Officials are reminding those on Medicare that they don’t need to sign up for health insurance coverage in Obamacare’s marketplaces starting Oct. 1. In the meantime, a new study says Rochester, N.Y., has the lowest Medicare spending, and the notion of investing a portion of the money in your Health Savings Account gains steam.The Wall Street Journal: Don’t Confuse Medicare With Obamacare The annual Medicare open-enrollment period, which runs from Oct. 15 through Dec. 7, overlaps this year with the initial registration for the Health Insurance Marketplace, a cornerstone of the Affordable Care Act (aka Obamacare). But don’t confuse the two. They serve different populations. If you’re already covered by Medicare, you needn’t give the Marketplace another thought (Waters, 9/7).Earlier, related KHN coverage: No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces (Jaffe, 8/25). The Associated Press/Wall Street Journal: Rochester, NY, Cited For Lowest Medicare SpendingA new study finds that the Rochester area has the lowest overall Medicare spending rate in the nation, a feat health officials attribute to aggressive regional planning that keeps a lid on unneeded hospital expansions and technology upgrades that insurers ultimately pay for (9/8).The Associated Press: How To Invest In Your Health CareYou already can invest your retirement money and your kid’s college savings on Wall Street. Next on the list: your health care. A growing number of employees are required by companies to set up special savings accounts to cover part of their medical bills. Over time, they are also encouraged to invest a portion of it in stocks, bonds or a mutual fund, just like they do with a 401(k) or IRA. Americans now have $18 billion in Health Savings Accounts. … That’s up more than 40 percent from a year ago (Sweet, 9/6). Seniors Can Ignore New Health Insurance Marketplaces This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Rep. Andy Harris, the state’s only Republican member of Congress, requested the investigation even as lawmakers from both parties — who have used the difficulties of the online insurance marketplace in the run up to this year’s gubernatorial election — say they welcome the review. News outlets also track developments in California, New York, Missouri, Hawaii, Colorado and South Carolina. The Washington Post: HHS Inspector General To Review Md. Health Exchange After Congressman Requests ProbeThe inspector general for the U.S. Department of Health and Human Services plans to review Maryland’s troubled online health insurance marketplace, according to a Republican congressman who called for an investigation into the tens of millions of dollars the state spent on the system, which has been marred with technical glitches and might soon be replaced or abandoned (Johnson, 3/10).The Associated Press/Washington Post: Lawmaker: Feds To Review Maryland Health ExchangeThe inspector general of the U.S. Department of Health and Human Services has agreed to review Maryland’s troubled health care exchange, a congressman said Monday. Rep. Andy Harris, the state’s only Republican congressman, said he has confidence that the nonpartisan and independent inspector general, who has subpoena power, will thoroughly investigate problems that have plagued the exchange since it opened in October (3/10).Politico: Feds To Investigate Flawed Maryland Obamacare ExchangeThe HHS Office of the Inspector General is launching an investigation into Maryland’s troubled health insurance exchange, the latest target of expanding federal oversight of poorly performing Obamacare exchanges. As requested by Rep. Andy Harris, a Maryland Republican and foe of the Affordable Care Act, investigators will look at the procedures state officials followed in contracting with the tech companies behind the site’s botched development and at troubles with Medicaid enrollment that are expected to significantly drive up costs (Norman, 3/10).The Baltimore Sun: State Officials Welcome Federal Review Of Health SiteElected officials from both parties said Monday they welcome a pending federal review of Maryland’s troubled health insurance exchange, even as they used the latest development to take swipes at one another ahead of this year’s gubernatorial election. The inspector general for the U.S. Department of Health and Human Services will examine how millions of dollars of federal money was spent on the site, according to the Republican lawmaker who requested it (Fritze, 3/10). U.S. News & World Report: Higher-Cost Obamacare Plans Don’t Guarantee More ChoiceA U.S. News analysis of health plans currently available on California’s new insurance exchange found little correlation between the monthly price a consumer pays for a plan and the number of hospitals in the plan’s network. The findings indicate that, with careful selection, it’s possible for most Californians to buy an Obamacare plan that offers some freedom in choosing a hospital without paying top dollar in monthly premiums (Heilbrunn, 3/10).The Associated Press/Wall Street Journal: NY Health Exchange Reports 591,000 EnrolleesThe state’s new health exchange reports more than 908,000 New Yorkers have completed applications for insurance while more than 591,000 of them have now enrolled for specific coverage (3/11).Kaiser Health News: Capsules: Missouri Pulls Out Stops, But Lags Better-Funded Illinois EffortCover Missouri — a coalition of 400 organizations led by the Missouri Foundation for Health — has 130 enrollment events statewide this month. The St. Louis Effort for Aids, for example, planned the Rock Enroll event last Saturday (Kulash, 3/10).The Associated Press: Lawmakers Propose Fees For [Hawaii] Health ExchangeState lawmakers are proposing charging a fee to insurers that are not participating in the state’s insurance exchange under President Barack Obama’s federal health care overhaul. The fee would help prop up the financially troubled Hawaii Health Connector. The exchange has enough money to cover its bills for this year — but not beyond that, without some help (Bussewitz, 3/10).Health News Colorado: Exchange CEO Complains Of ‘Cuts, Cuts, Cuts,’ But Board Refuses Fee HikesColorado’s health exchange board refused to hike user fees by 21 percent Monday despite complaints from Connect for Health Colorado’s CEO that she’ll have to cut spending without more revenue. The news comes as managers have slashed projected enrollments. The most optimistic projections once predicted that as many as 204,000 Coloradans would have signed up for private health insurance by the end of this month. Mid-level projections called for about 133,000 while about 90,000 people have actually signed up so far. New projections now call for as few as 152,000 people buying through Connect for Health both this year and next (McCrimmon, 3/10). Charleston, S.C., Post and Courier: Health Insurance Enrollment Continues To Climb In South CarolinaAbout 10,000 South Carolinians purchased a private insurance policy through the federal health insurance marketplace last month, driving total enrollment since Oct. 1 to nearly 37,000, according to the S.C. Department of Insurance. This includes only new customers who have actually paid their first month’s premium. Monthly reports released by the U.S. Department of Health and Human Services use a broader definition of enrollment, and include some customers who have picked a plan but not paid (Sausser, 3/10). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. HHS Inspector General To Examine Maryland’s Troubled Health Exchange
The Wall Street Journal’s Pharmalot: Actavis Wins A ‘Product Hopping’ Case As Namenda Battle Rages On This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Amgen Inc., the maker of cancer treatments and blood boosters to combat anemia, reported first-quarter profit that topped analysts’ estimates and raised its forecast for the year on stronger-than-expected drug sales. The shares rose in late trading. (Chen, 4/21) Earlier related Kaiser Health News coverage: Battle Over Dementia Drug Swap Has Big Stakes For Drugmakers, Consumers Reuters: Generic Drugmaker Teva Makes $40B Offer For Generic Competitor The Associated Press: Teva Offers To Buy Mylan In $40.1-Billion Cash-And-Stock Deal Modern Healthcare: Humana Invests Further In Home Health Visits Health insurer Humana has acquired Your Home Advantage, a Deerfield Beach, Fla.-based company that sends nurse practitioners and other providers to assess and care for patients in their homes. The company will become part of Humana At Home, Humana’s home-based services division that was previously known as SeniorBridge Family Cos. Humana bought SeniorBridge in 2012. (Herman, 4/21) Bloomberg: Amgen Profit Beats Estimates As Drugmaker Raises Forecast Teva Pharmaceutical Industries Ltd on Tuesday made an unsolicited $40 billion offer for smaller rival Mylan NV, a bold bid for growth as its lucrative Copaxone drug faces generic competition. The offer followed weeks of speculation that Israel-based Teva, the world’s largest generic drugmaker, would soon target Mylan. Shares of Mylan traded below the offer price of $82 in cash and stock, evidence of investor skepticism that Teva can win over the company, which has set up a defense that includes a poison pill. (Cohen and Humer, 4/21) Bloomberg: Teva Bid For Mylan Sparks Worries Of Rising Generic Drug Prices Four years ago, Warner-Chilcott caused a stir by adding a line, or “score,” to its Doryx tablets that are prescribed for treating acne. The move gained notice because it was seen by some as another effort by a brand-name drug maker to thwart generic competition, since any generic rival would have had to take the same time-consuming production steps to win regulatory approval to sell a copycat version. (Silverman, 4/21) And The Wall Street Journal looks at a ruling in one product-hopping case in advance of a decision on Alzheimers’ drug Namenda – A potential $40.1 billion generic-drug merger already has Brad Arthur bracing for a blow to his family-run pharmacy in Buffalo, New York. Arthur has been contending with rising generic drug prices for the better part of two years — a trend that has drawn Washington’s attention and caused an outcry from consumer advocates. Now the pharmacist says he fears the proposed takeover of Mylan NV by Israel’s Teva Pharmaceutical Industries Ltd. could threaten businesses like his by reducing competition even further. (Koons, 4/21) Teva Bid For Rival Spurs Anti-Competitive Concerns The $40 billion bid by the world’s largest generic drugmaker is expected to bring scrutiny by antitrust regulators. And Amgen raises forecasts on stronger-than-expected drug sales. Generic drug giant Teva formally offered to buy fellow drugmaker Mylan for about $40.1 billion in cash and stock on Tuesday, despite Mylan’s cold shoulder and the certainty the proposed acquisition will bring intense scrutiny by antitrust regulators. If Israel-based Teva Pharmaceutical Industries Ltd. succeeded, the combination would dominate the global generic drug market, be a major contender in some other specialty drug categories — and have the leverage to try to raise generic drugs prices. (Johnson, 4/21) Meanwhile, health insurer Humana acquires a company that sends nurse-practitioners for home visits.
The Wall Street Journal: Obama’s Medicaid Budget Trap Legislators in Arkansas, New Hampshire, South Dakota and elsewhere have spent the past three months considering whether they should expand Medicaid under the terms of the Affordable Care Act, or renew their previous commitment to do so. But new projections by the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) indicate the federal government’s cost of Medicaid expansion over the next decade will be significantly higher than originally expected. This raises serious questions about the program’s financial viability. (Justin Haskins, 4/7) The Dallas Morning News: Why Witch Hunts Can’t Kill Planned Parenthood Los Angeles Times: Putting Human Stem Cells In Animal Embryos? The NIH Should Get On Board. This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. The signs directing people to a big nonprofit gala at a downtown hotel last week were oddly neutral. Stylized placards with a pretty bluebonnet motif announced “2016 annual awards luncheon.” They didn’t say what luncheon. Times being what they are, it was understandable. It wasn’t a secret that this was the big spring fundraiser for Planned Parenthood of Greater Texas, but it wasn’t overtly publicized, either. (Jacquielynn Floyd, 4/7) The New York Times: Free Pfizer! Why Inversions Are Good For The U.S. Donald J. Trump wants to build a bricks-and-mortar wall to keep immigrants out of the United States. President Obama wants to build a virtual wall to keep companies from leaving. Neither is likely to work. On Monday, the Treasury Department issued new regulations in an attempt to limit “inversions” — in which American companies are acquired by foreign companies, legally lowering the tax burden of American companies. Speaking at the White House, Mr. Obama said, “We shouldn’t make it legal to engage in transactions just to avoid taxes.” (Diana Furchtogott-Roth, 4/7) Los Angeles Times: Pfizer Shows That Its Allergan Merger Was Only A Tax Dodge Even before Obamacare became the law of the land, the U.S. health-care system was undergoing a dramatic transformation. Millions of people were shifting from generous health-insurance plans to consumer-directed ones that pair low monthly premiums with high out-of-pocket costs. This shift has been encouraged by employers eager to reduce the cost of employee benefits. It has also been encouraged by market enthusiasts who contend that the U.S. health-care system needs to be more like the traditional consumer economy. (Peter Ubel, 4/8) When it announced its record-setting $160-billion merger with Allergan, the maker of Botox, last November, the giant drug company Pfizer tried valiantly to pretend that the deal wasn’t mostly about cutting its tax bill. “We are doing this because of the strategic importance of the franchises, the revenue growth we believe we can get within the U.S. and internationally, and the importance to combine the research approaches,” Pfizer CEO Ian Read told investment analysts on Nov. 23, after the merger was announced. He also said, a bit lamely: “I want to stress that we are not doing this transaction simply as a tax transaction.” (Michael Hiltzik, 4/6) Philadelphia Inquirer: Choices, Plans Overwhelming For Patients Thirty years ago Paul Simon immortalized one of the first animal-human transplants with the lyrics, “These are the days of miracle and wonder.… Medicine is magical and magical is art. Thinking of the boy in the bubble and the baby with the baboon heart.” Today we face the possibility of babies getting organs grown in human/nonhuman chimeras — beasts that are pigs except for a single human organ. To the uninitiated, this may sound more like the dark arts than modern medicine, but pursuing careful research and potential clinical use of these chimeras is both proper and important. Every day about 30 Americans die because they can’t get an organ transplant. Upward of 120,000 Americans are on transplant waiting lists. We are, medically, on the cusp of being able to save these lives in new ways: repairing failing organs with new genes or stem cells, building mechanical organs and growing replacement organs. (Henry T. Greely, 4/7) Viewpoints: The Unexpected Costs Of Expanding Medicaid; The Tricky Landscape Of Health Care Consumerism A selection of opinions from around the country.
The suits open another front in the burgeoning litigation against drugmakers including Purdue Pharma Inc. and the Janssen Pharmaceuticals unit of Johnson & Johnson and distributors such as McKesson Corp. and Cardinal Health Inc. The suits, which seek unspecified damages, seek to represent people who bought health insurance policies in those states since 1996. “All of the defendants in this action share responsibility for creating, sustaining and prolonging the opioid epidemic” in pursuit of corporate revenue, lead plaintiff Edward Grace alleges in a complaint filed Wednesday in Boston. (Harris and Hurtado, 5/2) WBUR: Latinos Are Hit Especially Hard By The Opioid Crisis In Mass. But Why? The state’s invalidated process for licensing new methadone clinics is delaying help for opioid addicts in rural communities. Many in those communities have to drive an hour or more to reach methadone clinics in more urban areas, said John Essenburg, vice president of medication assistance at Operation PAR, which runs several clinics in west Florida from Lee to Hernando counties. (Ochoa, 5/2) This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. CQ: Experts Weigh Merits Of House And Senate Opioid Legislation And in other news on the crisis — Addiction experts agree that tackling the opioid epidemic will require a multi-pronged approach. But as Congress advances dozens of proposals that would help combat the issue, identifying which bills are likely to create the biggest dent in the problem gets a little murkier. Last week, the Senate Health, Education, Labor, and Pensions Committee as well as the House Energy and Commerce Health Subcommittee both marked up legislation intended to address the opioid epidemic. The House subcommittee approved 56 opioid bills and one unrelated bill. The Senate HELP committee’s sole bill (S 2680) comprises more than 40 different proposals. (Raman, 5/2) As the opioid epidemic continues to claim tens of thousands of lives each year, prescribers are adopting new guidelines to restrict the use of opioids for chronic pain. And there are worries that there aren’t enough pain rehabilitation programs to treat all these additional patients with treatment that can be both costly and time-consuming. (Collins, 5/3) First-Of-Its-Kind Lawsuit Claims Pharma’s Role In Opioid Crisis Led To Higher Premiums For Everyone The industry is already defending itself against hundreds of lawsuits filed by cities and states, but this challenge takes a different route. “Insurance companies factored in the unwarranted and exorbitant healthcare costs of opioid-related coverage caused by defendants and charged that back to insureds in the form of higher premiums, deductibles, and co-payments,” the complaints allege. Meanwhile, experts weigh in on the opioid package moving through Congress. Health News Florida: Delays In Issuing Licenses For New Methadone Clinics Hurting Rural Communities Bloomberg: Opioid Makers Sued For Premium Hikes In First-Of-Kind Cases The opioid epidemic has unfairly increased health insurance costs across the board, not just for those suffering from addiction, plaintiffs allege in five proposed class-action lawsuits filed Wednesday. The suits, brought on behalf of people and businesses who have paid for health insurance in California, Illinois, Massachusetts, New Jersey and New York since 1996, represent a new front in litigation seeking to hold corporations accountable for the opioid crisis. (Randazzo, 5/2) Columbus Dispatch: Health-Insurance Customers Latest To Sue Cardinal Health, Others Over Opioid Crisis Proposed class-action lawsuits filed Wednesday in five states allege that Cardinal, distributors McKesson and AmerisourceBergen, and several drugmakers are partially to blame for increased health-insurance premiums over the past two decades related to the opioid crisis. (Matzer Rose, 5/2) Minnesota Public Radio: ‘What Do We Do Now?’ Many Struggle To Find Alternatives In Shift Away From Opioids Gov. John Kasich and leaders of state health-care profession licensing boards Wednesday announced a series of “common-sense” thresholds of opioid use that will trigger increased monitoring to ensure patients are receiving appropriate, non-dangerous doses. …Daily dosages of prescription opioid use, depending on the level, will require prescribers to re-evaluate underlying conditions causing pain, look for signs of prescription misuse and consult pain-care specialists. (Ludlow, 5/2) Columbus Dispatch: State To Enforce ‘Safety Checkpoints’ On Prescription Opioid Use Near-real-time data on the opioid epidemic in Massachusetts, produced by the Baker administration, shows the overdose death rate for Latinos has doubled in three years, growing at twice the rate of any other racial group. These numbers suggest the opioid crisis is hitting Latinos especially hard in Massachusetts. State officials say they don’t know why. (Bebinger, 5/3) The Wall Street Journal: New Front On Opioid Litigation: Suits Over Rising Premiums
Automakers Ask Trump To Ease Emissions Rules, EV Mandates – Get Ready For A War The Trump administration’s proposal would keep the average fuel economy of passenger vehicles at 37 miles per gallon through 2026. Under current rules adopted by the Obama administration, fuel economy would rise to an average of 47 mpg by 2025. There is a broad coalition of automakers, state governments, and environmentalists that oppose the Trump administration’s plan to freeze vehicle efficiency standards.Reichmuth said that GM recognizes the long-term need for vehicle electrification regarding economics and climate change. The company plans to launch 20 EV models in the next five years. “But that’s different from their short-term sales strategy of selling as many SUVs and pickup trucks as they can now,” he said. “We need to separate GM’s 50-state proposal from what they’re doing on electrification, which is very positive,” said Reichmuth.It’s a wash on EV sales number but not on EV policy.The UCS engineer is a Bolt driver. “It’s the first long-range, affordable battery-electric vehicle and that’s what I was waiting for,” he said. “And it’s the most fun to drive of any car I’ve owned.”Reichmuth explained in his blog post that GM’s proposal for a 50-state ZEV sales requires less than 5 percent of ZEV sales in the US by 2025. California electric vehicle sales are already at 6 percent in the first half of 2018. California and other so-called ZEV states are set to require about 8 percent ZEV sales by 2025.Reichmuth suggested that the zero-emission standards could be gamed because GM’s system would multiply ZEV credits by six-fold for automated electric vehicles, like the hundreds (or perhaps thousands) of self-driving Bolts going into fleets. Reichmuth said those credits could effectively reduce the total required number of EVs to as low as 3 percent of sales by 2025.In 2017, GM CEO Mary Barra announced that the Chevrolet Bolt is the company’s test vehicle for self-driving.Reichmuth admitted that GM’s nationwide plan could result in roughly the same total number of EVs across the country compared to the current landscape in which California and nine other states have much higher EV adoption. “It’s a wash on EV sales numbers, but it’s not a wash on what it does to EV policy,” said Reichmuth. “It’s not helpful to get rid of California’s ability to set their own standards.”The ability for California to push the boundaries on electrification is critical to making sure that automakers produce and sell EVs for the full range of vehicles from compacts to SUVs. “There’s an advantage to having some states go further that you wouldn’t get if you spread it out over all states equally,” said Reichmuth.InsideEVs reached out to General Motors for comment, but we haven’t heard back yet. Is GM pushing EVs while undermining overall MPG targets?General Motors last week called for a nationwide zero-emissions vehicle credit system. The proposal was made in response to the Trump administration’s plan to freeze vehicle efficiency standards. The Union of Concerned Scientists quickly fired back, arguing that GM’s plan “may sound like an innovative idea,” but it undermines the country’s progress to higher vehicle efficiency and reduced emissions.“GM’s ZEV proposal is hiding a call for a rollback of fuel economy standards,” said David Reichmuth, senior engineer for clean vehicles at UCS, in an interview with InsideEVs. “General Motors is a leader in EVs, and yet they are also calling for reduced efficiency standards for conventional vehicles. They can do good things and bad things at the same time.”Read about the ZEV Mandate Author Liberty Access TechnologiesPosted on October 31, 2018Categories Electric Vehicle News Source: Electric Vehicle News Unpacking The Zero Emission Vehicle Mandate Elon Musk: California’s ZEV “Credit Mandate Is Incredibly Weak”
Edmunds Drives 2019 Chevy Volt 70 Miles On Single Charge It’s a final farewell to the world’s most-beloved plug-in hybrid.This is the final year of production for the Chevy Volt, yet 2019 marks the first time the 2nd-gen Volt PHEV got significant revisions. Does the Volt exit the world on a new high?More 2019 Volt News 2019 Chevy Volt Still The Plug-In Hybrid Champion The most notable change for 2019 is the higher-powered on-board charger. For 2019, the Volt gets a 7.2-kW on-board charger, up from the old 3.6-kW. That means the car can refill its battery twice as quickly. This, in turn, means more electric miles and less use of gas. Most importantly, Chevy really focused on this more electric equals less gas for the Volt’s final year.Additionally, for those in colder climates who want to use as little gas as possible, the 2019 Volt has a new trick. The Volt allows owners to deactivate engine-assisted heating until minus 13 degrees F / minus 25 degrees C. This, again means more electric miles and less gas.Here video reviewer Alex on Autos takes a look at the 2019 Volt PHEV. He bids farewell to the plug-in hybrid that created the long-range segment. In closing, Alex says it’s the only PHEV with a truly split-down-the-middle personality.Video description:After we filmed this review, GM killed off its first plug-in hybrid model. After a great deal of debate, we decided to just go ahead and publish this review as a memorial to the only PHEV with a truly split-down-the-middle personality. 2019 Chevy Volt Finally Gets 7.2 kW Charger, -13 Degrees F Engine Activation Source: Electric Vehicle News Author Liberty Access TechnologiesPosted on January 19, 2019Categories Electric Vehicle News
Tesla Reduces Prices To Lessen Impact Of Tax Credit Drop Tesla To Close Order Books For Model S, X 75D Next Monday Source: Electric Vehicle News Author Liberty Access TechnologiesPosted on January 24, 2019Categories Electric Vehicle News In addition to the above, Tesla recently sold its 200,000th car in the U.S., which means the $7,500 federal EV tax credit is now in its sunset phase. In order to help consumers, the company has lowered vehicle prices. This may work to put a bigger dent in Tesla’s profits, since it reduces margins. However, if the automaker can continue to improve efficiencies and streamline production, the situation could be offset. Added to all of this, Tesla has promised a base Tesla Model 3 with a $35,000 price tag. With the tax credit going away, people are becoming even more eager for this vehicle to finally arrive.In an effort to make ends meet and bring the “inexpensive” Model 3 to market, Tesla recently announced that it’s cutting 7 percent of its full-time workforce. The brand is also eliminating the popular Tesla Referral Program, along with its least expensive Model S and Model X 75D vehicles. Rumors this week pointed to Model S and X production cuts as well.Now, according to Reuters, Tesla has admitted that it’s reducing production hours for its flagship vehicles. A Tesla spokesperson told the publication:As a result of this change [elimination of 75D models] and because of improving efficiencies in our production lines, we have reduced Model S and X production hours accordingly.These changes, along with continuing improvements, give us the flexibility to increase our production capacity in the future as needed.Tesla also shared that additional details will come at next week’s earnings call, which will happen on Wednesday, January 30, 2019.Source: Reuters Tesla To Slash Workforce In Effort To Bring Cheapest Model 3 To Market Tesla is making changes to push through anticipated adversity.It appears 2019 is going to be a tough year for automakers and many big businesses alike. However, many legacy companies likely have enough of a foothold that they’ll be able to push through relatively unscathed. This is especially true for some OEMs that are continuing to push gas cars and changing their business model to primarily produce popular trucks and SUVs. For Tesla, it could be a different story. While the automaker’s market cap is strong since it has invested so much capital into the future, profits have been almost nonexistent.Related Content:
500 BMW i3 are availableInnogy, the German energy company formerly known as RWE, earlier this month launched in Warsaw, Poland the world’s biggest car-sharing with BMW i3 electric cars.The fleet consists of 500 i3 and i3S, but not the latest 120 Ah battery version.Cars can be rented for 1.19 PLN (€0.28/$0.31) or 1.49 PLN (€0.35/$0.39) per minute respectively. Cost for the 24 hours is 239 PLN (€56/$63) or 299 PLN (€70/$79) in case of i3S.Car sharing Source: Electric Vehicle News Zipcar UK VW e-Golf Fleet Covered More Than 50,000 Trips In 6 Months Europcar Expands Its EV Fleet By Additional 85 Renault ZOE Author Liberty Access TechnologiesPosted on April 14, 2019Categories Electric Vehicle News 6 photos Website: Innogy GO! The new project was possible thanks to an investment in the 30 fast chargers (50 kW) in the city, which should be enough to keep the cars ready to go.Another important thing is access to bus lanes, which significantly shortens driving through the city. Renault Expands ZOE Fleet In Zity Car Sharing In Spain
Tesla is currently working on a new version of its Summon feature that enables its vehicles to autonomously navigate parking lots and pick up their owners on request.The latest version is becoming impressive as an owner demonstrated the capability in a crazy (yet low quality) video of his Model 3 picking him up. more…Subscribe to Electrek on YouTube for exclusive videos and subscribe to the podcast.https://www.youtube.com/watch?v=09bIEmS_KdYThe post Watch crazy video of Tesla Model 3 autonomously picking up owner in parking lot appeared first on Electrek. Source: Charge Forward
This is the 325th and final post of 2016.2016 was a record-breaking year in terms of the number of corporate enforcement actions as well as overall corporate settlement amounts. Each enforcement action was summarized in an in-depth manner and in real-time on FCPA Professor and FCPA Professor also covered DOJ and SEC policy developments and other related issues in a comprehensive and candid matter. All of this takes time, money, and substantial effort.If FCPA Professor added value to your practice or business or otherwise enlightened your day in 2016 and caused you to contemplate the issues in a more sophisticated way, please consider a donation to help defray the expenses associated with this free public website.I look forward to your readership in 2017.
The FCPA Flash podcast provides in an audio format the same fresh, candid, and informed commentary about the Foreign Corrupt Practices Act and related topics as readers have come to expect from written posts on FCPA Professor.This FCPA Flash episode is a conversation with Laura Brookover (Covington & Burling and former lawyer in the Enforcement Division of the Commodity Futures Trading Commission – CFTC). The podcast concerns the CFTC’s recent enforcement advisory concerning “violations of the Commodity Exchange Act (CEA) involving foreign corrupt practices” (see here for the prior post) and during the podcast Brookover discusses: the background of the CFTC and the CEA; why the CFTC may have issued the advisory; what type of conduct involving foreign corrupt practices could fall under the CEA; and various issues associated with CFTC enforcement actions.FCPA Flash is sponsored by Kreller Group.For the past 30 years, Kreller has distinguished itself as a best-in-class enhanced due diligence provider. It’s investigative network leverages the talent and integrity of some of the best law-enforcement, military specialists, business correspondents, and government contacts worldwide. With firsthand knowledge of the language, laws, regulations, political and economic climates and data availability in each country, Kreller provides reliable, compliant, and accurate information. A licensed private investigations firm, Kreller’s competitive advantage is experience, quality, commitment, and customer service.
Remember me Not a subscriber? Sign up for The Texas Lawbook. Password © 2016 The Texas Lawbook.By Jeff Bounds(May 16) – A Houston-based trial team at Winston & Strawn has engineered a huge victory for a small Pacific Northwest firm against food giant Mars, Inc. in a patent battle about pet treats.A Tyler jury on May 6 handed True Science Holdings a take-nothing defense verdict in Mars’ claims that the Eagle, Idaho-based firm’s Minties infringe a pair of its patents, which cover compositions of treats that freshen animals’ breath.Mars, which is based in McLean, Virginia., had sought . . .You must be a subscriber to The Texas Lawbook to access this content. Lost your password? Username
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. May 8 2018This week, I answered a grab bag of questions about drug copay coupons and primary care coverage on the health insurance marketplace.Q: My doctor wants me to take Repatha for my high cholesterol, but my Medicare drug plan copayment for it is $618 a month. Why can’t I use a $5 drug copay coupon from the manufacturer? If I had commercial insurance, I could. I’m on a fixed income. How is this fair?The explanation may offer you little comfort. Under the federal anti-kickback law, it’s illegal for drug manufacturers to offer people any type of payment that might persuade them to purchase something that federal health care programs like Medicare and Medicaid might pay for. The coupons can lead to unnecessary Medicare spending by inducing beneficiaries to choose drugs that are expensive.”The law was intended to prevent fraud, but in this case it also has the effect of prohibiting Part D enrollees from using manufacturer copay coupons … because using the coupon would be steering Medicare’s business toward a particular entity,” said Juliette Cubanski, associate director of the Program on Medicare Policy at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)The coupons typically offer patients with commercial insurance a break on their copayment for brand-name drugs, often reducing their out-of-pocket costs to what they would pay for inexpensive generic drugs. The coupons help make expensive specialty drugs more affordable for patients. They can also increase demand for the drugmaker’s products. If patients choose to use the coupons to buy a higher-cost drug over a generic, the insurer’s cost is likely to be more than what it would otherwise pay.In addition, consumers should note that the copay cards often have annual maximums that leave patients on the hook for the entire copayment after a certain number of months, said Dr. Joseph Ross, associate professor of medicine and public health at Yale University who has studied copay coupons.The coupons may discourage patients from considering appropriate lower-cost alternatives, including generics, said Leslie Fried, a senior director at the National Council on Aging.According to a 2013 analysis co-authored by Ross and published in the New England Journal of Medicine, 62 percent of 374 drug coupons were for brand-name drugs for which there were lower-cost alternatives available.Q: Last year, my marketplace plan covered five primary care visits at no charge before I paid down my $2,200 deductible. This year, it doesn’t cover any appointments before the deductible, and I had to pay $80 out-of-pocket when I went to the doctor. Is that typical now? It makes me think twice about going. Related StoriesSocial Security error jeopardizes Medicare coverage for 250,000 seniorsMedicare recipients may pay more for generics than their brand-name counterparts, study findsRobin Hood to rescue of rural hospitals? New math promised on Medicare paymentsUnder the Affordable Care Act, marketplace plans are required to cover many preventive services, including an annual checkup, without charging consumers anything out-of-pocket. Beyond that, many marketplace plans cover services such as some primary care visits or generic drugs before you reach your deductible.The likelihood of having a plan that offers some cost sharing for primary care before you reach your deductible (rather than requiring you to pay 100 percent of the cost until you hit that amount) varies significantly depending on whether you’re in a bronze, silver or gold plan, according to a recent analysis by the Robert Wood Johnson Foundation.In 2018, 77 percent of silver-level plans offered some cost sharing for primary care visits before enrollees had paid off their typical deductible of $3,800, the analysis found. In most cases, that means people owe a copayment or coinsurance charge for each visit until they reach their deductible. A small number of plans offered a limited number of no-cost or low-cost visits first, and then people using more services either had to pay the full charge for each visit or owed cost sharing until the deductible was met.Bronze plans were much stingier in what they offered for primary care before people reached their deductible, which was $6,400 or higher in half of plans. Only 38 percent of bronze plans offered any primary care coverage before the deductible, and generally patients still had to pay a copayment or coinsurace. A smaller percentage of bronze plans offered limited visits at no cost or low cost before the deductible.The share of people who chose bronze plans grew from 23 percent in 2017 to 29 percent this year, said Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation. While premiums are typically significantly lower in bronze plans than other “metal”-level plans, it can be worthwhile to check out how plans handle primary care services before the deductible, she said.Please visit khn.org/columnists to send comments or ideas for future topics for the Insuring Your Health column.
Jun 21 2018Networks identified for developing new therapies to treat Alzheimer’s disease Two strains of human herpesvirus-;human herpesvirus 6A (HHV-6A) and human herpesvirus 7 (HHV-7) -;are found in the brains of people with Alzheimer’s disease at levels up to twice as high as in those without Alzheimer’s, researchers from the Icahn School of Medicine at Mount Sinai report.Using evidence from postmortem brain tissue from the Mount Sinai Brain Bank, the research team also identified previously unknown gene networks that will both offer new testable hypotheses for understanding Alzheimer’s pathology and reveal novel potential targets for new drugs that may arrest Alzheimer’s disease progression, and could potentially prevent the disease if administered early enough.This is the first study to use a data-driven approach to study the impact of viruses on Alzheimer’s and to identify the role of HHV-6A and HHV-7 in the disease. This is also the first evidence that integration of HHV genomes into human brain genomes may play a role in the etiology of Alzheimer’s. These viruses can cause encephalitis and other chronic conditions.Results of the study will be published online in Neuron, at 11 am EDT on Thursday, June 21.The research team initially performed RNA sequencing on four brain regions in more than 600 samples of postmortem tissue from people with and without Alzheimer’s to quantify which genes were present in the brain, and whether any were associated with the onset and progression of Alzheimer’s. Through a variety of computational approaches, the team uncovered a complex network of unexpected associations, linking specific viruses with different aspects of Alzheimer’s biology. They examined the influence of each virus on specific genes and proteins in brain cells, and identified associations between specific viruses and amyloid plaques, neurofibrillary tangles, and clinical dementia severity. To evaluate the robustness of their findings, the team incorporated a further 800 RNA sequencing samples collected by the Mayo Clinic and Rush Alzheimer’s Disease Center, observing a persistent increase of HHV-6A and HHV-7 abundance in samples from individuals with Alzheimer’s, thus replicating their main findings in two additional, independent, geographically dispersed cohorts.Every 65 seconds, someone in the United States develops Alzheimer’s. In 2018, the costs of providing care to individuals with Alzheimer’s and other dementias are expected to total more than $277 billion. By mid-century, a new diagnosis will occur every 33 seconds, and costs are expected to exceed $1 trillion annually. Despite the dire public health implications, Alzheimer’s remains the only Top 10 cause of mortality in the United States for which no disease-modifying treatments are available.This study has been enabled by the extensive molecular profiling of several large patient cohorts, generated in the course of the National Institute on Aging (NIA) Accelerating Medicines Partnership-Alzheimer’s Disease (AMP-AD). AMP-AD is a precompetitive partnership among government, industry, and nonprofit organizations that focuses on discovering novel, clinically relevant therapeutic targets and on developing biomarkers to help validate existing therapeutic targets. This multisector partnership is managed by the Foundation for the NIH. The combined funding support for this five-year endeavor is $185.2 million. Through the generation of this large, “multi-omic” resource, the team was able to perform their investigation of viral activity in Alzheimer’s in an entirely data-driven manner. The term “multi-omic” is used as shorthand to imply that data from genes, proteins, fats, and other tissue components are all assessed and then represented qualitatively and quantitatively in a complex mathematical model.Related StoriesResearchers discover new therapeutic target for treatment of Alzheimer’s diseaseNew therapy shows promise in preventing brain damage after traumatic brain injuryStudy provides new insight into longitudinal decline in brain network integrity associated with aging”This study represents a significant advancement in our understanding of the plausibility of the pathogen hypothesis of Alzheimer’s,” said the study’s senior author, Joel Dudley, PhD, Director of the Institute for Next Generation Healthcare at the Icahn School of Medicine at Mount Sinai. “Our work identified specific biological networks that offer new testable hypotheses regarding the role of microbial defense and innate immune function in the pathophysiology of Alzheimer’s. If it becomes evident that specific viral species directly contribute to an individual’s risk of developing Alzheimer’s or their rate of progression once diagnosed, then this would offer a new conceptual framework for understanding the emergence and evolution of Alzheimer’s at individual, as well as population, levels.”Dr. Dudley notes that this study could potentially translate to the identification of virus, or virus-related, biomarkers that could improve patient risk stratification and diagnosis, as well as implying novel viral targets and biological pathways that could be addressed with new preventative and therapeutic drugs. As with any complex set of findings, they will need to be confirmed in additional patient cohorts, and further studies to specifically address a causal role for viruses are now being conducted by the research team.”This is the most compelling evidence ever presented that points to a viral contribution to the cause or progression of Alzheimer’s,” said one of the study’s authors, Sam Gandy, MD, PhD, Professor of Neurology and Psychiatry and Director of the Center for Cognitive Health and NFL Neurological Care at Mount Sinai. “A similar situation arose recently in certain forms of Lou Gehrig’s disease. In those patients, viral proteins were discovered in the spinal fluid of some Lou Gehrig’s patients, and patients with positive viral protein tests in their spinal fluid showed benefit when treated with antiviral drugs.” Source:https://www.mountsinai.org/about/newsroom/2018/unusually-high-levels-of-herpesviruses-found-in-the-alzheimers-disease-brain-mount-sinai-researchers-report
Reviewed by James Ives, M.Psych. (Editor)Aug 29 2018Neutrophils-;short-lived, highly mobile and versatile-;outnumber all other immune cells circulating through the blood stream. Yet, despite the cells’ abundance, the progenitor cell that only gives rise to neutrophils had eluded all efforts to track it down. Now, researchers at La Jolla Institute for Allergy and Immunology identified a progenitor of neutrophils in the bone marrow of mice and humans and tied it to cancer-promoting activities.Their study, published in the August 28, 2018, issue of Cell Reports, found that neutrophil progenitors promote tumor growth and that the frequency of the usually rare cell increases dramatically in the blood of human melanoma patients. The findings could assist in the detection of cancers by serving as an early warning sign and drive new therapeutic and pharmaceutical approaches for the treatment of neutropenia, chronic inflammation and cancer.”For many years, the cancer immunology field has been really focused on T cells, which led to the development of checkpoint blockade and CAR-T therapies but there’s a whole other arm of the immune system that plays a role in tumorigenesis,” says Catherine Hedrick, Ph.D., a professor in the Division of Inflammation Biology, who led the current study. “We found that this particular subset of progenitor cells that promotes tumor growth and shows up in high numbers in melanoma patients. If our initial findings hold up across the board, a simple blood test could indicate if you have cancer or not.”Neutrophils are among the first immune cells to arrive at the scene when pathogens breach the body’s physical barriers. Equipped with powerful anti-microbial tools, they form the initial line of defense against infections by destroying microbes, mopping up debris and sounding the alarm that alerts the rest of the immune system to an infection. Neutrophils also play a critical role in chronic inflammatory diseases, including cancer.Despite their abundance and importance, researchers had been unable to trace neutrophils’ lineage to their origin in the bone marrow, where multipotent hematopoietic stem cells give rise to a series of increasingly specialized progenitor cells that eventually differentiate into their target cell types, including red blood cells, lymphocytes and neutrophils.”Over the years, people identified different white blood cell progenitors but the one that was missing was the neutrophil progenitor because we didn’t have the tools to pull the populations apart,” says postdoctoral researcher and the study’s first author, Yanfang Peipei Zhu, Ph.D. “Now, we can study disease where neutrophils execute unique and important functions and investigate further how certain subsets of them promote tumor growth.”Related StoriesNanoparticles used to deliver CRISPR gene editing tools into the cellComprehensive cell atlas of the human liverRetina can restructure itself following gene therapyThe successful search started with high-dimensional mass cytometry, which is also known as cytometry by time-of-flight (CyTOF). Immune cells are characterized by subtle differences in the expression of a multitude of markers. Each combination serves as a unique cellular ID that allows scientists to distinguish between different types of immune cells. CyTOF allowed Zhu to simultaneously analyze 39 surface markers known to pinpoint hematopoietic stem and progenitor cells, transient myeloid precursors, and terminally differentiated myeloid cells, especially granulocytes, the subset of immune cells neutrophils belong to.The high-dimensional bird’s-eye view led to the discovery of a previously unknown progenitor population with neutrophil characteristics. In vivo adoptive transfer approaches confirmed that this progenitor gives rise only to neutrophils, bringing a decades-long search for a committed neutrophil progenitor to its successful conclusion.Once the mouse neutrophil progenitor had been identified, Zhu and her colleagues were able to track down an equivalent neutrophil progenitor in healthy human bone marrow. When transferred in mouse cancer models, both the murine and human neutrophil progenitors promoted tumor growth.”It seems this progenitor works through T cells, possibly suppressing them and turning them off but we still need to look at the mechanism,” says Zhu. “It could be one of the factors that have an impact current immunotherapy by making them less efficient.Surprisingly, when Zhu compared the blood of healthy people and patients recently diagnosed with melanoma, she found elevated levels of circulating neutrophil progenitors. Zhu is now trying to determine whether the same holds true for other cancers as well. “If so, it could be used as a simple biomarker for early cancer discovery,” says Zhu. Source:https://www.lji.org/news-events/news/post/researchers-find-elusive-source-of-most-abundant-immune-cell/
Source:https://www.yale.edu/ Reviewed by James Ives, M.Psych. (Editor)Sep 24 2018Genomic screening of more than 50,000 people shows that more than 80% of those who carry an identifiable genetic risk for breast, ovarian, prostate, and pancreatic cancer don’t know it despite frequent interaction with the healthcare system.The findings were published Sept. 21 in the journal JAMA Network Open.In the absence of routine screening, most people only discover they carry cancer-associated variants in the BRCA1 or BRCA2 genes when that person or family members receive a cancer diagnosis.Related StoriesAdding immunotherapy after initial treatment improves survival in metastatic NSCLC patientsStudy: Nearly a quarter of low-risk thyroid cancer patients receive more treatment than necessaryResearchers use AI to develop early gastric cancer endoscopic diagnosis system”As a colleague said, it usually takes a tragedy for people to get tested,” said Michael Murray, professor of genetics at Yale School of Medicine and senior author of the study conducted at Geisinger Medical Center in Danville, Pennsylvania. “Our reliance on a documented personal or family history as a trigger to offer testing is not working. Hopefully, one day we can change that with effective DNA-based screening for everyone.”The mean age of subjects in the study was 60. Two hundred and sixty-seven of those screened possessed a BRCA risk variant, yet only 18% of them were aware they possessed this risk factor for cancer prior to being informed by the study.Among the group of living BRCA-positive patients, 16.8% of them had a BRCA-associated cancer. In the small group of BRCA-positive patients who had died before the study’s conclusion, 47.8% of them had a BRCA-associated cancer.”Once risk is identified, we can apply proven tools for early diagnosis and prevention, and we believe that the 31% difference in cancer incidence in these two groups is a window into an opportunity to decrease cancer and cancer deaths through genomic screening approaches,” Murray said.
In 2011, scientists interested in mapping seafloor habitats sunk cameras into the chilly waters of a glacial fjord in Norway’s Svalbard archipelago in the Arctic Ocean. Later, when analyzing the photographs, they spotted something unexpected growing in the murky depths: an abundant, dark brown macroalga (seen above) attached to stones and waving in the current. At 166 meters, the seaweed—which needs some light to survive—is the deepest known living macroalga in the high Arctic, the scientists report online this month in Marine Biodiversity Records. Not many fauna seem to find the dark bottom an appealing place to live; a pink sea star and an unknown creature that could be a bryozoan—an aquatic invertebrate also known as a moss animal—were the only other species observed among the white shells of dead clams. Other studies have documented some macroalgae living at greater depths—down to 268 meters—in temperate and tropical climates, but the water there is much clearer, allowing more sunlight to filter through. In polar regions, however, scientists have documented that increased sunlight can actually inhibit photosynthesis in macroalgae that are adapted to survive the long, dark winter nights and ice cover. In the future, the scientists plan to collect specimens of their find to help verify that what they see is in fact a macroalga and, if so, what kind. Such taxonomic identification will be the first step in understanding what adaptations allow the mysterious organisms to make their home on the fjord’s dimly lit sea floor.