Podcasts about vbid

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Mark Fendrick of The University of Michigan's Center for Value-Based Insurance Design (VBID) to discuss the recent announcement from CMS that the Medicare Advantage VBID model would be ending after 2025, and what the future holds for VBID moving forward with the new Trump administration. Check out a recently released Health Policy brief from Nathaniel Tran and Gilbert Gonzales exploring LGBTQI+ policies.Join Health Affairs on February 25 for an exclusive Insider virtual event featuring Stacie Dusetzina and Laura Tollen discussing HHS's announcement of the 15 additional drugs selected for Medicare drug price negotiations, including weight-loss drugs such as Ozempic and Wegovy.Also, join a live recording of A Health Podyssey on March 12 featuring Rob Lott and Yashaswini Singh discussing her recent paper on the effect of private equity on physician turnover.  Register for the live taping here. Related Articles:The End Of The MA Value-Based Insurance Design Model: What Next? (Health Affairs Forefront)V-BID X: Creating A Value-Based Insurance Design Plan For The Exchange Market (Health Affairs Forefront)Medicare Advantage Value-Based Insurance Design (VBID) Model to End after Calendar Year 2025 (CMS) Subscribe to UnitedHealthcare's Community & State newsletter.

Medicare Advantage & VBID Insights: Navigating the 2025 Landscape | The Agent Boost Podcast Welcome to the ultimate insurance podcast!

What if you could stay ahead of the curve in hospice care while balancing inspiration and regulatory updates?  On this special episode, guest host Mark Cohen, stepping in for Chris Comeaux, engages in a rich conversation with Cordt Kassner and Joy Berger from Hospice and Palliative Care Today.  We dive into their meticulous process for curating news, offering insights into how they select articles that resonate with a diverse audience, ranging from C-suite executives to frontline clinicians.  Joy Berger highlights their interdisciplinary approach and the importance of balanced content to keep hospice professionals well-informed about the latest industry trends.Discover the top healthcare trends from our May podcast as we cover everything from regulatory updates and mission moments to reimbursement challenges and workforce issues. Learn about the latest developments from CMS and HHS, and be inspired by stories like a 98-year-old Marine veteran earning his high school diploma.  We also address the pressing challenges of nursing shortages and the impact of unions, while examining how big companies are entering the healthcare space and the demographic shifts influencing the care of an aging population.In another compelling segment, we explore the broader implications of years-long stories like the rise and fall of stories VBID and retail health clinics and whether the media covered these well.  Understand the effects on local healthcare ecosystems and the emergence of pharmacy and hospice deserts.  This episode underscores the necessity of proactive issues management in healthcare to stay ahead of sociopolitical trends and stakeholder expectations.  Join us for an insightful and heartwarming discussion that sheds light on the critical issues shaping the hospice and palliative care landscape.TakeawaysIssues management is crucial for healthcare organizations to anticipate and respond to emerging trends and changes in the sociopolitical environment.Staying informed about competition, workforce challenges, patient demographics, regulatory issues, technology and innovations, and more is essential for Hospice decision makers.Understanding different perspectives and engaging in interdisciplinary collaboration is key to effective issues management.Subscribing to Hospice newsletters and and listening to podcasts like this are the foundation of a solid issue management program.Guest:Joy Berger, Editor in Chief, Hospice & Palliative Care TodayCordt Kassner, Owner / Publisher of Hospice and Palliative Care TodayGuest Host:Mark Cohen, Strategic Communications Consultant/Cohen-Fyfe Communications BiographyBlog page: https://www.teleioscn.org/tcntalkspodcast/top-news-stories-of-the-month-may-2024Chapter Markers0:01      Brevity in Hospice News Publishing17:02   Top Trends in Healthcare Articles32:49   Fluctuating Trends in Healthcare Environment49:40   DeltaCareRx Sponsorship and ServicesTeleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

Judi Lund Person, former vice president of regulatory and compliance at NHPCO, shares her journey into the hospice industry and her passion for ensuring patients and families receive the care they need and want.Judi emphasizes the importance of addressing bad hospice care and uncovering fraud and abuse in the industry.  She discusses the proposed changes in the 2025 Hospice Wage Index and Payment Conditions, including the implementation of the HOPE tool and the revised hospice cap survey.  Also, Judi highlights the sunset of the VBID demonstration and the need to focus on accountable care organizations and quality reporting.The conversation concludes with a focus on the importance of putting patients and families at the center of hospice and palliative care.  The discussion highlights the need for personalized care and the role of volunteers in providing support. The conversation also touches on the potential for innovation and collaboration with Medicare and Medicare Advantage plans.  The wage index and its impact on hospice reimbursement rates are discussed, along with the potential for value-based purchasing arrangements in the future.TakeawaysEnsure patients and families receive the care they need and want.Address bad hospice care and uncover fraud and abuse in the industry.Stay informed about proposed changes in the 2025 Hospice Wage Index and Payment Conditions.Prepare for the implementation of the HOPE tool and revised hospice cap survey.Stay engaged with accountable care organizations and quality reporting Patients and families should be the focus of hospice and palliative care, with personalized care tailored to their needs.Volunteers play a crucial role in providing support and should be integrated into hospice programs.There is potential for innovation and collaboration with Medicare and Medicare Advantage plans to improve care delivery.The wage index and its impact on reimbursement rates for hospice services should be carefully considered.Value-based purchasing arrangements may be a future direction for hospice care.This is a great listen for staff, leaders, and boards of hospice and palliative care organizations. Here's a great quote from the discussion: “You never know when something you do or somebody you talk to changes the course of your life."  Join us, this is timely and relevant. https://www.teleioscn.org/tcntalkspodcast/judi-lund-person-unleashedTeleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

Take a first look at the Fiscal Year 2025 Hospice Wage Index Rule with the unparalleled insights of industry authorities Katie Wehri (NAHC) and Patrick Harrison (NHPCO). Our conversation slices through the complexity to deliver a focused commentary on what this proposed rule signifies for hospice care providers, highlighting the rule's unexpected early release and the notable absence of anticipated program integrity proposals. We delve into the ramifications of the missing measures and the adaptability required in the wake of this development. The advent of the HOPE assessment tool is scrutinized as it transitions from a patient-centric assessment to a pivotal data collection asset, with an eye on the nuances of its rollout.The hospice community stands at the precipice of change with the Medicare Advantage hospice component sunset within the VBID model by CMS. We dissect the repercussions of this pivot from earlier value-based system inclinations and emphasize the balance between cautious optimism and the realities of the evolving healthcare system. The episode also honors the dedication of hospice workers amid workforce tribulations and increased CMS scrutiny, championing a dual focus on patient care and compliance. We invite our listeners to deepen their engagement with this critical dialogue by leveraging resources such as NHPCO and NAHC, and by partaking in informative webinars that illuminate the path ahead. Your involvement and feedback are the heartbeat of our community, and we're thankful for every clinician's commitment to excellence in hospice care.Upcoming Events:NHPCO's Focusing on Opportunities and Challenges on the Front Lines - click here to register Visit our websiteConnect with us - LinkedIn, Twitter, YouTube, FacebookMake Lives Better

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to TransformChange, transformation, disruption: whatever you want to call it, it's happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consolidation is changing the playing field. How do hospices respond? In this series, we explore how hospices are and can restructure their businesses. We discuss the opportunities and limits of different models: palliative care, affiliations for payor contracting or the more transformative change brought through a merger or acquisition. While there is no one-size-fits-all approach, hospices can explore new ways of being. We are excited to guide you on this road and hope these conversations help as you explore these important questions within your organization and determine your best path into the future.Today's Episode: Think Before You Sign - Five Key Insights for VBID and Managed Care ContractsPrivate payor contracts will define future revenue for hospices. Whether it be Medicare Advantage Value-Based Insurance Design (VBID) contracts for hospice services or for upstream non-hospice services (palliative and supportive care), the rules of the road will be defined by what you negotiate with payors. In this episode, Husch Blackwell's Meg Pekarske and Andrew Brenton unpack five takeaways learned in working with hospices on their managed care contracts. We hope you enjoy the conversation and thanks for listening.

Value-based insurance design (VBID) uses incentives to increase health care quality and to promote cost efficient health care services and consumer choices. But like all approaches to health care cost containment, VBID isn't one-size-fits-all. For VBID to be effective—that is, promote high-quality services and discourage use of low-quality care—incentives must embrace clinical nuance, using data to assess how clinical benefits vary by person, provide and site of service. Leslie shifts from our typical “supply side” perspective to talk health care demand and how VBID engages consumers in their own health decisions with Christine Juday, Vice President at Discern Health, Real Chemistry's consultancy focused on quality-based payment and delivery models. For more news about VBID and other value-based delivery models, sign up for Real Chemistry's Quality Report newsletter. LINK:  https://www.w2ogroup.com/quality-report-newsletter/

In this episode, I have the privilege of hosting the outstanding Dr. Mark Fendrick, a founding Partner of VBID Health and Director of the University of Michigan Center for Value-Based Insurance Design. Dr. Fendrick educates us on VBID (Value-Based Insurance Design), what his center is doing to improve value-based care and the dilemma of how procedures are being paid vs engaging with health care consumers. He shares his insights on the impact of high-value services and low-value services, having a system that incentivizes routine care, and more. Dr. Fendrick also talks of policies he and his team helped create, and one of them resulted in getting free COVID shots for everyone in the U.S! There are many things to learn about VBID so please tune in!

Listen NowOne way to increase the value of insurance coverage is to eliminate or lower a patient's out of pocket costs (OOP), i.e., their co-pays and/or deductables, for health care services that are of high value, for example, vaccines and/or alternatively increase OOP costs for low value service, for example, certain imaging tests.  The concept is based on the straight forward rationale that, based on clinical evidence, certain health care products or services are proven to be more effective than others.  (This is the rationale for the Choosing Wisely program, at: https://www.choosingwisely.org/.)  OOP costs therefore should not be uniform for all services and medications, particularly when non-adherence rises along with rising health care OOP spending.  This largely explains the problem of medication non-adherence.  Phrased another way, we need need to solve for the increasing problem of under consuming high value care.  This idea was recognized in the 2010 Affordable Care Act, specifically Section 2713 [c] that eliminates patient cost sharing for specific preventive care services.  For example, OOP costs for significantly under-utilized breast and colorectal screenings, for which approximately only 72% and 60% of patients, respectively, are screened.  The value-based idea was furthered by the ACA-created CMS Innovation Center that in 2017 the launch the MA VBID demonstration - that was recently extended to 2024.  (This discussion is related to or can serve as a follow up to my May 11th conversation with Professor Andrew Ryan concerning measuring for value or spending efficiency.)During this approximately 30 minute conversation, Dr. Fendrick discusses moreover the creation of the University of Michigan's VBID Center, provides his assessment of the current CMS Medicare Advantage VBID demonstration, the U. of MI Center's just announced V-BID X insurance design, VBID efforts at the state level and the Treasury Department's just-announced guidance allowing Health Savings Account/High Deductible Health Plans to practice VBID.   Dr. A. Mark Fendrick is the Director of the Value-Based Insurance Design Center at the University of Michigan.  He is also Professor of Internal Medicine in the School of Medicine and a Professor of Health Management and Policy in the School of Public Health at the University of Michigan.  He has authored over 250 articles and book chapters and has received numerous awards for the creation and implementation of value-based insurance design.  Dr. Fendrick is an elected member of the National Academy of Medicine (formerly the Institute of Medicine or IOM), serves on the Medicare Coverage Advisory Committee, and has been invited to present testimony before the U.S. Senate Committee on Health, Education, Labor and Pensions, the U.S. House of Representatives Ways and Means Subcommittee on Health, and the U.S. Senate Committee on Armed Services Subcommittee on Personnel.  Dr. Fendrick is the co-editor in chief of the American Journal of Managed Care and is an editorial board member for three additional peer-reviewed publications.  He is also a member of the Institute for Healthcare Policy and Innovation at the University of Michigan, where he remains clinically active in the practice of general internal medicine.  Dr. Fendrick received a bachelor's degree in economics and chemistry from the University of Pennsylvania and his medical degree from Harvard Medical School.  He completed his residency in internal medicine at the University of Pennsylvania where he was a fellow in the Robert Wood Johnson Foundation Clinical Scholars Program.For information about U. of Michigan's Center for Value-Based Insurance Design to go: https://ihpi.umich.edu/center-value-based-insurance-design-v-bid.A summary of the V-BID X proposal is at: https://www.healthaffairs.org/do/10.1377/hblog20190714.437267/full/.  The more complete white paper is at: http://vbidcenter.org/wp-content/uploads/2019/07/VBID-X-Final-Report_White-Paper-7.13.19.pdf.  For information concerning Dr. Fendrick's mention of the just-released US Treasury guidance allowing HSA-HDHP plans the flexibility to cover specified medications and services prior to meeting the plan deductible go to: https://ihpi.umich.edu/center-value-based-insurance-design-v-bid .  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Episode 08: Improvised Explosive Devices (IEDs) Discussion of IEDs - Improvised Explosive Devices (aka bombs) in Active Shooter Events. Bill Godfrey: Welcome to this next discussion in ongoing podcast series talking about active shooter incident management. Today, we are going to be talking about the impact of improvised explosive devices in the presence of active shooter events. I have with us today to join the conversation Billy Perry, retired detective and bomb technician from the Jacksonville area. Welcome, thanks for coming in Billy. Billy Perry: Thank you for having me. Bill Godfrey: And Tom Billington, retired fire chief from the south Florida area. Tom, thanks for coming in.Tom Billington: Thanks for having me.Bill Godfrey: I am Bill Godfrey, also one of the other instructors. Tom and Billy, both instructors here with C3 on the active shooter incident management course. Billy, let's start off with you on the bomb tech side. What is the real threat of bombs to us from a practical point of view in these active shooter events? Based on what we've seen and what's going on, what is the threat? Billy Perry: I'm glad you're asking these questions, Bill. Bombs and IEDs are becoming much more prevalent in our world. When I say "our world", I'm talking about our world in the law enforcement fire community and especially in the active shooter realm. They are becoming more frequent. They're becoming more sophisticated. They're becoming more reliable and, as a result, more dangerous. One of things that we like to say is "bombs have the right of way". You can't negotiate with them. They're an inanimate object and they're something to be concerned with. In our curriculum, we talk about 50 pounds and less being a device that we're concerned with. Where I came from and our jurisdiction, we were responsible for everything under 100 pounds under water. That's a lot. 50 pounds of explosives is a significant amount and will do a lot of damage. Ignorance reigns supreme and to be frank, when I was involved in the explosive breaching side as a S.W.A.T. guy, I was very cavalier about explosives and I was terrified of a dirty bomb. Then, I found out that a, once I learned about explosives, I realized that I wasn't afraid of a dirty bomb. I could fix that with a whisk broom and dust buster, but conventional explosives now, I'm mortified of. They terrify me. We have to be concerned about that. We have to be concerned about secondaries because bombers are like knife fighters. If you have one knife in law enforcement, you always look for another one and a third. The same thing with bomb. If they do one, they like to have two. Redundancy. Like I said before, they come from the department of redundancy department. You want to be cognizant of that. Just be careful with them. Bill Godfrey: Interesting segue in that, they come from the redundancy department is kind of funny, but I guess in many ways true here. From the active shooter events that we've seen and from the security information you're privy to, what are the kinds of things that guys that are operating on the inside should be looking for? If they have a bomb or they seize, if there is a bomb present, somebody brought an IED to the thing, what are the sizes? What's the range of the threat that they're looking for? What's the size of the package the device triggers? Any common stuff there? Anything to keep eyes out for? Billy Perry: Absolutely. They're the normal ones and we've seen all of them in the instance such as the Boston bombing, such as the San Bernardino incident. They've had the triggers from electric. They've had, when I say "electric", San Bernardino was a Christmas bulb which ran off of a battery. They had a remote-controlled, San Bernardino, remote-controlled car. The Boston bombers made grenades out of elbows, galvanized elbows. We have to be very cognizant of all those. They're usually hand-portable, but they are still very formidable devices. Bill Godfrey: Got you. As we're a contact team or a rescue task force, both of them, they're moving downrange, they see something that just doesn't look right, what are the steps? What's the initial action? Billy Perry: Great question again. I'll tell you, in our curriculum we say IED and tell where it goes on the checklist. We talk about that, where is it and talk about what it is. Where I come from, we were not super smart and what we had to do is, because I'm one of us and I can say that and we keep things really, really simple. We use the word "bomb" because nothing else can be mistaken for "bomb". The only time that we use the word "go" is in response, or in regards, I should say to "bomb". We say "bomb cover" or "bomb go". If we are moving down a passageway, a hallway or down in a area and we run into a device and by running into, I mean we see it, the point man sees it. No matter what size it is, we're practicing a 540 scan, 360 around, 180 degrees up and down and if you see it, immediately stop. Just like the military has a 5-25-5 meter immediate area scan, 25 meter area scan, we do the 5 foot scan and the 25 foot area scan to look for other things, but we call out "bomb cover". If the bomb is a distance from us, we say "bomb cover" and we move to cover creating angles and air gaps. [inaudible 00:05:33] one person will hold on it, not necessarily looking at it because what are we covering? The bomb. If you can see the bomb, the bomb can see you. You've got to remember a bomb is a gun that fires in a 540 degree arc. It doesn't miss. We want to make sure that we keep that away, but we're still paying attention for actionable intelligence and stimulus. If it's coming at us, I should say, like if the bomber comes out or the shooter comes out and throws something towards us, that would be "bomb go" and we're going to move past it. Is this moving toward us? We're going to move past it towards them and continue the assault. Bill Godfrey: Tom, I want to bring you into the conversation at this point. We've got a group of injured. There's a contact team that's either in the area or passed through the area because we've seen this happen in some incidents across the country. We're working to provide some medical, emergent medical care to the patients and then get them evacked out and then we find a device. What's the impact, because on the rescue task force for medics being downrange, we talk about them being in a warm zone, but obviously if we're in the vicinity of what we believe is a bomb, that makes it a direct threat environment. Suddenly, it becomes a hot zone. What's the course of action? Tom, from your perspective, you've got medics downrange. They're already in there. You've got patients that need to get evacked out. Lo and behold, turn around, there's a backpack, there's a thing, there's a whatever. What actions are they going to take? What do you think is going to happen? Tom Billington: Actually, this is a good discussion point. Usually before we activate the RTF, law enforcement will tell the EMS or fire crew, "Here's what's going to happen if somebody starts shooting". It might be a good idea to have the conversation, "Here's what we're going to do if we see something suspicious. That way, it doesn't take the fire or EMS personnel off guard. If somebody says "bomb", I know that right away can make a firefighter go, "Oh, what do we do now?" Obviously, having the conversation beforehand is very important. Again, making sure we have relationships with our law enforcement, very important. Again, if I was on the scene with Billy and we're looking at something that was maybe a device and he gave me direction, I would listen to it because I trust him wholeheartedly. I know his abilities. We need to make sure that the fire community is meeting with these experts not during, but way before an incident occurs. I think those two things alone will really help the fire or EMS folks be able to handle a situation when it comes up. Bill Godfrey: Billy, that scenario and what Tom is describing, I think it makes a lot of sense. They're in a room. They're in a casualty collection point. Lo and behold, you're working on five, six, seven patients and here's a device. Here's an honest goodness believed to be legit device. What are the things that they can do. What are the things that they can do to try to make themselves a little safer, make the patients a little safer short of the obvious of grab them and get them out of there? Are there anything, other things that they can do? Billy Perry: If it's a small room, we're going to get them out of there. We're going to have to move them. Space is your friend. If an area will provide you cover from rifle fire, it's probably going to be okay for distance from a bomb. It's going to be better than obviously nothing. Space and good cover and angles. Multiple angles are even better, not in a confined area, but we're going to, if it is a very small device and again, all devices aren't the same. It's hard to pack ourselves up. Again, I don't want to overemphasize them, but I don't want to downplay them too much either. If you look at a hand grenade that's a small amount of composition B, but man, the amount of damage that it does compared to a block of C4, that's amazingly devastating, but a pipe bomb with black powder, let's say, is going to be a significant event, but it's not going to be anywhere near the same because you've got a low explosive versus a high explosive. If they are in a closed area, obviously bunkering it, the device without touching it and that. I think, for your RTF, I think if your initial responders and everybody are pretty switched on, they're going to be looking for that because I know we train for that. We train to look for that. They're going to see something that's out of the ordinary. Again, there's a huge difference between something with a radio antenna coming out of it like the car in San Bernardino and a pipe bomb with a fuse that's burned, you can see the burn marks that it didn't go off. There's a huge difference between the two because the one is probably not going to happen obviously, or it would've, and then there's the other. Then, there's the other types of devices that you're worried about, but go ahead. Bill Godfrey: I want to try to get you to clarify something because I know what you mean, but obviously on a podcast when we're just talking about things, it's sometimes a little hard to explain because you've mentioned several times angles. Can you be a little more clear on what you mean by angles for the people that are listening? Billy Perry: Absolutely. When you encounter a device, you want to create angles. You want to move in a 90-degree angle from it, like if you can go down another hallway, if you can go around the corner of a building. Again, multiple angles are even better. You don't want to be in a room or a house with it if you can or a building if you can. You want to get out. If you have to stay in it, you want to create as much air and angles from it adjoining rooms and areas as you can. Again, if it's bomb cover, we're going to have one person that's going to stop and provide cover being responsible for cover downrange without staring at the device. Somebody else is going to be moving to look for an alternate route, just try to find another way around it and move on, but if we get stimulus, if we get actionable intelligence, we're going to move past that device frankly with the exception of possibly a PIR, a passive infrared or a motion detector no different than you have on a flood light or a motion detector on a burglar alarm. Those are different because those are pretty effective. We're going to be very cognizant of those. That's going to require another entry.Bill Godfrey: Best case scenario: You spot it, call it out to the team, fall back, find another way around it and then continue to execute your mission. We haven't talked about [inaudible 00:12:23] yet. Guess let's put a tag in that one and come back to it.Billy Perry: Okay. Okay.Bill Godfrey: The idea of angles, we want to get around corners. Part of that is the blast wave. Is it also the fragmentation that you're trying to get away from? Billy Perry: You're trying to get away from ... Bombs injure us and kill us in three ways: Heat, fragmentation and overpressure, or the shockwave, the overpressure, the changes in pressure. They're all dangerous. They're all bad. You're a firefighter, you know. [inaudible 00:12:49] burned, we don't want pressure and we definitely don't want frag, which is a bunch of baby bullets or big bullets even. That's why distance and cover are important.Bill Godfrey: Okay. With that said, let's talk a little bit about marking it. If you come upon something, and when we say "come upon it", let's just be clear, we're not talking about it is at your feet and you've closed on it to six inches. That's not what we're talking about. You've seen it 15, 20, 30 feet down the hallway as you're coming up on something. Billy Perry: Hopefully.Bill Godfrey: Hopefully. We hope.Billy Perry: Right. Hopefully. Bill Godfrey: What's the kinds of things that are effective for marking it to alert other crews not to go down there or alert it that that's, there's something unusual there? Billy Perry: We really emphasize glow sticks. We really do. Green and red glow sticks. We emphasize those and we emphasize everybody having a bag for active incidents and having those in there. We recommend, if you mark it with red, that means it's something along the lines of a PIR or something that's command-detonated with an antenna. Don't go past that. Don't go past that. We recommend something that is green and red combined, link them together for something that has a fuse that's burned. This is probably not going to go off, but don't tarry here. Move by. If you've got to move by, we'd look at it and I've always said, "Just move. Don't sit and look at it. Don't waste time. Look at where you want to go and go. Don't look at the bomb. Don't mess with the bomb. Don't mess with it. Just let it go. Hopefully you ignore it, it ignores you and you move on." Then, green for something that a bomb tech would put down saying, "This one has been mitigated, trip wires." Be cognizant of that. That's another thing to look for. Look for the initiating mechanism. If you do see a device, look and see if you see any wires or fishing line or anything like that. Bill Godfrey: Okay. I'm going to tangent a little bit here and ask a harder question. This scenario I'm about to give you has come up a number of times in training that we've done and it's been interesting seeing responder's reactions to it. In some cases, there's been the threat of a vehicle-borne IED, which you make an interesting point about the distinction between a bomb in a vehicle and a vehicle that is a bomb. I'll let you explain on that a little bit as well, but the threat of what is believed to be a vehicle-borne IED that has an exposure to people that you need to rescue and as quick as you're going to move, it's going to take time. You've got 15, 20, 30 people that need to be rescued. No matter how you chalk it up, that's going to take a lot of time and a lot of people. Tom, recall back the scenarios we've seen where people have used firetrucks as shielding between where the casualties are and between where this potential vehicle-borne IED. On the one hand, firetruck, big red truck, made mostly of aluminum, which is not necessarily that good, but also there got a lot of water sitting in the middle of them. Billy Perry: That's what I was about to say.Bill Godfrey: Talk a little bit about what are the strategies. Tom, I'm trying to remember how many times we've seen that now. Is that a good strategy? Are there better ideas? How do you handle ... Tom and I are on the medical side. What are we supposed to see with these patients that are in a hot zone that are exposed to this thing? We can't diffuse it. We can't make the bomb go away. We can't get rid of it. What do we do? Billy Perry: You're on the right track. Absolutely firetrucks are amazing cover, so are garbage trucks. They really are. They're big, heavy, they deflect pressure waves. They're really, really good, but those, but while you're putting those in place, be moving as many as you can. We have to move them. [inaudible 00:17:00] whatever, we've got to move them, got to get them out of there because we're not going to move the car obviously, because another thing that we don't do when we have a device, even in a movement area, like with an active shooter in a building or in an office complex or whatever, we're not going to change the environment. We're going to leave the environment where it is and we're not going to change the lights. We're not going to move it obviously, which that brings me to another good point. Let's put a pin in that one, or about touching bombs. We're not going to change the car. We're not going to move the car out of the way. We're not going to move that. The point you were talking about is, there's a big difference between the pipe bomb in the backseat of a car, that's not a car. That's not a VBID, that's not a car bomb. That is a bomb in a car. Putting something like 50 pounds of explosives in the backseat, something that uses the car as the case or as the actual mechanism for transport, that would be a car bomb. There's a huge difference in them. If you look at Secora, New Mexico, you'll see that requires a lot of space, but you also want the cover as close to the patients as possible because the pressure waves [crosstalk 00:18:10] Bill Godfrey: That was one of the questions I was going to ask is: Do we want the cover closer to the vehicle or closer to the patients? Billy Perry: Closer to the patients because the pressure wave will go over them.Tom Billington: Joining on what Billy just said about the shockwave and making sure we have the barrier as close to the patients as possible, something for the RTFs to think about and again, as Billy said, we're not going to be worrying about [inaudible 00:18:32] and things like that. We need to do rapid extrication. Time is going to be our friend. We've got to hurry up, get the people out of there. For treatment, we also need to be sure that our medical people understand the injuries that can occur from a bomb, such as the shockwave. In Hollywood, when a bomb blows up, people hit the ground, they stand up and go back to work. That's not the case here. Our patients who may not look like patients right away after the shockwave hits them, in a short amount of time will start having serious internal injuries and other things that will start occurring. We have to make sure we're trained up on how to handle these incidents, even if they don't look as severe right away, thinking about the future. Bill Godfrey: You think it's something, the pulmonary injury from the overpressure wave, those kinds of issues? Tom Billington: Right.Billy Perry: Absolutely.Tom Billington: Right. Billy Perry: The traumatic brain injuries that you don't see that manifest themselves over time. Bill Godfrey: Yeah. I was taught the rule of thumb was, if somebody is close enough to a blast that they got knocked down, got their breath knocked out of them or had any indication of fluid out of the eyes, nose or ears, that was an automatic trip to the ER to get screened even if they said they were okay. Billy, is that still consistent with training that you're getting now? Billy Perry: Absolutely. Just a couple of pounds of overpressure are really detrimental health-wise. Distance, let's talk about distance. One of things about explosives is a foot, one foot between, let's say just as arbitrary numbers, ten feet could be injury and eleven feet be absolutely unscathed, depending on the explosive that goes off. You could be ten feet away and actually have a minor injury, eleven feet, you're completely unscathed. It's just that. Distance is your friend, but you're not going to outrun it. That's another one of the things.Bill Godfrey: You're not going to dive in the bathtub and get away from it.Billy Perry: You're not going to dive in the bathtub from the toilet and get away with it. Not going to happen because you're not going to move it 20,000 feet per second, which it is for a high explosive, so you've got to be cognizant of that. What I was going to talk to you about too about the bomb, about not changing the environment, we're not going to touch them. Never, ever, ever touch a bomb. Never, ever, ever, ever, never touch a bomb. As a result of that, keeping in continuity with tactics, we don't ever, ever, ever touch a bomber because a bomber is bomb. With that said, we have to emphasize, "You don't handcuff them. You don't touch them." We're going to end up undressing them probably with a robot and a razor knife. Bill Godfrey: The implications then on the medical side is, we don't touch them either? Billy Perry: No. Not at all. Nobody touches them. Like I said, even to include handcuffing. If they don't do exactly what we say, and this is something that individual officers and this is a scary and a new event that we have to discuss, but you need to, agencies need to clear it with their local prosecutors. We have to have an agreement. We've done that in the fourth judicial circuit where we understand that they're not going to be handcuffed and if you don't, if you're an actual bomber, if you been an active bomber, if you don't obey voice commands, you're going to get shot. Bill Godfrey: That's serious business.Billy Perry: Very serious business.Bill Godfrey: Serious business. Tom, anything else on the medical side that you wanted to ask Billy or bring up on this? Tom Billington: No, just that, again, as we have said through most of other podcasts, we have to talk about these things face to face with the people we are responding with before it ever occurs. That's the most important part, knowing what to do. We don't want to react. We want to act. We want to know how we're supposed to act beforehand. That's the most important lesson I can bring from this.Bill Godfrey: Yeah. I think the other piece of this, for me on the medical side, we're teaching and preaching it's warm zone. It's warm zone EMS care. We don't deliberately go into a hot zone or purposely go into a hot zone. The problem here with bombs, IEDs is that suddenly gets a little bit of a gray area, because now, by definition, it's not a warm zone. It is a hot zone, a direct threat environment, but if it's medical-related problem, that is supposed to be our domain on the medical side and probably need to have some conversation about that ahead of time. I don't think that's a discussion you want to get into at a scene about who is going to go in and get the patients. Is it going to be law enforcement? Billy Perry: It's definitely too late at that point, right. Bill Godfrey: Is it going to be fire, EMS? Who is going to go do it and whose responsibility is it going to be? The other sobering consideration is, if you have a significant number of patients that need to be moved and rescued, that is not going to get done by three or four medics and police officers. That's going to take a lot of people. As fast as we want to move, you could commit 10 people to move 30 and it's going to take a long time. . Billy Perry: Sure.Bill Godfrey: Or, you could commit 100 people to move 30 and it'll go pretty quickly, but you've got a large number exposed. Billy Perry: Right. You've exposed 100 people.Bill Godfrey: Yeah, so which is better? I don't know that there is really a right or wrong answer to that. It's going to have to be a judgment call based on the environment. Before we leave this topic, Billy, I've got to bring up the age-old one. Tom, this is going to make you laugh because I know you and I have been hearing this since we were both young guys riding on the back step. Radios around a bomb. Billy Perry: The mythical radio. Bill Godfrey: The mythical ... Debunk this one for us a little bit. Billy Perry: Absolutely. Would be happy to. It is something that is still prevalent in every operational order that I know of across the country and it's still one of those things. Bill Godfrey: Including our checklist.Billy Perry: Including our checklist. Honestly, it's one of those things that we just have to really understand modern information. You and I talked about it a year ago or a little over a year ago and you did research and found, as did I, that the only one we could find, we think it was like 40 years ago in a construction side. Modern data radios transmit data packets. They don't have the high wattage outputs for a sustained period of time that the old ones did. That's the only one that we can find of it. Again, we were schooled on it by the military. I was actually in a bomb suit doing an exercise and they said, "What are you talking to the command post back with?" I said, "The radio." It hit me. It's the exact same radio in the pocket of my sleeve of my bomb suit, my 92-pound bomb suit that we use in patrol. It's no difference. I'm leading over said device, pushing the button in the center of my chest telling everybody what I'm looking at. It's one of those ephiphanal moments when you realize, this is why I said earlier, "I'm not smart." I have empirical data to back that up, but it is. We still want you limit it in the event, whatever and don't put your antenna on a device again, in keeping with the "don't touch it mentality" and [inaudible 00:25:55] a bunch of times, say, "Yep, it's not going off." Just maintain respect of it, but it's not the "Oh my gosh, it's the doomsday event that we've always thought it was."Bill Godfrey: So, some common sense. Billy Perry: Some common sense. Can't hurt, might help, but honestly, if you've got something you need to say, say it.Bill Godfrey: We want to get air gaps. We want to get around a corner anyways, so hold your transmission til you get to your cover and then put it out. Billy Perry: Right. Put it out. The 300 foot, whatever, be cognizant of your standoff distances and look at how far those really are. That's big. Again, never, ever touch a bomb. Those are our takeaways. Don't touch the bomb. I'm not saying that we're going to execute a bomber, but I am saying we are not going to negotiate with one. Bill Godfrey: Okay. Well put. Never touch a bomb. Billy Perry: Never touch a bomb. Bill Godfrey: Never touch a bomb and don't touch it with your radio or [crosstalk 00:26:49] Billy Perry: Don't look at it.Bill Godfrey: [crosstalk 00:26:51] Billy Perry: Don't fold it, spindle it, mutilate it. Don't mess with it. Don't move it. Don't change the environment, like I said. Just use you common sense. It's a weapon. It is a firearm that fires at 540 degrees and does not miss. A bomber is a bomb and we're not going to touch a bomb. We're not going to touch a bomber. Bill Godfrey: Thank you very much. I think that's a good place to leave it for today and wrap this one up. Billy Perry: Thank you.Bill Godfrey: Tom, thanks for coming in. Tom Billington: Thank you. Bill Godfrey: Billy, thank you very much. Billy Perry: Thank you so much.Bill Godfrey: Appreciate you guys being here. Original Source: https://www.c3pathways.com/podcast/improvised-explosive-devices

As the country searches a new way to address cost of care, value-based insurance design (VBID), is gaining traction as one way of encouraging the use of high-value services and discouraging the use of low-value services. VBID would give patients access to treatments and services with high clinical value at reduced or no cost sharing. Currently, health plans tend to value all treatments and services as equal in clinical value to all patients, even though this is not the reality. On March 14, the University of Michigan’s V-BID Center hosted its annual VBID Summit with discussions on aligning around value, how public payers are adopting VBID principles, addressing the use of low-value care services, and creating a smarter high-deductible health plan. Read coverage of the panels from the V-BID Summit: The Challenge of Addressing Low-Value Care Once It's Identified: www.ajmc.com/conferences/v-bid-summit-2018/the-challenge-of-addressing-lowvalue-care-once-its-identified How Public Payers Are Adopting VBID Principles Despite Constraints: www.ajmc.com/conferences/v-bid-summit-2018/how-public-payers-are-adopting-vbid-principles-despite-constraints Aligning Around Value: Challenges With Quality Measures and Implementing Clinical Nuance: www.ajmc.com/conferences/v-bid-summit-2018/aligning-around-value-challenges-with-quality-measures-and-implementing-clinical-nuance Path to a Smarter High-Deductible Plan Includes Flexibility, Disruptive Innovation: www.ajmc.com/conferences/v-bid-summit-2018/path-to-a-smarter-highdeductible-plan-includes-flexibility-disruptive-innovation

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care stories included a report from CMS that found healthcare spending will rise 5.5% over the next 8 years; the budget deal passed by Congress included a number of provisions with long-term health impact; a study found eating a low-carb could help reverse type 2 diabetes. Read more about the stories in this podcast: By 2026, National Health Spending Will Climb to 19.7% of Economy, Report Says: www.ajmc.com/newsroom/by-2026-national-health-spending-will-climb-to-197-of-economy-report-says- Proposed Bipartisan Bill, 2018 Budget Deal Provide Positive Implications for VBID: www.ajmc.com/focus-of-the-week/proposed-bipartisan-bill-2018-budget-deal-provide-positive-implications-for-vbid Congress Includes Language Protecting the Rights of Diabetes Patients in Budget Deal: www.ajmc.com/newsroom/congress-includes-language-protecting-the-rights-of-diabetes-patients-in-budget-deal ASCO Review Finds Clinical Pathway Programs Adhere to Guidelines: www.ajmc.com/newsroom/asco-review-finds-clinical-pathway-programs-adhere-to-guidelines After a Year, Low-Carb Diet Helps Many Patients Reverse Type 2 Diabetes, Lose Weight, and Stop Insulin: www.ajmc.com/focus-of-the-week/after-a-year-low-carb-diet-helps-many-patients-reverse-type-2-diabetes-lose-weight-and-stop-insulin Medicare Accountable Care Spending Patterns: Shifting Expenditures Associated With Savings: www.ajmc.com/journals/ajac/2018/2018-vol6-n1/medicare-accountable-care-spending-patterns-shifting-expenditures-associated-with-savings

Suzanne talks to Mark Fendrick, the Director of University of Michigan's Center for Value-based Insurance Design (VBID), about his dream of designing a benefit that reimburses generously for the care consumers need most and where the VBID movement is headed now. Learn more about the work of the V-BID Center by visiting vbidcenter.org.

More bills than anyone could possible read were passed by a branch of Congress in June, including the 994 page National Defense Authorization Act (NDAA), four government funding bills, and thirty bills governing a wide range of topics, including Wall Street, MediCare, fishing, carbon dioxide emissions, stolen art, chemical storage, taxes, and more. Please support Congressional Dish: Click here to contribute with PayPal or Bitcoin; click the PayPal "Make it Monthly" checkbox to create a monthly subscription Click here to support Congressional Dish for each episode via Patreon Mail Contributions to: 5753 Hwy 85 North #4576 Crestview, FL 32536 Thank you for supporting truly independent media! New Congressman Rep. Trent Kelly of Mississippi's 1st district was sworn into office Emergency The Obama Administration continued the national emergency declared in Executive Order 13405 on June 16, 2006 with respect to Belarus Bulletin: Prospects for Belarus' Membership in the WTO by Anna Maria Dyner, The Polish Institute of International Affairs, July 31, 2013. Laws H.R. 2048: USA Freedom Act Outlined and discussed in Congressional Dish Episode 98: The USA Freedom Act H.R. 2620: United States Cotton Futures Act Hearing: House Agriculture Committee, June 17, 2015. Exempts cotton from foreign companies from part of the United Sates Cotton Futures Act, which will allow foreign cotton companies to participate in cotton futures trading. Current law only allows 100% U.S. cotton to be traded on the futures exchange. Passed the House of Representatives and the Senate by voice votes Sponsored by Rep. David Scott of Georgia's 13th district His #2 contributor is ICE Group, (stands for Intercontinental Exchange) which is a network of financial exchanges and clearing houses; it operates eleven exchanges, including three in the United States, Canada, and Europe that deal with agriculture futures. The company has ten lobbyists and has spent over $1.3 million lobbying for the last Congressional election. In the last election cycle, ICE Group gave more to Rep. David Scott than to any other politician, and over the years, the company has given Rep. David Scott at least $73,850. 1 page H.R. 1626: DHS IT Duplication Reduction Act Makes the DHS submit a report about the department's technology and gives them no additional money to complete it. Passed the House of Representatives and the Senate by voice votes Sponsored by Rep. Will Hurd of Texas's 23rd district 2 pages Bills H.R. 1735: National Defense Authorization Act Passed the House of Representatives 269-151 The version passed by the House of Representatives received a veto threat by President Obama Passed the Senate with changes 71-25 Sponsored by Rep. Mac Thorneberry of Texas's 13th district 994 pages Weird advertisement for the NDAA H.R. 2685: Department of Defense Appropriations Act Passed the House of Representatives 278-149 Received a veto threat from President Obama Sponsored by Rep. Rodney Frelinghuysen of New Jersey's 11th district 170 pages H.R. 2596: Intelligence Authorization Act for Fiscal Year 2016 Passed the House of Representatives 247-178 Received a veto threat from President Obama Sponsored by Rep. Devin Nunes of California's 22nd district 63 pages H.R. 2578: Commerce, Justice, Science, and Related Agencies Appropriations Act, 2016 Passed the House of Representatives 242-183 Received a veto threat from President Obama Sponsored by Rep. John Culberson of Texas's 7th district 218 pages H.R. 2577: Transportation, Housing, and Urban Development, and Related Agencies Appropriations Act Passed the House of Representatives 216-210 Received a veto threat from President Obama Sponsored by Mario Diaz-Balart of Florida's 25th district 354 pages H.R. 1335: Strengthening Fishing Communities and Increasing Flexibility in Fisheries Management Act Hearing: House Rules Committee, May 19, 2015. Changes the rules for management of an overfished fishery so that there is no hard deadline (currently 10 years) to replenish the fishery and adds exceptions, including one that allows the overfishing to continue if replenishment can't be done "without significant economic harm to the fishery". Doubles the amount of time an emergency regulation can adjust a fishery management plan. Adds economic impact to "fishing communities" to the list of factors that need to be considered when creating catch limits and exempts for some fish with short life spans. Regional Fishery Management Council meetings will have to be posted online All requirements of the the National Environmental Policy Act and all related implementing regulations will be deemed approved if the Regional Fishery Management Council completes a fishery impact statement. Creates a pilot program for using electronic monitoring at fisheries. Repeals independent peer-reviewed analysis' of the quality of statistics collected on fishing populations and a requirement for catch limits for Gulf of Mexico red snapper for recreational and commercial fishermen Ensures that this law will trump the National Marine Sanctuaries Act, the Antiquities Act, and the Endangered Species Act Prohibits the government from factoring in red snapper killer during the removal of offshore oil rigs when determining catch limits. Prohibits the government from factoring fish caught by foreign vessels in the U.S. economic zone when determining catch limits. Requires new guidelines be issued that will use nongovernmental sources for fisheries management decisions. Passed the House of Representatives 225-152 Received a veto threat from President Obama Sponsored by Rep. Don Young of Alaska His #4 contributing industry for the upcoming election is Fisheries and Wildlife; he has taken $9,000 from them for this election cycle as of 9/11/15. 57 pages H.R. 2042: Ratepayer Protection Act of 2015 Hearing: House Rules Committee, June 23, 2015. Prohibits any final rule to address carbon dioxide emissions from existing fossil-fuel powered electric utilities from being enforced until all lawsuits and appeals filed within 60 days of the final rule's publication are complete. Exempts states from complying with a final rule addressing carbon dioxide emissions from existing fossil fuel powered plants if the Governor informs the EPA that the rule would increase rates or have a significant adverse effect on the reliability of the State's electricity system. Hydropower will be counted as renewable energy Passed the House of Representatives 247-180 Received a veto threat from President Obama Sponsored by Rep. Ed Whitfield of Kentucky's 1st district His #1 and #2 industries for the upcoming election are Oil and Gas and Electric Utilities; he's taken $46,100 from Oil and Gas and $38,500 from Electric Utilities as of 9/11/15. Over the course of his Congressional career, he has taken at least $771,315 from Electric Utilities and $562,097 from Oil and Gas. 6 pages H.R. 2289: Commodity End-User Relief Act Hearing: House Rules Committee, June 2, 2015. Extends operations of the Commodity Futures Trading Commission Limits the rules and regulations that can be enacted on futures commissions merchants Adds seven more considerations (including alternatives to regulation) to the requirements of cost-benefit analysis of regulations. Orders the CFTC cost benefit analysis to be reviewed by a judge. Allows the traders to be regulated to challenge new CFTC rules directly to the US Court of Appeals, the second most powerful court in the country. Limits the subpoena power of the CFTC Removes the requirement that the CFTC be immune from lawsuits that arise from sharing data about swaps with domestic and foreign authorities and backdates this change to July 21, 2010, the effective date of Dodd Frank Financial Reform. Adds "a utility operations-related swap" to the list of swaps that can be traded, which allows gambling on the future of natural gas or electric generation, purchases, sales, supplies or delivery. Exempts traders from being classified and regulated as a "swaps dealer" if they trade less than $8 billion (current CFTC rule exemption limit is $3 billion). Expands the number of financial models swaps dealers will be allowed to use to determine how much actual money they need to hold onto. Passed the House of Representatives 246-171 Received a veto threat from President Obama Sponsored by Rep. Michael Conaway of Texas's 11th district His top contributor for the upcoming election is Depository Trust & Clearing Corporation, which is a swaps clearing house; he received $15,000. His top 5 contributors over the course of his career are, in this order, the American Institute of CPA's an international association of accountants, KPMG LLP, a multinational corporation specializing in auditing and regulation compliance, PricewaterhouseCoopers, and even larger multinational corporation specializing in regulation compliance, Energy Future Holdings Corp, a portfolio of energy companies, and Deloitte LLP, the self-proclaimed "world's largest" multinational corporation that specializes in auditing and risk management. From these five companies, Conaway has taken at least $319,873. 80 pages H.R. 1190: Protecting Seniors' Access to Medicare Act of 2015 Hearing: House Rules Committee, June 16, 2015. Repeals the Independent Payment Advisory Board, which is designed to suggest solutions if Medicare costs get out of control. Drastically cuts funding for the Prevention and Public Health Fund, cutting it by a total of $8.8 billion by 2026, which is a 61% cut. Passed the House of Representatives 244-154 Received a veto threat from President Obama Sponsored by Rep. Phil Roe of Tennessee's 1st district His #1 contributing industry over the course of his career is Health Professionals; he has taken $435,088 as of 9/11/15. 3 pages H.R. 160: Protect Medical Innovation Act of 2015 Hearing: House Rules Committee, June 16, 2015. Repeals the medical device excise tax The effects of this repeal on the budget will not be counted The Joint Committee on Taxation estimates that this will increase the budget deficit by $24.4 billion Passed the House of Representatives 280-140 Received a veto threat from President Obama Sponsored by Rep. Erik Paulsen of Minnesota's 3rd district His #3 contributing industry over the course of his career has been Pharmaceuticals/Health Products; he has taken at least $654,929. His #4 contributing industry has been Health Professionals; from them, he has taken $622,645. 4 pages H.R. 2200: CBRN Intelligence and Information Sharing Act of 2015 Allows the Office of Intelligence an Analysis of the Department of Homeland Security to share information and work with the Intelligence community to analyze possible chemical, biological, radiological, and nuclear attacks. Allows the Department of Homeland Security to share information related to terrorist attacks with the public. Passed the House of Representatives 420-2 Sponsored by Rep. Martha McSally of Arizona's 2nd district 6 pages H.R. 805: DOTCOM Act of 2015 Press Release: NTIA Announces Intent to Transition Key Internet Domain Name Functions, March 14, 2014. Prohibits the transition of NTIA's functions in Internet domain name registry until 30 days after a report is submitted. Passed the House of Representatives 378-25 Sponsored by Rep. John Shimkus of Illinois's 15th district 4 pages H.R. 2576: TSCA Modernization Act Eliminates a requirement that EPA use the "least burdensome requirements" when regulating toxic chemicals Orders the EPA to do risk evaluations on chemicals used, stored, sold or disposed of by commercial companies. The risk evaluations will not consider cost If the risk evaluation is requested by a manufacturer, the manufacturer will pay for the risk assessment The EPA will be required to do at least 10 risk assessments per year "subject to the availability of appropriations". Adds an exemption for "replacement parts" from the EPA rules prohibiting chemicals unless the replacement parts "contribute significantly to the identified risk". Adds the requirement that any rules created "shall provide for a reasonable transition period." Eliminates the requirement for an informal hearing when making rules about toxic chemicals. Creates a "critical use exemption" option for the EPA if the requirement is not "cost-effective", if it would "significantly disrupt the national economy, national security, or critical infrastructure" The exemption would be valid for 5 years at a time The exemption will include conditions on the use of the toxic chemical Allows data to be shared with State, local, or tribal governments and with health care professionals to assist with diagnosis or treatment. Forces companies that want to keep information confidential to explain their reasons and automatically releases the information to the public in 10 years, unless the company justifies the confidentiality again in writing. Eliminates caps of fees that can be collected and creates a "TSCA Service Fee Fund" to collect, store, and disperse the funds to pay for the EPA's costs for regulating chemicals. Passed the House of Representatives 398-1 Sponsored by Rep. John Shimkus of Illinois's 15th district 48 pages H.R. 1615: DHS FOIA Efficiency Act of 2015 Orders the Chief Freedom of Information Act Officer of the Department of Homeland Security to update Freedom of Information Act regulations within 90 days of the bill's passage. Orders the Chief FOIA Officer to identify the total annual cost of implementing the FOIA within 90 days. Orders the Chief FOIA Officer to identify unnecessary actions taken in the course of processing requests and eliminate them within a year of identifying them. Orders the Chief FOIA Officer to develop a plan to to process requests electronically. Orders the Chief FOIA Officer to issue guidance to the necessary people to reach the goal of reducing the FOIA request backlog by 50 percent by 2018. Passed the House of Representatives 423-0 Sponsored by Rep. Buddy Carter of Georgia's 1st district 7 pages S.611: Grassroots Rural and Small Community Water Systems Assistance Act Authorizes $15 million per year until 2020 to provide technical assistance to small public water systems. Passed the Senate by a voice vote Sponsored by Senator Roger Wicker of Mississippi 5 pages S. 653: Water Resources Research Amendments Act Adds a requirement for additional research into new water treatments into the Water Resources Research Act Requires an evaluation of water resource research projects every three years and withdraws funds from projects that do not qualify based on the evaluation. Authorizes $13.5 million per year through 2020. Passed the Senate by a voice vote Sponsored by Senator Ben Cardin of Maryland 5 pages H.R. 2088: United States Grain Standards Act Reauthorization Act of 2015 Reauthorizes the Department of Agriculture's process for grain inspections until September 30, 2020. Forces the Secretary of Agriculture to waive weighting and inspections of grain in an "emergency, a major disaster"; currently, the Secretary has the option to do so, but does not have to. A "major disaster" is defined to specifically include "a sever weather incident causing a region-wide interruption of government services". Changes the location of export inspections to specifically "export elevators" at export port locations. Widens the criteria for who is qualified to perform official inspections by deleting a list of requirements. Delegations of authority to conduct grain inspections to a State will expire every five years, and my be renewed. Adds a public comment period before the Secretary can delegate inspection responsibility to a State and requires a notice in the Federal Register announcing if the State was approved and the rational for the decision. The State would have to give at least 90 days notice advanced notice in writing to the Dept. of Agriculture if they want to stop performing grain inspections, unless there has been a major disaster. The public must be given online a list of the States delegated to perform official inspections, which needs to be updated at least twice a year. Passed the House of Representatives by a voice vote Sponsored by Rep. Michael Conaway of Texas's 11th district His #2 contributing industry over the course of his career has been Crop Production and Basic Processing; he has taken at least $646,470. 18 pages H.R. 2051: Mandatory Price Reporting Act of 2015 Extends mandatory price reporting requirements for livestock until September 30, 2020. Clarifies that reports are expected on days the Dept. of Agriculture is open for business, including days when the government is "on shutdown or emergency furlough as a result of a lapse in appropriations". Allows transactions between pork packers and producers to take place using a new pricing formula. Changes the definition of an importer of lamb to include anyone who imports an average of 1,000 metric tons per year; currently importers have to comply with regulations if they import and average of 2,500 metric tons of lamb per year. Changes the definition of a lamb packer to someone who owns 50% or more of a facility and slaughters an average of 35,000 heads of lambs per year; currently if they slaughter 75,000 lambs per year. Passed the House of Representatives by a voice vote Sponsored by Rep. Michael Conaway of Texas's 11th district 8 pages H.R. 2394: National Forest Foundation Reauthorization Act of 2015 Reauthorizes and appropriates $3 million per year until 2018 for the National Forest Foundation Act, which established a partnership with a non-profit to study and restore national forests. This is triple the previous funding. Passed the House of Representatives by a voice vote Sponsored by Rep. Glenn Thompson of Pennsylvania's 5th district 3 pages H.R. 235: Permanent Internet Tax Freedom Act Article: Internet tax moratorium extended again by Grant Gross, IDG News Service, December 15, 2014. Makes the moratorium on Internet access taxes permanent. Passed the House of Representatives by a voice vote Sponsored by Rep. Bob Goodlatte of Virginia's 6th district 2 pages H.R. 889: Foreign Cultural Exchange Jurisdictional Immunity Clarification Act Prohibits art imported into the United States to be temporarily displayed from being seized by the United States, even if that art is discovered to have been stolen. This immunity does not apply to art stolen by the Nazis. Passed the House of Representatives by a voice vote Sponsored by Rep. Steve Chabot of Ohio's 1st district 5 pages S. 184 and H.R. 1168: Native American Children’s Safety Act Requires criminal background checks of any person who lives in a house applying to provide foster care to an Indian child and prohibits placement if anyone in the home is found to have committed certain crimes. This will not apply to emergency foster care placement Both bills passed the Senate and the House of Representatives by voice votes S. 184 was sponsored by Senator John Hoeven of North Dakota and H.R. 1168 was sponsored by Kevin Cramer of North Dakota S. 184: 12 pages H.R. 1168: 10 pages S. 246: Alyce Spotted Bear and Walter Soboleff Commission on Native Children Act Establishes the Alyce Spotted Bear and Walter Soboleff Commission on Native Children. All 11 members will be appointed by the President and Congressional leaders and their appointments will be for the entire duration of the commission. The Commission's job will be to complete a study on the effectiveness of programs aimed at the health and education of native children and to make recommendations for fixing the inadequacies. The Commission will terminate 90 days after they submit their report. Authorizes, but does not appropriate, $2 million. Passed the Senate by a voice vote Sponsored by Senator Heidi Heitkamp of North Dakota 27 pages H.R. 404: Authorizing early repayment of obligations to the Bureau of Reclamation within the Northport Irrigation District in the State of Nebraska Allows Nebraska landowners to repay construction debts at any time. Passed the House of Representatives by a voice vote Sponsored by Rep. Adrian Smith of Nebraska's 3rd district 3 pages H.R. 1493: Protect and Preserve International Cultural Property Act Directs the State Department to designate an existing employee to coordinate efforts to protect art around the world from being stolen and/or destroyed. Establishes a committee, which will meet once a year and be made up of representatives from various Federal agencies, who will "coordinate and inform Federal efforts to protect international cultural property". Blocks importation of "archaeological or ethnological material of Syria" starting 120 days after the bills enactment. The import restrictions will expire in five years, but can be extended. Passed the House of Representatives by a voice vote Sponsored by Rep. Eliot Engel of New York's 16th district 19 pages S. 253: Federal Communications Commission Consolidated Reporting Act Orders a public report every two years on competition, availability of services, and regulatory barriers to entry into the communications services business. Repeals an annual public report on privatization of the communications services industry, which includes public comments. Repeals an annual report on foreign and domestic competition in the communications satellite market. Eliminates an annual report on the "status of competition in the market for the delivery of video programming". Eliminates the requirement that a report on cable industry price be completed annually. Eliminates the requirement that a report on regulatory barriers be reviewed every three years. Eliminates an FCC analysis "of whether any of such competitors have a dominant share of the market" Passed the Senate by a voice vote Sponsored by Sen. Dean Heller of Nevada 16 pages S. 565: Federal Vehicle Repair Cost Savings Act Encourages Federal agencies to use remanufactured vehicle parts to maintain Federal vehicles. Passed the Senate by a voice vote Sponsored by Sen. Gary Peters of Michigan 4 pages H.R. 2570: VBID for Better Care Act Establishes a three year demonstration project to test "value-based insurance" for Medicare patients at two Medicare Advantage sites. Value based insurance allows insurance companies flexibility with co-payments, allowing them to lower co-payments for services deemed to be "high value" preventative services and increasing rates for services with uncertain value. It's designed to "create financial disincentives for poor health choices". The demonstration projects would not allow increases in co-payments to discourage the use of services. Passed the House of Representatives by a voice vote Sponsored by Rep. Diane Black of Tennessee's 6th district 17 pages H.R. 2507: Increasing Regulatory Fairness Act Extends the amount of time between proposed Medicare rate changes are announced and when they can go into effect from 60 days to 90 days. Requires more information about why the changes are being implemented. Passed the House of Representatives by a voice vote Sponsored Rep. Kevin Brady of Texas's 8th district 4 pages H.R. 2505: Medicare Advantage Coverage Transparency Act Requires an annual report to Congress detailing the location and number of people enrolled in Medicare, Medicare Advantage, and Medicare Part D. Passed the House of Representatives by a voice vote Sponsored by Rep. Mike Kelly of Pennsylvania's 3rd district 4 pages H.R. 2582: Securing Seniors' Health Care Act Prohibits the government from terminating a contract for a Medicare Advantage organization because it fails to meet minimum quality standards until the end of 2018. Passed the House of Representatives by a voice vote Sponsored by Rep. Vern Buchanan of Florida's 16th district 10 pages H.R. 1633: DHS Paid Administrative Leave Accountability Act of 2015 Article: Administrative Leave Restrictions at DHS Backed, FedWeek, July 8, 2015. Orders a report to be completed by the Department of Homeland Security four times per year on the number of people on paid administrative leave for more than six months and the cost associated. Passed the House of Representatives by a voice vote Sponsored by Rep. Barry Loudermilk of Georgia's 11th district 7 pages H.R. 1646: Homeland Security Drone Assessment and Analysis Act Orders a report on how commercially available small and medium sized drones could be used to commit terrorist attacks and what the Department of Homeland Security could do to stop this type of attack. Passed the House of Representatives by a voice vote Sponsored by Rep. Bonnie Watson Coleman of New Jersey's 12th district 4 pages H.R. 1637: Federally Funded Research and Development Sunshine Act of 2015 Orders an annual report on the Federally funded research projects being conducted by the Department of Homeland Security Passed the House of Representatives by a voice vote Sponsored by Rep. John Ratcliffe of Texas's 4th district 3 pages H.R. 2390: Homeland Security University-based Centers Review Act Orders an annual report on the effectiveness of using universities to conduct Department of Homeland Security research. Passed the House of Representatives by a voice vote Sponsored by Rep. Bennie Thompson of Mississippi's 2nd district 5 pages June Hearings Senate Committee on Foreign Relations: Security Assistance in Africa, June 4, 2015. Senate Committee on Foreign Relations: Trade Promotion and Capacity Building in the Asia-Pacific Region, June 16, 2015. House Committee on Transportation and Infrastructure: Western Hemisphere Drug Interdiction Efforts, June 16, 2015. House Committee on Financial Services: The Impact of the International Monetary Fund: Economic Stability or Moral Hazard?, June 17, 2015. House Committee on Oversight and Government Reform: Drones: The Next Generation of Commerce?, June 17, 2015. House Committee on Energy and Commerce: A National Framework for the Review and Labeling of Biotechnology in Food, June 18, 2015. House Committee on Foreign Affairs: The Future of Property Rights in Cuba, June 18, 2015. Senate Committee on Foreign Relations: American Energy Exports, June 23, 2015. Senate Caucus on International Narcotics Control: Cannabidiol, June 24, 2015. House Committee on Homeland Security: DHS' Efforts to Secure .Gov, June 24, 2015. House Committee on Transportation and Infrastructure: The State of Positive Train Control Implementation in the United States, June 24, 2015 House Committee on Ways and Means: Repatriation of Foreign Earnings as a Source of Funding for the Highway Trust Fund, June 24, 2015 Senate Committee on Agriculture, Nutrition, and Forestry: Country of Origin Labeling, June 25, 2015 Senate Committee on Banking, Housing, and Urban Affairs: Global Impact of a Greek Default, June 25, 2015. Jen's Podcast Appearances September 9, 2015 episode of American Workers Radio Music Presented in This Episode Intro & Exit: Tired of Being Lied To by David Ippolito (found on Music Alley by mevio) Money, Money, Money by The Undercover Hippy (found on Music Alley by mevio)