, to be vaccinated against COVID-19 on Aug. 1, employers can't drop the ball now. That's the warning from Erin McLaughlin, an attorney and shareholder for Buchanan Ingersoll & Rooney, who specializes in healthcare labor and employment. Overall, McLaughlin sees the shift back to voluntary vaccinations as a plus for nursing homes struggling to hire. But some providers may want to hang onto their own requirements, making the new era of staff vaccination ripe for legal challenges. Changing state rules will certainly complicate providers' efforts in some places. “If you are in a state which would allow you to have a vaccine mandate for your workers, you're still going to have to comply with the requirements, under both the Americans with Disabilities Act and Title 7 as it relates to religious accommodations, which have just been expanded by the Supreme Court,” McLaughlin says in this episode hosted by McKnight's Long-Term Care News Senior Editor Kimberly Marselas. “You will have to continue to have really good processes and procedures in place to deal with potential accommodations,” she adds. The Centers for Medicare & Medicaid Services has also promised to maintain strong data tracking to understand trends in cases and protection for both residents and staff. McLaughlin offers tips on remaining vigilant as both an employer and a caregiving organization.

CMS Health Equity Conference Recap

McDermott+Consulting

Play Episode Listen Later Jun 15, 2023 15:03

Kayla Holgash joins the Breakroom to discuss her time at the Centers for Medicare & Medicaid Services' inaugural Health Equity Conference, and explores what's being done to advance equity in healthcare and why it's such an important initiative.

conference centers health equity breakroom medicare medicaid services

Accessible Housing Through Medicaid? How California's CalAim Program Has the Potential to Change the Way We Think about Health Care Benefits

Accessible Housing Matters

Play Episode Listen Later May 22, 2023 29:54

Are you looking for a game-changer in healthcare and housing support? In this episode, Jacey Cooper – the California State Medicaid Director – talks about the changes being made to Medicaid in California to provide a broader range of services related to housing and accessibility. From providing community supports such as medically supportive housing and home modifications to recuperative care and rental assistance, she explains how these services are designed to help those in need remain safely housed. Hear how the CalAim initiative has successfully changed the trajectory of people's lives and how it can be cost-effective for states to advocate for similar initiatives. Tune in now! Ms. Cooper is responsible for the overall leadership of Benefits, Eligibility, Delivery Systems, Financing, Behavioral Health, Quality, Population Health, and Legislative and Governmental Affairs. As State Medicaid Director, Ms. Cooper represents California's Medicaid program (Medi-Cal) with federal partners at the Centers for Medicare & Medicaid Services. [00:01 - 07:39] Opening Segment • How Medicaid in California is changing regarding services being offered to consumers Housing, medically supportive services, home modifications, and social needs • How to support individuals experiencing homelessness or whose homes are not meeting their needs Recuperative care, short-term post-hospitalization housing, and enhanced care management [07:40 - 14:42] How Enhanced Care Management Can Help Those Experiencing Homelessness • Housing bundle, sustaining services, and recuperative care • The short-term post-hospitalization housing • Programs in the community or home for life skills, budgeting, cooking, cleaning, interpersonal relationships • Coordination across several people is needed for enhanced care coordination [14:43 - 21:56] California's Enhanced Care Coordination Program • Asking managed care plans to pay for something they know little about has been a monumental task • The role of counties, public hospital systems, safety net providers, and community-based organizations • Biggest challenge so far is the admin burden of different authorization forms and processes How is the team recognizing this quickly and working to streamline it? [21:57 - 29:53] Closing Segment • California's CalAim program aims to improve healthcare access and lower costs • The goal is to provide full-blown benefits, not just in lieu of services • Why Medicaid has a role to play in providing non-traditional supports Head to California Health Care Foundation and get the health care you need! Key Quotes: “We want people to be able to live in the community, live in their home, or an assisted living environment that allows them to receive the medical services that they need.” - Jacey Cooper “We're trying to build a true continuum of care and services and supports for someone experiencing homelessness to be able to heal and improve their health outcomes ultimately.” - Jacey Cooper Please check out videos of many of the podcast episodes on my YouTube channel: Accessible Housing Matters, To learn more, share feedback, or share guest ideas, please visit my website, or contact me on Facebook and Twitter. Like what you've heard? Please review us! That helps let other people know about the podcast. Accessible Housing Matters is dedicated to raising awareness about important issues around accessibility and housing and getting conversations going. I'd love to learn more about what's on your mind and get your feedback about the show. Contact me directly at stephen@accessiblehousingmatters.com to share your thoughts or arrange a call.

McKnight's Home Care, Newsmakers: Denial rates rising thanks to home health cuts, Dombi, Cunningham say

healthcare partnership rising national association rates denial cuts centers cunningham long term care home care mcknight senior living home health newsmakers medicare medicaid services

Play Episode Listen Later May 11, 2023 18:10

The 3.925% payment cut that went into effect in January has had a serious impact on home health providers and the healthcare system. In anticipation of the proposed home health rule, which is due out this summer, National Association for Home Care & Hospice President William Dombi and Partnership for Quality Home Healthcare CEO Joanne Cunningham asked the Centers for Medicare & Medicaid Services to implement a one-time forecast error correction related to market basket shortfalls in 2021 and 2022. www.mcknightshomecare.comFollow us on social media:Twitter: @McKHomeCareFacebook: McKnight's Home CareLinkedIn: McKnight's Home CareInstagram: mcknights_homecare

EP403: The Mix & Match With the How Doctors Get Paid, With Rachel Reid, MD, MS

Play Episode Listen Later May 4, 2023 32:37

This is a conversation about physician compensation, which is often oddly misaligned from the way that the whole physician or provider organization is getting paid. Now, first thing to point out: There are lots of different kinds of physicians doing all kinds of different things. As with most everything in healthcare, lumping everybody together and making general proclamations about what is best is a really cruddy idea. With that disclaimer, if you think about the main models of physician compensation, there are two; and this is oversimplified, but let's call one fee for service (FFS), which is really getting paid for generating RVUs (relative value units)—in short, getting paid for volume. The more you do (especially the more expensive things you do), the more you get paid. And then we have getting some kind of capitation payment. A capitated payment is some kind of per member per month-ish flat payment to ideally keep patients healthy, and you will make the most money if you can figure out how to have the least volume of expensive stuff. As an individual doc getting a salary to care for a patient panel of a certain size, let's just consider commensurate with that. These incentive models obviously have a big impact on any given doctor's ability to get paid to do things that they think they should be doing. For example, the current fee-for-service RVU fee schedule frequently rewards those doing the stuff a lot of specialists do much more than those doing primarily cognitive work, including those doing work for patients who aren't sitting in the exam room at the time—like a PCP arranging for a patient to go to hospice or answering patient portal questions. In my opinion, the goal here should be to pay docs and others fairly for providing high-value care. These payments also should actually be proven to actually incent that high-value care. Here's the obvious problem: Neither of these two things, either the quantifiable definition of high-value care and/or the best way to pay for it, has any kind of canon. There are no rules which are considered to be particularly authoritative and definitive here, really. So, what is the downside of not aligning physician compensation models to what good looks like, meaning to the kind of care that patients really need in that particular community? A couple of downsides for you: One is moral injury. Not the only reason, but a reason for moral injury is getting paid in misalignment with what is best for patients. That sucks. You want to help your patients as best you can, and then you can't earn a living and/or you get in trouble with the boss if you do what you think is right. This can cause real mental anguish for especially PCPs but also others who see the need to do anything that doesn't have a billing code. Here's another downside to not worrying about physician compensation, and it's for plan sponsors (employers, maybe) who are trying to get integrated care or a medical home for their employees. I was talking to Katy Talento about this. She was telling me that in ASO (administrative services only) contracts, there are often line items for value-based care and for capitated payments. So, good news? Well, let's follow the dollar here, because we wind up with a disconnect that doesn't help patients but certainly can earn a nice little kitty for those who can get away with it. Here's where that dollar goes: This VBC (value-based care) or capitated payment kitty may go to a health system that the ASO says is to be a medical home for employees or plan members. But the PCPs mainly who are treating members in those medical homes are getting paid, it often turns out, fee for service with maybe some quality kickers. So, the plan is paying a value-based care payment, but the PCPs are getting paid FFS. Is anyone shocked when the members report that they don't actually feel like they are getting integrated care, that they are getting rushed in and out because maximizing throughput becomes a thing when you're getting paid for volume? Dan O'Neill also talks about this at length in episode 359, because IPAs (independent physician associations) are doing kinda the same thing. Getting so-called value-based care contracts with MA (Medicare Advantage) plans or CMS or employer groups, I'd imagine, and then paying all the individual practices or the solo practitioners fee for service and scooping up the excess payments themselves, most docs manage to provide high-enough-quality care that the contract holder can scoop up the profit off the capitation without actually having to share the capitation to achieve this high-enough-quality care. In this healthcare podcast, I am digging into all of this physician compensation ballyhoo with Rachel Reid, MD, MS. She was an author on a study at the Center of Excellence on Health System Performance at RAND. This study specifically set out to look at how health systems and provider organizations (POs) affiliated with those health systems incentivize and compensate the physicians who work there. Short version: Yeah, it's confirmed. Most docs are paid using the classic RVU productivity measures representing a big chunk of their compensation, even PCPs. There's frequently some kickers or extra payments to achieve some kind of quality metric, but this is the icing, not the cake. The cake is still very fee for service-y. This is true regardless of how the physician organizations, the provider organizations themselves are getting paid by payers. I asked Dr. Rachel Reid a bunch of questions about this, but one of them was (this seems weird, a weird misalignment), Why is this happening? And Dr. Reid listed out five reasons beyond the macro existential question of what is value and do we even know how to change human behavior to get it. 1. The payment is not big enough from the payer for the physician organization to go through all the time and trouble and risk frankly of changing the whole comp model. 2. The value-based payment arrangements that do exist at the organizational level often have a fee-for-service chassis with an icing of quality payments or some kind of value payment on top of it. So, maybe there's actually more alignment than we might think. 3. It's hard to try to change comp models—it's a thing. And there is risk in messing it up. 4. Inertia. The ever-present inertia. 5. We know what we want to move from, but what exactly are we moving to? And this “What do we want to move to?” is going to change for PCPs and for every single different specialty and could even vary by patient population. I then also asked Dr. Reid what could be done by plan sponsors, for example, to pay docs in alignment with the goals of the contract; and she said, write physician comp expectations into the contract. Something to think about. We dig into all of this today. Shows that you should, for sure, listen to for additional insights include the one with Dan O'Neill (EP359) as aforementioned. Also the show with Brian Klepper, PhD (AEE16), where we dig into how the RUC is behind some of these FFS rates. Also episode 391 with Scott Conard, MD. My guest today is Rachel Reid, MD, MS. She is a physician policy researcher at RAND Corporation and a primary care physician at Brigham and Women's Hospital. You can learn more about Dr. Reid, her publications, and the work she has done on the RAND Web site. Rachel Reid, MD, MS, is a physician policy researcher at the RAND Corporation. Also a practicing primary care physician, her research focuses on measuring cost, quality, and value in healthcare. She has particular interest in the primary care delivery system, physician payment and compensation, and delivery and payment system reform. Dr. Reid has been engaged in the RAND Center of Excellence on Health System Performance, assessing health systems' compensation and incentives for physicians, leading work related to assessing low-value healthcare delivery, and measuring primary care spending. She is the principal investigator on an NIH-funded grant assessing novel Medicare billing codes for transitional care provided after hospital discharge. Prior to joining RAND, Dr. Reid worked in the Research and Rapid Cycle Evaluation Group at the Centers for Medicare & Medicaid Services' Innovation Center. Her clinical work has included ambulatory primary care and hospital-based internal medicine. She is an associate physician at Brigham and Women's Hospital and an instructor in medicine at Harvard Medical School. Dr. Reid received her AB in biochemical sciences from Harvard University and her MD and MS in clinical research from the University of Pittsburgh School of Medicine. 07:13 What did Dr. Reid's recent study show about how doctors are currently being paid and incentivized? 08:11 Why Dr. Reid decided to do the study in the first place. 09:49 What are the main foundations of what doctors are paid on? 10:31 Why is value-based compensation still just the “icing” on the cake? 13:08 What is the biggest value add for doctors, and does it vary between specialties? 14:32 Why wouldn't a physician organization change their comp models? 19:55 Are we at a moment of evolution? 20:20 “Tying dollars to measured quality gaps doesn't necessarily produce results.” 20:42 EP295 with Rebecca Etz, PhD. 22:04 “I don't think there's a current gold standard for how to pay doctors.” 25:37 Job one: What are we trying to incent? 31:28 From the payer or insurer perspective, what's the leverage they have to change doctor compensation? You can learn more about Dr. Reid, her publications, and the work she has done on the RAND Web site. Rachel Reid, MD, MS, of @RANDCorporation discusses on our #healthcarepodcast how doctors get paid. #healthcare #podcast Recent past interviews: Click a guest's name for their latest RHV episode! Dr Amy Scanlan, Peter J. Neumann, Stacey Richter (EP400), Dawn Cornelis (Encore! EP285), Stacey Richter (EP399), Dr Jacob Asher, Paul Holmes, Anna Hyde, Dea Belazi (Encore! EP293), Brennan Bilberry

Inflation Reduction Act's Drug Price Negotiation Provisions – What's Next?

Mobility Management Podcast

Play Episode Listen Later May 4, 2023 39:12

The Inflation Reduction Act (IRA), signed into law in August 2022, included significant and controversial drug-pricing provisions. What key compliance issues must industry stakeholders consider as these provisions are put into effect? On this episode, Epstein Becker Green attorneys Leslie Norwalk, Connie Wilkinson, and Alexis Boaz discuss key considerations for the health care and life sciences industry as the Centers for Medicare & Medicaid Services works its way through the initial stages of implementation of the Medicare Drug Price Negotiation Program and the Medicare Prescription Drug Inflation Rebate Program under the IRA. Visit our site for related resources and email contact information: https://www.ebglaw.com/dhc64. Subscribe for email notifications: https://www.ebglaw.com/subscribe. Visit: http://diagnosinghealthcare.com. This podcast is presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.

NCART Update: After Seat Elevation, What's Next?

Play Episode Listen Later Mar 31, 2023 28:18

A landmark proposed decision on Medicare funding for seat elevation should be very encouraging to Complex Rehab Technology (CRT) stakeholders, but several other CRT issues are also demanding attention. In this first podcast of the year with NCART Executive Director Wayne Grau and Associate Director Mickae Lee, Mobility Management Editor Laurie Watanabe asks about power standing (the Centers for Medicare & Medicaid Services has not yet responded to the industry's request for Medicare coverage consideration), the expansion of right-to-repair laws, and what else the industry can expect for 2023.

seat medicare centers crt elevation wheelchairs seating medicare medicaid services complex rehab technology

PBI Signatory Showcase featuring Robins Kaplan

Pro Bono Happy Hour

Play Episode Listen Later Mar 29, 2023 13:26

Robins Kaplan Pro Bono and Indigenous People In a pro bono case that has drawn national attention, Robins Kaplan sued the federal government on behalf of the Rosebud Sioux Tribe after the Centers for Medicare & Medicaid Services closed the only emergency room on the Rosebud Reservation. On behalf of the Tribe, Robins Kaplan attorneys argued that the closure of the emergency room violated the federal government's treaty duty to provide the Tribe with adequate health care services. We spoke with Robins Kaplan Partner, Tim Billion, for this special edition of the Pro Bono Happy Hour Podcast. Listen to how Robins Kaplan got involved, and how they won the case for the Rosebud Sioux Tribe.

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The End of the Public Health Emergency – What's to Come?

Speak English Now Podcast: Learn English | Speak English without grammar.

Play Episode Listen Later Mar 16, 2023 32:44

In conjunction with the national COVID-19 public health emergency (PHE), the Centers for Medicare & Medicaid Services and other federal agencies have issued waivers and other declarations with the goal of giving providers flexibility in order to render services during the PHE. How should stakeholders prepare for the end of the PHE on May 11, 2023? On this episode, Epstein Becker Green attorneys Amy Lerman, Jenny Nelson Carney, and Dan Fahey discuss the expiration of the PHE and the impact it will have on health care providers and organizations. Recorded on February 22, 2023, just prior to the release of the Drug Enforcement Administration's proposed rules. Visit our site for related resources and email contact information: https://www.ebglaw.com/dhc60. Subscribe for email notifications: https://www.ebglaw.com/subscribe. Visit: http://diagnosinghealthcare.com. The EMPLOYMENT LAW THIS WEEK® and DIAGNOSING HEALTH CARE podcasts are presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.

covid-19 healthcare public health medicare centers medicaid health services public health emergency drug enforcement administration health law phe medicare medicaid services medical law epstein becker green ebg amy lerman

#241 The Public Healthcare System in The U.S.

Play Episode Listen Later Feb 16, 2023 10:15

Transcript: Are you curious about how the healthcare system works in the U.S.? In this episode, I will explain the basics of the American healthcare system. There is not one universal system, but a range of public and private insurance options. I will lay out how these plans work so that you can gain a better understanding. And yes. Contrary to what some people assume, public health care exists in the USA. There are several public systems, both federal and state. All Americans must have health insurance or face a federal offense. Therefore, everyone should be properly insured. If someone is unemployed, they may be eligible for federal or state public insurance programs to help them access the necessary health care services. Let's find out more about public health in the U.S. In 1965, the federal government created Medicare and Medicaid, which provided health coverage to the elders and the poorest segments of the population. What are Medicare and Medicaid? Medicare is a federal health insurance program primarily available to people 65 or older, certain younger people with disabilities, or people with End-Stage Renal Disease. Medicaid offers health insurance to countless Americans, such as eligible low-income adults, children, pregnant women, senior citizens, and people with disabilities. States must follow federal rules while running the program, which is funded by both state and federal money. Other programs, such as the Children's Health Insurance Program (CHIP), is a federal-state partnership program administered by the Centers for Medicare & Medicaid Services. Children's Health Insurance Program provides health insurance coverage to low-income children and pregnant women who do not qualify for Medicaid but cannot afford private health insurance. I hope you found this episode interesting. In the next one, I will continue talking about healthcare in the U.S. [END OF THE EXTRACT] Get the transcript here: SpeakEnglishPodcast.com/podcast

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Encore! EP326: The Unfortunate News About HRRP, With Insight Into How to Fix It, With Rishi Wadhera, MD, MPP

Play Episode Listen Later Dec 29, 2022 34:18

HRRP stands for Hospital Readmissions Reduction Program, by the way. I wanted to encore this episode with Dr. Rishi Wadhera because it's a great representation of a common root cause reason why quality metrics sometimes don't end well in real life. This root cause is otherwise known as Goodhart's Law, and we dig into Goodhart's law later on in this healthcare podcast. But the actual and ultimate impact of HRRP is also a pretty good representation of the consequences, what happens, when you create a blunt-force policy that assumes hospitals with very different circumstances are the same. Before we kick in to the episode, I asked Dr. Wadhera, my guest today as aforementioned, if there'd been any updates regarding HRRP since this show originally aired last year; and he told me that two key pieces have come out this past month in JAMA journals calling out CMS (Centers for Medicare & Medicaid Services) to move on from/retire this policy: A Decade of Observing the Hospital Readmission Reductions Program—Time to Retire an Ineffective Policy Readmission Reduction as a Hospital Quality Measure: Time to Move on to More Pressing Concerns? Thanks so much to Dr. Steve Schutzer and also BoneDoc66 for your really nice reviews this past month. So appreciated … thank you so much! And here is your encore. Today's guest is Rishi Wadhera, MD, MPP. Dr. Wadhera authored a retrospective analysis in the BMJ about the HRRP, which we will talk about in this healthcare podcast. Dr. Wadhera is a cardiologist at Beth Israel Deaconess Medical Center. He also has a master's in public policy at the Harvard Kennedy School of Government and also a master's in public health from the University of Cambridge. But here's the larger epiphany that pertains to all value-based care and all quality metrics which Dr. Wadhera brings up in this healthcare podcast and which my nerd heart could not love more: Goodhart's Law. This law is the root of so very many problems. Goodhart's Law is this (which I learned from Dr. Wadhera): “When a measure becomes a target, it ceases to be a good measure.” In other words, when we set a goal, people will try to take a shortcut to the goal, regardless of the consequences. And sometimes the consequences, paradoxically, are to do worse at the goal. Maybe because bean counters and admins and maybe even goal-oriented clinicians themselves will go right to the end goal, inadvertently skipping a whole bunch of (it turns out) rate-critical steps. For example, teaching to the test may not lead to students who deeply understand a subject. And anyone trying to achieve value-based care success, improve quality, form collaborations, or make sales might want to remember that old proverb, “Sometimes the shortest way home is the long way around.” You can learn more at Dr. Wadhera's Harvard Catalyst profile and the Beth Israel Deaconess Medical Center Web site. Rishi K. Wadhera, MD, MPP, MPhil, is an assistant professor of medicine at Harvard Medical School, a cardiologist at Beth Israel Deaconess Medical Center (BIDMC), and the associate program director of the cardiovascular medicine fellowship at BIDMC. He is also health policy and equity researcher at the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology. Dr. Wadhera received his MD from the Mayo Clinic School of Medicine as well as an MPhil in public health as a Gates Cambridge Scholar from the University of Cambridge. He completed his internal medicine residency and cardiovascular medicine fellowship at Brigham and Women's Hospital in Boston. During this time, he also received a master's in public policy (MPP) at the Harvard Kennedy School of Government, with a focus on health policy. Dr. Wadhera's research spans questions related to healthcare access, quality, and disparities, as well as understanding how local, state, and national policy initiatives impact care delivery, health equity, and outcomes. Dr. Wadhera has published more than 80 articles to date, and he receives research support from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institutes of Health (NIH) 03:30 What was the Hospital Readmissions Reduction Program intended to do? 05:22 Why did the Centers for Medicare & Medicaid (CMS) think some readmissions were preventable? 06:02 “The spirit of the Hospital Readmissions Reduction Program was to incentivize hospitals to improve … discharge planning, transitions of care, and post-discharge follow-up and care.” 06:58 How has research in the last few years changed the thoughts on the effectiveness of the Hospital Readmissions Reduction Program? 08:16 “The 30-day readmission measure—it's an incomplete measure.” 11:48 “I think patients … are smart, and they know what's going on.” 13:34 “What's happening is, we're just increasing the number of times they need to come back to the ER within that 30-day period.” 13:55 “The weird thing about the HRRP is that when it evaluates hospitals' 30-day readmission rates, it's a yes-no phenomenon.” 15:03 “What CMS does is, it risk adjusts … and that is what we should be doing.” 18:30 “This program has been incredibly regressive.” 19:04 “Poverty, neighborhood disadvantage, housing instability—these factors are out of hospitals' control.” 21:50 “Blunt policies like this that are rolled out nationally probably elicit mixed behavioral responses.” 22:06 “It just makes no sense to take resources away from hospitals.” 22:32 EP295 with Rebecca Etz, PhD. 23:47 What's the way to improve quality of care globally? 25:37 “CMS's approach to improving quality of care has really anchored … [that] to payment.” 26:08 “It's time for us to rethink what our approach to quality improvement should be.” 29:22 “Policy makers have an obligation to rigorously test the impact of these types of policies before they roll them out nationally.” 31:41 Can you scale healthcare nationally? You can learn more at Dr. Wadhera's Harvard Catalyst profile and the Beth Israel Deaconess Medical Center Web site. @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission What was the Hospital Readmissions Reduction Program intended to do? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission Why did CMS think some readmissions were preventable? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “The spirit of the Hospital Readmissions Reduction Program was to incentivize hospitals to improve … discharge planning, transitions of care, and post-discharge follow-up and care.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission How has research in the last few years changed the thoughts on the effectiveness of the Hospital Readmissions Reduction Program? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “The 30-day readmission measure—it's an incomplete measure.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “What CMS does is, it risk adjusts … and that is what we should be doing.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “Blunt policies like this that are rolled out nationally probably elicit mixed behavioral responses.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “It just makes no sense to take resources away from hospitals.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission What's the way to improve quality of care globally? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “It's time for us to rethink what our approach to quality improvement should be.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission Can you scale healthcare nationally? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission Recent past interviews: Click a guest's name for their latest RHV episode! Ge Bai (Encore! EP356), Dave Dierk and Stacey Richter (INBW37), Merrill Goozner, Betsy Seals (EP387), Stacey Richter (INBW36), Dr Eric Bricker (Encore! EP351), Al Lewis, Dan Mendelson, Wendell Potter, Nick Stefanizzi, Brian Klepper (Encore! EP335), Dr Aaron Mitchell (EP382), Karen Root, Mark Miller, AJ Loiacono, Josh LaRosa, Stacey Richter (INBW35), Rebecca Etz (Encore! EP295), Olivia Webb (Encore! EP337), Mike Baldzicki, Lisa Bari, Betsy Seals (EP375), Dave Chase, Cora Opsahl (EP373), Cora Opsahl (EP372), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371), Erik Davis and Autumn Yongchu (EP370)

women university israel law phd government er medicine hospitals md policy decade cambridge poverty centers national institutes retire harvard medical school observing cms lung blunt unfortunate jama cardiology brigham harvard kennedy school rishi mpp mark miller bmj health nih mphil beth israel deaconess medical center goodhart erik davis national heart outcomes research rishi k al lewis medicare medicaid services readmission wendell potter dave chase bidmc mayo clinic school gates cambridge scholar blood institute nhlbi cms centers

High Country - December 21, 2022 - Government and Politics News from the American West

Heartland POD

Play Episode Listen Later Dec 21, 2022 10:22

Song playsIntro by hostWelcome to High Country - politics in the American West. My name is Sean Diller; regular listeners might know me from Heartland Pod's Talking Politics, every Monday.Go to heartlandpod.com for information on all our political podcasts, and a link to support our work on Patreon. Sign up as an Official PODhead for just $5 per month to access all our premium podcast segments and political writing. To join the conversation on Twitter, find us at THE Heartland POD. Alright! Let's get into it: NEVADA CURRENT: Water managers across drought-stricken West agree on one thing: ‘This is going to be painful'BY JENIFFER SOLIS - MONDAY DECEMBER 19, 2022 5:25 AMWater authorities in the Western U.S. don't have a crystal ball, but rapidly receding reservoirs uncovering sunken boats and other debris lost in their depths decades ago give a clear view of the hard choices ahead.If western states do not agree on a plan to safeguard the Colorado River — the source of the region's vitality — there won't be enough water for anyone.Water managers, researchers, agricultural producers and others from across the drought-stricken river basin met in Las Vegas last week for the Colorado River Water Users Association annual convention to face hard truths about the state of the river and historically-low levels of its biggest reservoirs.Two decades of drought and poor planning have caused the river's biggest reservoirs — Lake Mead and Lake Powell — to drop to their lowest collective volume since they were filled. Rebecca Mitchell, director of the Colorado Water Conservation Board said “Time is not on our side. Hydrology is not on our side. That's the frightening reality Every day that passes this problem gets harder and harder to solve.”The water could drop below what's needed to generate power as soon as next year, according to water experts. If nothing is done there is a real possibility water levels in both reservoirs will drop so low in the next two years that water will no longer flow downstream to the 40 million people in the West who rely on the Colorado River.To put it in perspective, this winter both reservoirs were about a quarter full - 25%. In December 1999, Lake Powell was at 88% capacity, and Lake Mead was at 96% capacity. In 2021, Lower basin states faced their first-ever federally declared water shortage, which directs how much water states can draw from the Colorado River. Deeper cuts were declared this year.Ted Cooke, the general manager for the Central Arizona Project.In June, Bureau of Reclamation Commissioner Camille Touton issued an ultimatum to states: Develop a plan to save 2 million to 4 million acre-feet of water by next year — roughly one-fifth of their currently allocations—or the federal government will step in.During a panel discussion at last week's convention in Las Vegas, representatives for the seven western states who rely on the Colorado River said reaching a compromise will be their collective priority for the next six months.They agree that the longer it takes to stabilize the river and conserve the water needed to keep the river functional, the more likely reservoir levels will continue to plummet, leaving states with fewer and fewer options.Just last week, all of Southern California was declared to be in a drought emergency by the Metropolitan Water District, the main water supplier for Los Angeles county.Officials for the U.S. Bureau of Reclamation warned that aridification, the long-term shift to a drier climate, means even less snow runoff is making it to the river each year.Currently, there is nearly $4 billion set aside for the Colorado River that would allow the Bureau of Reclamation to use some funds to pay users to voluntarily forgo water use.“We have to accept that we can not cling to our entitlements or allocations. If they are not there none of it matters,” Mitchell continued. “Folks in the room have to be willing to let us make hard decisions, because this is going to be painful.” Becky Mitchell Colorado Water Conservation BoardSOURCE NM:New Mexico's HSD proposes medication-assisted treatment for incarcerated peopleBY: AUSTIN FISHER - DECEMBER 19, 2022 4:35 AMBeginning in 2024, New Mexico's Medicaid program could start providing medication-assisted treatment to incarcerated people 30 days before they are released, along with a 30-day supply of medication when they leave. The hope is that this will be a step toward reducing the harms of criminalizing substance use disorder, and producing better outcomes.In a 275-page application to the U.S. Centers for Medicare & Medicaid Services by the New Mexico Human Services Department published Friday, HSD says it hopes to ensure formerly incarcerated people stay on their medication after release, and don't commit more crimes, end up in an emergency room or unhoused.At any given time in New Mexico, more than 14,000 people are held in state, local or youth correctional facilities, and nearly 50,000 people churn through local jails in the state each year. according to a lawsuit filed Thursday by ACLU-NM and Disability Rights New Mexico, New Mexico's prison system forces people who are on medication for opioid use disorder, to withdraw from it when they enter prison.The lawsuit cites research showing that someone leaving incarceration is nearly 13 times more likely than the general population to die of an overdose in the first two weeks after their release.HSD wants to get people who are being held in jail before a trial, or who are imprisoned post-conviction, on Medicaid so they can get medication-assisted treatment while inside state prisons, local jails, youth correctional facilities, tribal holding facilities, tribal jails and at the New Mexico Behavioral Health Institute.The department plans to focus on incarcerated people with serious mental health conditions, severe emotional disturbance, substance use disorder, or an intellectual or developmental disability. It estimates 7,500 people per year could benefit.COLORADO SUN:The biggest election 2022 spender in Colorado? Jared Polis — by a long shot.Sandra Fish3:41 AM MST on Dec 15, 2022Democratic Gov. Jared Polis spent $12.6 million of his own money on his successful reelection bid this year, more than any other state-level candidate. May sound like a lot,Polis' 2022 spending, however, didn't come close to the more than $23 million of his own wealth spent in 2018 to win his first gubernatorial campaign. After Gov Polis, the No. 2 state-level political spender in Colorado this year was Total Wine & More at $12 million. That money went toward supporting Proposition 124, an unsuccessful ballot measure that would have let the retail giant open more liquor stores in Colorado.A few more highlights from the final campaign finance reports: Democratic candidates dominated spending on state-level statewide contestsThe Polis campaign spent more than three times the $3.7 million spent by his Republican opponent, who lost by more than 19 percentage points.Polis spent $9 per vote cast in his favor in the general election, less than the $9.72 per vote he spent in the 2018 general election and far less than the nearly $40 per vote he spent winning a four-way primary that year.The Democratic Attorneys General Association's state super PAC spent $2.9 million supporting Phil Weiser against his GOP challenger, John Kellner. In the costliest state Senate contest, Jefferson County-based Senate District 20, Republican developer Tim Walsh loaned his campaign more than $1 million in his loss to Democratic state Rep. Lisa Cutter, who spent just $262,000.Democratic super PACs also outspent their Republican counterparts on state legislative races: All Together Colorado spent more than $11 million helping elect Democratic state Senate candidates, compared with the $8.5 million spent by Senate Majority Fund, which supported Republicans.Natural Medicine Colorado spent $4.46 per vote on Proposition 122, which legalized psilocybin mushrooms and was approved by nearly 54% of voters. Nearly $4.4 million of the total $5.8 million that was spent came from the national nonprofit New Approach and its federal PAC.Healthy School Meals For All Colorado Students spent $1.32 per vote in successfully passing Proposition GG, which eliminated a tax break for wealthy Coloradans so that schools can provide free meals to all students. Numerous nonprofits accounted for the committee's $1.8 million in spending.COLORADO NEWSLINE: Mayor Hancock works to address influx of migrantsBY: LINDSEY TOOMER - DECEMBER 15, 2022 3:37 PMDenver Mayor Michael Hancock has issued an emergency declaration so the city can more easily free up resources to support the ongoing influx of migrants into the city - having already spent upwards of $800,000 in city funds on the efforts.At a news conference at the city's Emergency Operations Center Thursday, Hancock said about 700 unhoused migrants had arrived in recent weeks. And he isn't sure how many more the city can expect. The original emergency shelter the city set up at a recreation center hit capacity with 275 people, leading to two more recreation centers being pulled into the effort.Hancock said at the news conference. “This influx of migrants, the unanticipated nature of their arrival, and our current space and staffing challenges have put an immense strain on city resources, to the level where they're on the verge of reaching a breaking point. What I don't want to see is a local humanitarian crisis of unsheltered migrants on our hands because of the lack of resources.”Mayor Hancock noted that most of the people seem to be coming through El Paso, Texas, and while the city has seen groups of migrants arriving for several months, only recently have they started arriving at the current volume and without notice. City officials say the migrants come from Central and South America, including Venezuela. Employees from multiple city agencies are being pulled from their regular duties and “working around the clock” to support them as they arrive, Hancock said. The city is most desperate for support when it comes to shelter space and staffing. Hancock asked that anyone who might have space that can serve as a shelter, or who can volunteer to help, reach out to the city's Emergency Operations Center at donations@denvergov.org. He thanked the many city staff, volunteers, nonprofit and faith organizations that have already stepped up to support the city's sheltering and reunification efforts. Hancock also thanked the hundreds of Denver residents who have donated clothing and supplies and asked for their continued patience as the city works through the situation. He said he has been in direct contact with Gov. Jared Polis as well as members of Colorado's federal Congressional delegation to help identify additional resources to help.Mayor Hancock also said, “We are committed to doing what we can for the migrants and the asylum seekers who have come here. But here in Denver and cities all over this country are once again having to respond because of the failure of our Congress and federal government to address a very critical situation … I'm not trying to sound political, but I'm trying to sound pragmatic and practical. This is going to continue to happen, continue to overwhelm cities all over this country until Congress works on fixing the situation.”Denver first opened an emergency shelter at an undisclosed recreation center on Dec. 6. There's an ongoing need for donations and local faith-based groups and nonprofits are continuing to assist the city with its efforts to support the migrants. The city has established a drop-off location for physical donations at Iglesia Ciudad de Dios located at 5255 W Warren Ave. in Denver. Donations are being accepted on Tuesdays and Wednesdays between 4 p.m. and 7 p.m.The city released a list of needed items, and noted that the list could change based on supply and demand:Coats (men's S and M, women's M) Pants (waist 30-33) SocksUnderwearWinter apparel (hats, gloves, scarves, boots)Children's clothing for ages 10 and younger Overall, the city said there is a high demand for new clothing for adults sizes small through large, with a special need for medium-sized clothing and winter weather clothing.The city is also asking local faith-based groups, non-profits and private sector partners to reach out if they are able to support its efforts by contacting the Emergency Operations Center at donations@denvergov.org.CONCERT PICK OF THE WEEK: The Roots, with support from Big KRIT: Tuesday December 27 at Denver's Mission Ballroom. GA tickets are $60 and available at axs.com. The Roots then play San Francisco on Thursday December 29, and Los Angeles on New Year's Eve. In 2023, their only U.S. show is in Chicago, March 18. Welp, that's it for me! From Denver I'm Sean Diller. Original reporting for the stories in today's show comes from the Colorado Sun, 9NEWS Denver, Nevada Current, Colorado Newsline, Source NM, and Denver's Westword.Thank you for listening! See you next time.

time new year texas children chicago los angeles las vegas water san francisco west colorado congress original employees republicans southern california ga roots develop senate new mexico venezuela south america dios democratic lower deeper pac donations folks bureau gop centers gov congressional el paso drought medicaid officials aclu welp numerous hancock proposition new approach american west opioid crisis polis coats reclamation colorado river substance use disorders pacs migrant crisis jefferson county talking politics lake mead senate district high country coloradans lake powell water shortages jared polis hydrology drug policy alliance westword colorado river basin medicare medicaid services tim walsh hsd colorado sun government and politics emergency operations center metropolitan water district phil weiser colorado politics mayor hancock rebecca mitchell john kellner

High Country - December 21, 2022 - Government and Politics News from the American West

The Heartland POD

Play Episode Listen Later Dec 21, 2022 10:22

Song playsIntro by hostWelcome to High Country - politics in the American West. My name is Sean Diller; regular listeners might know me from Heartland Pod's Talking Politics, every Monday.Go to heartlandpod.com for information on all our political podcasts, and a link to support our work on Patreon. Sign up as an Official PODhead for just $5 per month to access all our premium podcast segments and political writing. To join the conversation on Twitter, find us at THE Heartland POD. Alright! Let's get into it: NEVADA CURRENT: Water managers across drought-stricken West agree on one thing: ‘This is going to be painful'BY JENIFFER SOLIS - MONDAY DECEMBER 19, 2022 5:25 AMWater authorities in the Western U.S. don't have a crystal ball, but rapidly receding reservoirs uncovering sunken boats and other debris lost in their depths decades ago give a clear view of the hard choices ahead.If western states do not agree on a plan to safeguard the Colorado River — the source of the region's vitality — there won't be enough water for anyone.Water managers, researchers, agricultural producers and others from across the drought-stricken river basin met in Las Vegas last week for the Colorado River Water Users Association annual convention to face hard truths about the state of the river and historically-low levels of its biggest reservoirs.Two decades of drought and poor planning have caused the river's biggest reservoirs — Lake Mead and Lake Powell — to drop to their lowest collective volume since they were filled. Rebecca Mitchell, director of the Colorado Water Conservation Board said “Time is not on our side. Hydrology is not on our side. That's the frightening reality Every day that passes this problem gets harder and harder to solve.”The water could drop below what's needed to generate power as soon as next year, according to water experts. If nothing is done there is a real possibility water levels in both reservoirs will drop so low in the next two years that water will no longer flow downstream to the 40 million people in the West who rely on the Colorado River.To put it in perspective, this winter both reservoirs were about a quarter full - 25%. In December 1999, Lake Powell was at 88% capacity, and Lake Mead was at 96% capacity. In 2021, Lower basin states faced their first-ever federally declared water shortage, which directs how much water states can draw from the Colorado River. Deeper cuts were declared this year.Ted Cooke, the general manager for the Central Arizona Project.In June, Bureau of Reclamation Commissioner Camille Touton issued an ultimatum to states: Develop a plan to save 2 million to 4 million acre-feet of water by next year — roughly one-fifth of their currently allocations—or the federal government will step in.During a panel discussion at last week's convention in Las Vegas, representatives for the seven western states who rely on the Colorado River said reaching a compromise will be their collective priority for the next six months.They agree that the longer it takes to stabilize the river and conserve the water needed to keep the river functional, the more likely reservoir levels will continue to plummet, leaving states with fewer and fewer options.Just last week, all of Southern California was declared to be in a drought emergency by the Metropolitan Water District, the main water supplier for Los Angeles county.Officials for the U.S. Bureau of Reclamation warned that aridification, the long-term shift to a drier climate, means even less snow runoff is making it to the river each year.Currently, there is nearly $4 billion set aside for the Colorado River that would allow the Bureau of Reclamation to use some funds to pay users to voluntarily forgo water use.“We have to accept that we can not cling to our entitlements or allocations. If they are not there none of it matters,” Mitchell continued. “Folks in the room have to be willing to let us make hard decisions, because this is going to be painful.” Becky Mitchell Colorado Water Conservation BoardSOURCE NM:New Mexico's HSD proposes medication-assisted treatment for incarcerated peopleBY: AUSTIN FISHER - DECEMBER 19, 2022 4:35 AMBeginning in 2024, New Mexico's Medicaid program could start providing medication-assisted treatment to incarcerated people 30 days before they are released, along with a 30-day supply of medication when they leave. The hope is that this will be a step toward reducing the harms of criminalizing substance use disorder, and producing better outcomes.In a 275-page application to the U.S. Centers for Medicare & Medicaid Services by the New Mexico Human Services Department published Friday, HSD says it hopes to ensure formerly incarcerated people stay on their medication after release, and don't commit more crimes, end up in an emergency room or unhoused.At any given time in New Mexico, more than 14,000 people are held in state, local or youth correctional facilities, and nearly 50,000 people churn through local jails in the state each year. according to a lawsuit filed Thursday by ACLU-NM and Disability Rights New Mexico, New Mexico's prison system forces people who are on medication for opioid use disorder, to withdraw from it when they enter prison.The lawsuit cites research showing that someone leaving incarceration is nearly 13 times more likely than the general population to die of an overdose in the first two weeks after their release.HSD wants to get people who are being held in jail before a trial, or who are imprisoned post-conviction, on Medicaid so they can get medication-assisted treatment while inside state prisons, local jails, youth correctional facilities, tribal holding facilities, tribal jails and at the New Mexico Behavioral Health Institute.The department plans to focus on incarcerated people with serious mental health conditions, severe emotional disturbance, substance use disorder, or an intellectual or developmental disability. It estimates 7,500 people per year could benefit.COLORADO SUN:The biggest election 2022 spender in Colorado? Jared Polis — by a long shot.Sandra Fish3:41 AM MST on Dec 15, 2022Democratic Gov. Jared Polis spent $12.6 million of his own money on his successful reelection bid this year, more than any other state-level candidate. May sound like a lot,Polis' 2022 spending, however, didn't come close to the more than $23 million of his own wealth spent in 2018 to win his first gubernatorial campaign. After Gov Polis, the No. 2 state-level political spender in Colorado this year was Total Wine & More at $12 million. That money went toward supporting Proposition 124, an unsuccessful ballot measure that would have let the retail giant open more liquor stores in Colorado.A few more highlights from the final campaign finance reports: Democratic candidates dominated spending on state-level statewide contestsThe Polis campaign spent more than three times the $3.7 million spent by his Republican opponent, who lost by more than 19 percentage points.Polis spent $9 per vote cast in his favor in the general election, less than the $9.72 per vote he spent in the 2018 general election and far less than the nearly $40 per vote he spent winning a four-way primary that year.The Democratic Attorneys General Association's state super PAC spent $2.9 million supporting Phil Weiser against his GOP challenger, John Kellner. In the costliest state Senate contest, Jefferson County-based Senate District 20, Republican developer Tim Walsh loaned his campaign more than $1 million in his loss to Democratic state Rep. Lisa Cutter, who spent just $262,000.Democratic super PACs also outspent their Republican counterparts on state legislative races: All Together Colorado spent more than $11 million helping elect Democratic state Senate candidates, compared with the $8.5 million spent by Senate Majority Fund, which supported Republicans.Natural Medicine Colorado spent $4.46 per vote on Proposition 122, which legalized psilocybin mushrooms and was approved by nearly 54% of voters. Nearly $4.4 million of the total $5.8 million that was spent came from the national nonprofit New Approach and its federal PAC.Healthy School Meals For All Colorado Students spent $1.32 per vote in successfully passing Proposition GG, which eliminated a tax break for wealthy Coloradans so that schools can provide free meals to all students. Numerous nonprofits accounted for the committee's $1.8 million in spending.COLORADO NEWSLINE: Mayor Hancock works to address influx of migrantsBY: LINDSEY TOOMER - DECEMBER 15, 2022 3:37 PMDenver Mayor Michael Hancock has issued an emergency declaration so the city can more easily free up resources to support the ongoing influx of migrants into the city - having already spent upwards of $800,000 in city funds on the efforts.At a news conference at the city's Emergency Operations Center Thursday, Hancock said about 700 unhoused migrants had arrived in recent weeks. And he isn't sure how many more the city can expect. The original emergency shelter the city set up at a recreation center hit capacity with 275 people, leading to two more recreation centers being pulled into the effort.Hancock said at the news conference. “This influx of migrants, the unanticipated nature of their arrival, and our current space and staffing challenges have put an immense strain on city resources, to the level where they're on the verge of reaching a breaking point. What I don't want to see is a local humanitarian crisis of unsheltered migrants on our hands because of the lack of resources.”Mayor Hancock noted that most of the people seem to be coming through El Paso, Texas, and while the city has seen groups of migrants arriving for several months, only recently have they started arriving at the current volume and without notice. City officials say the migrants come from Central and South America, including Venezuela. Employees from multiple city agencies are being pulled from their regular duties and “working around the clock” to support them as they arrive, Hancock said. The city is most desperate for support when it comes to shelter space and staffing. Hancock asked that anyone who might have space that can serve as a shelter, or who can volunteer to help, reach out to the city's Emergency Operations Center at donations@denvergov.org. He thanked the many city staff, volunteers, nonprofit and faith organizations that have already stepped up to support the city's sheltering and reunification efforts. Hancock also thanked the hundreds of Denver residents who have donated clothing and supplies and asked for their continued patience as the city works through the situation. He said he has been in direct contact with Gov. Jared Polis as well as members of Colorado's federal Congressional delegation to help identify additional resources to help.Mayor Hancock also said, “We are committed to doing what we can for the migrants and the asylum seekers who have come here. But here in Denver and cities all over this country are once again having to respond because of the failure of our Congress and federal government to address a very critical situation … I'm not trying to sound political, but I'm trying to sound pragmatic and practical. This is going to continue to happen, continue to overwhelm cities all over this country until Congress works on fixing the situation.”Denver first opened an emergency shelter at an undisclosed recreation center on Dec. 6. There's an ongoing need for donations and local faith-based groups and nonprofits are continuing to assist the city with its efforts to support the migrants. The city has established a drop-off location for physical donations at Iglesia Ciudad de Dios located at 5255 W Warren Ave. in Denver. Donations are being accepted on Tuesdays and Wednesdays between 4 p.m. and 7 p.m.The city released a list of needed items, and noted that the list could change based on supply and demand:Coats (men's S and M, women's M) Pants (waist 30-33) SocksUnderwearWinter apparel (hats, gloves, scarves, boots)Children's clothing for ages 10 and younger Overall, the city said there is a high demand for new clothing for adults sizes small through large, with a special need for medium-sized clothing and winter weather clothing.The city is also asking local faith-based groups, non-profits and private sector partners to reach out if they are able to support its efforts by contacting the Emergency Operations Center at donations@denvergov.org.CONCERT PICK OF THE WEEK: The Roots, with support from Big KRIT: Tuesday December 27 at Denver's Mission Ballroom. GA tickets are $60 and available at axs.com. The Roots then play San Francisco on Thursday December 29, and Los Angeles on New Year's Eve. In 2023, their only U.S. show is in Chicago, March 18. Welp, that's it for me! From Denver I'm Sean Diller. Original reporting for the stories in today's show comes from the Colorado Sun, 9NEWS Denver, Nevada Current, Colorado Newsline, Source NM, and Denver's Westword.Thank you for listening! See you next time.

time new year texas children chicago los angeles las vegas water san francisco west colorado congress original employees republicans southern california ga roots develop senate new mexico venezuela south america dios democratic lower deeper pac donations folks bureau gop centers gov congressional el paso drought medicaid officials aclu welp numerous hancock proposition new approach american west opioid crisis polis coats reclamation colorado river substance use disorders pacs migrant crisis jefferson county talking politics lake mead senate district high country coloradans lake powell water shortages jared polis hydrology drug policy alliance westword colorado river basin medicare medicaid services tim walsh hsd colorado sun government and politics emergency operations center metropolitan water district phil weiser colorado politics mayor hancock rebecca mitchell john kellner

CD261: Inflation Reduction Act

Congressional Dish

Play Episode Listen Later Oct 30, 2022 104:32

The Inflation Reduction Act is a new law designed to hasten the United States' energy transition (and do nothing about inflation). In the last episode before the midterm election, learn about the energy path the Democratic Party has plotted for us and learn how this new law can possibly save you tens of thousands of dollars. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via PayPal Support Congressional Dish via Patreon (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: 5753 Hwy 85 North, Number 4576, Crestview, FL 32536. Please make checks payable to Congressional Dish Thank you for supporting truly independent media! View the show notes on our website at https://congressionaldish.com/cd261-inflation-reduction-act Jen Podcast Appearances EP 63 Honest Government Analyst Jennifer Briney talks Privilege, White House & Hotels. The Living Numbers Podcast with Tony Rambles. Disaster - Jennifer Briney. A Word with Tom Merritt. Background Sources Recommended Congressional Dish Episodes CD259: CHIPS: A State Subsidization of Industry CD250: Congress Saves the Postal Service CD246: BIF: Appalachian Chemical Storage CD240: BIF The Infrastructure BILL CD218: Minerals are the New Oil CD205: Nuclear Waste Storage CD146: Repeal & Replace CD048: The Affordable Care Act (Obamacare) Tax Credits and Refunds Home Energy Efficiency Tax Credits “Tax Credits for Energy Efficient Home Improvements.” eFile. Rocky Mengle. Sept 16, 2022. “Save More on Green Home Improvements Under the Inflation Reduction Act.” Kiplinger. “Federal Income Tax Credits and Other Incentives for Energy Efficiency.” Updated Aug 18, 2022. Energy Star. Electric Appliance Rebates “Quick Facts: United States.” U.S. Census Bureau. Electric Car Tax Credit 26 U.S. Code § 30D - Clean vehicle credit. Cornell Law School Legal Information Institute. Alternative Fuels Data Center. “Electric Vehicles with Final Assembly in North America.” U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy. Kelley R. Taylor. Oct 18, 2022. “EV Tax Credits Are Changing: What's Ahead.” Kiplinger. Greg Iacurci. Oct 15, 2022. “The 'bummer' of the $7,500 electric vehicle tax credit: Its full value may be hard to get.” CNBC. John Bozzella. Aug 5, 2022. “What If No EVs Qualify for the EV Tax Credit? It Could Happen.” Alliance for Automotive Innovation. John Bogna. Jun 22, 2022. “Hydrogen-Powered Cars: Fuel Cell Electric Vehicles Explained.” PCMag. U.S. Geological Survey. “Mineral Commodity Summaries 2021.” U.S. Department of the Interior. “OFAC Sanctioned Countries.” Princeton University Research & Project Administration. Alternative Fuel vehicle refueling property credit Kelley R. Taylor. Sept 14, 2022. “The Federal Tax Credit for Electric Vehicle Chargers is Back.” Kiplinger. 26 U.S. Code § 30C - Alternative fuel vehicle refueling property credit. Cornell Law School Legal Information Institute. Hydrogen Catherine Clifford. Sep 8, 2022. “The clean hydrogen energy economy was a dream. The climate bill could make it a reality this decade.” CNBC. Emma Ochu et al. Jun 17, 2021. “Hydrogen Fact Sheet: Production of Low-Carbon Hydrogen.” Columbia University School of International and Public Affairs, Center on Global Energy Policy. “Lisa Murkowski.” Open Secrets. Jay Bartlett and Alan Krupnick. December 2020. “Decarbonized Hydrogen in the US Power and Industrial Sectors: Identifying and Incentivizing Opportunities to Lower Emissions.” Resources for the Future. 24/7 Wall St. Feb 16, 2020. “How Many Gas Stations Are In U.S.? How Many Will There Be In 10 Years?” Market Watch. Health Care “The Inflation Reduction Act Lowers Health Care Costs for Millions of Americans.” Oct 5, 2022. Centers for Medicare & Medicaid Services. “Inflation Reduction Act: CMS Implementation Timeline.” 2022. Centers for Medicare & Medicaid Services. Carbon Capture Angela C. Jones and Ashley J. Lawson. Oct 5, 2022. “Carbon Capture and Sequestration (CCS) in the United States.” Congressional Research Service. Emily Pontecorvo. Aug 22, 2022. “Will the Inflation Reduction Act jumpstart carbon capture?” Grist. “Global Status of CCS 2021.” 2021. Global CCS Institute. “Carbon capture and storage could also impact air pollution.” Nov 17, 2011. European Environment Agency. Offshore Wind Leases Abby Husselbee and Hannah Oakes. Aug 25, 2022. “The IRA Offshore Energy Leasing Provisions' Potential Impacts.” Harvard University Environmental & Energy Law Program. “Memorandum on the Withdrawal of Certain Areas of the United States Outer Continental Shelf from Leasing Disposition.” Sept 8, 2020. The White House. Fossil Fuels David Jordan. Oct 6, 2022. “Interior moves forward with oil and gas drill site leasing.” Roll Call. “Inflation Reduction Act Fossil Fuel Provisions.” Aug 18, 2022. Enersection. 30 U.S. Code § 226 - Lease of oil and gas lands. Cornell Law School Legal Information Institute. The Associated Press. Apr 16, 2022. “Biden increases oil royalty rate and scales back lease sales on federal lands.” NPR. Taxes Kelley R. Taylor. Oct 10, 2022. “The Inflation Reduction Act and Taxes: What You Should Know.” Kiplinger. “Inflation Reduction Act includes 15% corporate minimum tax on book income.” August 16, 2022. EY. Jacob Bogage. Aug 12, 2022. “The new Wall Street tax key to Democrats' Inflation Reduction Act.” The Washington Post. Peter Warren. Aug 11, 2022. “‘Inflation Reduction Act' Holds the SALT.” Empire Center. “Lobbying: Intuit Inc.” Open Secrets. “CBO Cost Estimate: H.R. 1 - the Tax Cuts and Jobs Act.” November 13, 2017. Congressional Budget Office. The Law H.R.5376 - Inflation Reduction Act of 2022 “Summary: Estimated Budgetary Effects of H.R. 5376, the Inflation Reduction Act of 2022.” Revised August 5, 2022. Congressional Budget Office. Audio Sources Full Committee Hearing On Opportunities and Challenges in Deploying Innovative Battery and Non-Battery Technologies for Energy Storage September 22, 2022 Senate Committee on Energy and Natural Resources Witnesses: Tim Hemstreet, Managing Director for Renewable Energy Development, PacifiCorp Spencer Nelson, Managing Director, Research and New Initiatives, ClearPath Ted Wiley, President and Chief Operating Officer, Form Energy 19:19 Sen. Joe Manchin (D-WV): When it comes to storage, there has rightly been a focus on the supply chain, particularly for lithium ion batteries that power electric vehicles and phones in our pockets and many other modern technologies. While we have benefited from the use of this important battery chemistry, the fact that China is responsible for 75% of global lithium ion battery production, including 60% of the world's cathode production and 80% of the world's anode production, should give everyone pause. That is why I was proud to champion Inflation Reduction Act which incentivized the onshoring of the entire battery supply chain, from the production and processing of raw materials, to the battery pack assembly and everything in between. Full Committee Hearing On Domestic Critical Mineral Supply Chains March 31, 2022 Senate Committee on Energy and Natural Resources Witnesses: Dr. Steve Fortier, Director, USGS National Minerals Information Center, U.S. Department of the Interior Scott Melbye, President, Uranium Producers of America Julie Padilla, Chief Regulatory Officer, Twin Metals Minnesota Abigail Wulf, Vice President, Critical Minerals Strategy and Director of the Center for Critical Minerals Strategy, Securing America's Future Energy Dr. Paul Ziemkiewicz, Director, West Virginia Water Research Institute, West Virginia University 24:14 Sen. Joe Manchin (D-WV): It makes no sense to remain beholden to bad actors when we have abundant resources in manufacturing know-how here in the United States. And make no mistake, we are beholden, particularly when it comes to many of the minerals that go into clean energy technologies. That is why I've sounded the alarm about going down the path of EVs alone and advocated for equal treatment for hydrogen 45:08 Abigail Wulf: As things stand, without some significant course corrections on America's critical minerals enterprise, the leading automobile power won't be the United States. It will be China. Not because of superior design or technology, but because of their massive head start and established market power, if not utter dominance, in all aspects of the supply chain that powers these [electric] vehicles. But simply mining alone does not begin to address the fundamentals of America's mineral supply chain challenge. Where we are most lacking and where China is most dominant is in that crucial but largely hidden processing phase and midstream component production. We simply can't dig up a rock and stick it in a Tesla. You have to crush it, smelt it, and refine it into precursor material that has been sold to somebody else to turn it into battery guts, namely cathodes, anodes and electrolytes. Today, the United States has less than 4% of all minerals processing capacity and makes 0% of the world's cathodes and anodes. By contrast, China is the world's largest processor of copper, nickel, cobalt, lithium and rare earth elements, and they control 60% of anode production and 40% of global cathode production. Consider that in 2019, about 70% of the world's cobalt supply was mined in the Democratic Republic of Congo, but more than 70% of that cobalt was refined in or controlled by China. Full Committee Hearing On Clean Hydrogen February 2, 2022 Senate Committee on Energy and Natural Resources Witnesses Dr. Sunita Satyapal, Director, Hydrogen and Fuel Cell Technologies Office, Hydrogen Program Coordinator, U.S. Department of Energy Dr. Glen Richard Murrell, Executive Director, Wyoming Energy Authority Jonathan Lewis, Senior Counsel and Director of Transportation Decarbonization, Clean Air Task Force Michael J. Graff, Chairman & Chief Executive Officer, American Air Liquide Holdings, Inc. Brian Hlavinka, Vice President, New Energy Ventures, Corporate Strategic Development, Williams 21:07 Sen. Joe Manchin (D-WV): However, we have some challenges to tackle in order to build a clean hydrogen economy. Producing hydrogen without emissions is two to six times the cost of current production methods. Also, retrofitting end-use applications to use hydrogen as a feedstock, from chemical plants to cars and trucks, will take huge investments from both public and private sectors. This is the demand that we need to develop hydrogen markets that can sustain themselves. The other big challenge is the safe and efficient transport and storage of large volumes of hydrogen, given its physical properties. There's a lot of promising work being done in this space and will allow us to leverage our vast natural gas pipeline network to transport hydrogen to market. 22:00 Sen. Joe Manchin (D-WV): That is why I made research, development, and demonstration of these technologies a central part of the Energy Infrastructure Act, which this committee reported with bipartisan support last year, and which was subsequently included in the recently enacted Bipartisan Infrastructure Law. In that bill, we fund $9.5 billion in research, development and demonstration of clean hydrogen, and we tasked the Department of Energy to develop a national strategy and a roadmap to get us to a clean hydrogen economy. 27:25 Sen. James Lankford (R-OK): I'm concerned that the conversation around green versus blue hydrogen will pit technologies against each other rather than working together to establish a robust hydrogen marketplace. The simple truth right now is that 95% of hydrogen produced in the United States is made from natural gas. 1:42:00 Sen. Lisa Murkowski (R-AK): Can you share what the administration's policy is with regards to converting natural gas to hydrogen? We recognize that there are some within the [Biden] administration, certainly some groups that may have influence on the administration, who are very firm about not using fuel sources like natural gas. So the question is, is there a role for conversion to play? And what might we anticipate with regards to support and funding that might come with it? Dr. Sunita Satyapal: Thank you again for the question. And as mentioned, with hydrogen shot, we're really looking at all of the pathways. It's really about clean hydrogen. So whether it's natural gas, carbon feedstocks, nuclear renewables, you know, any pathway to get to the low carbon intensity, we're really pivoting away from the colors. There's a lot of complexity: green, blue, purple, turquoise….Pyrolysis is another approach. In fact, our loan program office just announced financing of $1 billion solid carbon, which is another value added product, no need for the CCS portion. So definitely an all-of-the-above strategy needed to meet all of our goals. Full Committee Hearing to Examine Development and Deployment of Large-Scale Carbon Dioxide Management Technologies July 28, 2020 Senate Committee on Energy and Natural Resources Witnesses: Steven Winberg, (Former) Assistant Secretary for Fossil Energy at the US Department of Energy Shannon Angielski, Executive Director of the Carbon Utilization Research Council Dr. Julio Friedmann, Center on Global Energy Policy, Columbia University 25:06 Dr. Julio Friedmann: Net zero means that any residual emissions must be balanced by removal, as Secretary Moniz said. It means that reduction of co2 emissions and removal of co2 emissions are complementary but distinct actions and that both are necessary. The National Academies and the IPCC find that this must be done at enormous scale exceeding the size of the global oil and gas industry today. We are not where we need to be to make this real. 48:35 Shannon Angielski: In addition, the International Energy Agency modelled the contributions of different technologies to meet that mid-century 2 degree scenario. And it shows that CCUS accounts for approximately 100 Giga tons of needed global co2 emissions reductions by 2060. To put this into perspective, this would be achieved by the operation of 1100 carbon capture systems on the equivalent of 500 megawatt coal fired units, or 3200 natural gas combined cycle units, which would need to be operating for the next 30 years. 1:59:00 Steven Winberg: The rest of the world is going to continue using fossil energy, whether it's coal or oil or natural gas. And that's why we have moved forward quickly on the coal first program, because it offers the opportunity for what I think of as 21st century coal. Right now the Chinese own the space in power generation — coal fired power generation. We have an opportunity to take technology and springboard over what the Chinese are building, which is basically 1970s vintage technology that we built, and they now have improved slightly, but they're selling it around the world, to countries that have coal under their feet, and they're going to continue using that coal. But with the coal first program, we can move into power generation, and we can move into hydrogen production, because these countries also, as they build out their transport sector, may not do it the same way that developed countries, they may move more swiftly into hydrogen. And so there's an opportunity there to take our technology using their natural resources that are under their feet, and produce zero emitting power generation and zero emitting hydrogen and perhaps even net negative hydrogen and net negative electricity and they can use that hydrogen in the transportation sector as well as the industrial sector. Cover Art Design by Only Child Imaginations Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio)

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