Category Archives: Progress

Dear School District of Philadelphia Families,

The School District of Philadelphia is excited to announce that on Thursday, February 10th, 2022, we will release the school year 2020-2021 School Progress Report on Education and Equity (SPREE).

The new SPREE replaces the old School Progress Report (SPR) which provided information about each schools achievement and areas for improvement. The SPREE is an enhanced tool that aligns more closely with the Board of Educations Goals & Guardrails, which set clear expectations for what students must be able to accomplish and the conditions that must be in place at each school to empower our students to succeed in and beyond the classroom. The SPREE highlights our overall progress as a District and shows each schools growth in both traditional performance measures like proficiency on state assessments and graduation rates, as well as additional measures of school climate, culture and opportunity.

As we know all too well, 2020-2021 was not a normal school year. Because the pandemic forced us to shift to virtual learning, many students did not take state assessments like Keystones and PSSAs. Therefore, because that assessment data informs various SPREE measures, the report for the 2020-21 school year, which will be called SPREE Lite, will look slightly different than future reports. It will not include performance information in the areas of Reading & English Language Arts or Math & Science, nor will it include overall scores. Instead, each schools SPREE Lite will show the list of all the metrics that will be scored in future SPREE reports, but will only provide performance information for the measures that we could assess at this time College & Career Readiness and Climate, Culture & Opportunity.

We have developed a few helpful resources to assist you in reading and understanding the SPREE. This Family Guide provides an overview of the SPREE and how it connects to the Goals & Guardrails. This User Guide provides more detailed and technical information about how we calculate scores for each measure. And finally this FAQ will answer additional questions that you may have. All of these resources and more can be found on the SPREE website at http://www.philasd.org/spree.

Thank you for partnering with the District as we strive together to help all students succeed!

Last modified: February 8, 2022

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District to Release 2020-2021 School Progress Report on Education and Equity (SPREE) The School District of Philadelphia - philasd.org

With 9 approved markers in nonsmall cell lung cancer and a plethora of established and emerging therapies that have been designed to target them, the need for molecular testing is more important than ever.

With 9 approved markers in nonsmall cell lung cancer (NSCLC) and a plethora of established and emerging therapies that have been designed to target them, the need for molecular testing is more important than ever, according to Joel W. Neal, MD, PhD, who added that this group is projected to expand even further, with the emergence of targets such as HER2 exon 20 insertions and amplification, MET amplification, and NRG1 fusions.

It is really [imperative] to do the testing; [we need] to find all these targetable molecular alterations. Tumor testing is the gold standard. However, I believe RNA tissue testing is going to be [an emerging] gold standardespecially for patients in whom we didnt find [a driver alteration] by liquid biopsy or tumor tissue biopsy, Neal said in a presentation delivered during the 19th Annual Winter Lung Cancer Conference, an event hosted by Physicians Education Resource, LLC.1 The problem is, with next-generation sequencing and DNA testing of tissue, [the process] can be really slow. Liquid biopsies are fast and convenient. But [well] keep looking until we find it. The rest of my talk is irrelevant if you miss the target in the patient.

In his presentation, Neal, an associate professor of medicine/oncology at Stanford University, detailed the many advancements made in the treatment of patients with NSCLC whose tumors harbor ALK mutations, ROS1 rearrangements, MET exon 14 alterations, RET fusions, and NTRK fusions, as well as emerging information on newer targets that have come to light.

The preferred options for utilization in the first-line setting in ALK-positive lung cancer are brigatinib (Alunbrig) and alectinib (Alecensa), according to Neal. That is because these drugs, along with lorlatinib [Lorbrena], have all cleanly been shown to be superior to crizotinib [Xalkori], the first drug that was FDA approved for [this disease], Neal said.

In December 2015, the FDA granted an accelerated approval to alectinib for the treatment of patients with ALK-positive disease following progression on or were intolerant of crizotinib, based on data from 2 single-arm phase 2 clinical trials (NCT01871805; NCT01801111), which showed objective response rates (ORRs) ranging from 38% to 48%.2-3 Approximately 2 years later, in November 2017, they agent received a regular approval based on findings from the phase 3 ALEX trial (NCT02075840), after it was found to result in improved progression-free survival (PFS) vs crizotinib.4

Among 303 patients with ALK-positive disease who did not previously receive systemic therapy for metastatic disease, the median PFS with alectinib (n = 152) was 25.7 months (95% CI, 19.9not estimable) per independent review committee (BIRC) assessment vs 10.4 months (95% CI, 7.7-14.6) with crizotinib (n = 151; HR, 0.53; 95% CI, 0.38-0.73; P < .0001).

In April 2017, the FDA granted an accelerated approval to brigatinib for use in patients with ALK-positive NSCLC whose disease was resistant to prior crizotinib.5 This decision was based on data from the phase 2 ALTA trial (NCT02737501). Final data from the trial, presented during the 2021 ESMO Congress, showed that at a median follow-up of 40.4 months (range, 0-52.4) with brigatinib (n = 137) and 15.2 months (range, 0.1-5.7) with crizotinib (n = 138), the median BIRC-assessed PFS was 24.0 months (95% CI, 18.5-43.2) and 11.1 months (95% CI, 9.1-13.0), respectively (HR, 0.48; 95% CI, 0.35-0.66; P < .0001).6

In November 2018, lorlatinib garnered an accelerated approval for the treatment of patients with metastatic ALK-positive NSCLC who progressed on 1 or more ALK TKIs.7 The indication was expanded in March 2021, for use in the frontline setting based on data from the phase 3 CROWN trial (NCT03052608), in which lorlatinib resulted in a 72% reduction in the risk of disease progression or death vs crizotinib in 296 treatment-nave patients (HR, 0.28; 95% CI, 0.19-0.41; P < .0001) per BICR assessment.8

Why are [these options] superior [to crizotinib]? Well, alectinib, brigatinib, and lorlatinib all [have shown the ability to] overcome many of the acquired resistance mutations, which are much more complicated than the relatively simple T790M that we used to see in EGFR-mutant lung cancer, Neal explained. In addition, most of the newer second- and third-generation ALK inhibitors have much better central nervous system [CNS] penetration, and [this population] has a high risk of brain metastases. As such, its clear that crizotinib is no longer the standard of care.

Tumors that have become resistant to any of these drugs can be re-biopsied to identify secondary mutations. Only approximately 30% of those who have these tumors have secondary mutations that are targetable, according to Neal. If we try second- or third-generation ALK inhibitors and they become ineffective, chemotherapy is the standard, Neal said. I do not recommend immunotherapy with that. I favor bevacizumab [Avastin]-based [treatment] or just platinum chemotherapy.

In March 2016, crizotinib was approved by the FDA for use in patients with advanced NSCLC whose tumors harbor a ROS1 gene alteration, based on findings from the phase 1 PROFILE 1001 trial (NCT00585195).9 Data from an expansion cohort of the phase 1 trial showed that among 50 patients who received the agent at the standard twice-daily dose of 250 mg, crizotinib elicited an ORR of 72% (95% CI, 58%-84%) with a median duration of response (DOR) of 17.6 months (95% CI, 14.5not reached [NR]) and a median PFS of 19.2 months (95% CI, 14.4-NR).10

Additional findings from the EUROS1 cohort of a retrospective study showed that among 32 patients, 29 of whom evaluable for best response, the ORR achieved with crizotinib was 80%, the disease control rate was 86.7%, and the median PFS was 9.1 months.11

It was just a stroke of luck that crizotinib happened to inhibit ROS1 gene rearrangements. It was originally designed was a MET inhibitor, and thats what the phase 1 trial was, Neal noted. Theres a lot of evidence for crizotinib, which is an FDA-approved therapy based on data from phase 1 extensions of clinical trials and phase 2 expansion cohorts.

Entrectinib (Rozlytrek) joined the US treatment arsenal for this population in August 2019 after the agent was shown to elicit an ORR of 78% in 51 adult patients examined across several clinical studies.12 Of the 40 patients who were noted to have experienced tumor shrinkage, 55% had shrinkage that persisted for at least 1 year.

Additional data from 32 patients with ROS1 inhibitornave NSCLC who were enrolled across phase 1 and 2 trials examining the agent at a once-daily dose of 600 mg given in 4-week cycles showed that the BICR-assessed ORR was 69%, the median DOR was 28.6 months (95% CI, 6.8-34.8), and the median PFS was 29.6 months (95% CI, 7.7-36.6).13

Entrectinib has a slightly different toxicity profile than crizotinib, which tends to be pretty well tolerated with some mild gastrointestinal [GI] effects and lower extremity edema. Entrectinib is also fairly well tolerated, with a bit more dysgeusia, fatigue, some dizziness, weight increases, and paresthesia, Neal noted. However, the biggest distinguishing factor between the 2 options is the CNS penetration. Its clear that entrectinib can get into the CNS, whereas crizotinib does not have effective CNS penetration.

Integrated data from three phase 1/2 trialsALKA-372-001 (EudraCT 2012-000148-88), STARTRK-1 (NCT02097810), and STARTRK-2 (NCT02568267)showed that at a median follow-up of 15.5 months, within the cohort of patients with ROS1-positive NSCLC who had measurable CNS disease (n = 12/53), the intracranial ORR achieved with entrectinib was 75.0% (95% CI, 42.8%-94.5%).14 The median intracranial DOR was 12.9 months (95% CI, 4.6not evaluable [NE]), and the median intracranial PFS was 19.3 months (95% CI, 3.8-19.3).

With crizotinib, usually we would see CNS response rates ranging from 20% to 30% and they are not durable, Neal said. Entrectinib is clearly the preferred agent for patients with newly diagnosed ROS1-positive NSCLC and brain metastases. Otherwise, its a toss-up right now.

After disease progression on crizotinib or entrectinib, agents like lorlatinib and repotrectinib may represent potentially effective options. Data from a phase 2 trial (NCT01970865) showed that among 34 patients who had received prior crizotinib, lorlatinib elicited an ORR of 27%, a median DOR that had not yet been reached, and a median PFS of 8.5 months.15 Additionally, preliminary findings from the phase 1/2 TRIDENT-1 trial (NCT03093116) showed that among 18 patients with ROS1-positive NSCLC who were TKI pretreated, repotrectinib elicited a confirmed ORR of 39% (95% CI, 17%-64%).16

After crizotinib or entrectinib, lorlatinib is not on label, but it is an agent to consider and see if it works, Neal said. Then theres repotrectinib, not yet FDA approved, but has promising data both for systemic response rates after crizotinib and some CNS intracranial penetration. Repotrectinib is an exciting new therapy that we can keep our eyes on.

Crizotinib has known activity in patients with MET exon 14 (METex14) skipping mutations, according to Neal. Data from an expansion cohort of the phase 1 PROFILE 1001 (NCT00585195) showed that among 52 evaluable patients who harbored this mutation and received a twice-daily dose of 250 mg, the ORR was 32%, the median DOR was 9.1 months, and the median PFS was 7.3 months.17

However, 2 new agents have since garnered regulatory approval from the FDA for use in this patient population: tepotinib (Tepmetko) and capmatinib (Tabrecta).18,19 Findings from the phase 2 VISION trial (NCT02864992) indicated that 157 patients with METex14-altered disease, the ORR with tepotinib was 44.7% (95% CI, 36.7%-53.0%), the median DOR was 11.1 months (95% CI, 8.4-18.5), and the median PFS was 8.9 months (95% CI, 8.2-11.2).20

Data from the phase 2 GEOMETRY mono-1 trial (NCT02414139) showed that capmatinib induced an ORR of 68% (95% CI, 48%-84%) by independent review in 28 treatment-nave patients with METex14-altered disease.21 Among those who received 1 or 2 prior lines of therapy (n = 69), the ORR with capmatinib was 41% (95% CI, 29%-53%).

They look similarly effective overall, with similar safety profiles. Both have better CNS penetration than crizotinib, and they look like they have a longer DOR overall, Neal said. I would go with tepotinib or capmatinib before I would consider crizotinib [in these patients].

Other MET inhibitors, like glesatinib (MGCD265), savolitinib, and elzovantinib (TPX-0022) are currently under development, along with MET bispecific antibodies and antibody-drug conjugates.

Off label, we used to use a lot of drugs to treat those with RET gene rearrangements that were identified, but most of these drugs had a lot of VEGF activity, a lot of toxicity, Neal explained. Vandetanib [Caprelsa], cabozantinib [Cabometyx], even alectinib, were fairly toxic and not particularly well tolerated. As such, it was super exciting when a couple of new agents came out.

In May 2020, the FDA granted an accelerated approval to selpercatinib (LOXO-292; Retevmo) for use in patients with RET-positive NSCLC based on findings from the NSCLC cohort of the phase 1/2 LIBRETTO-001 trial (NCT03157128).22 Among 105 patients who were previously treated with platinum chemotherapy, the ORR with the agent was 64% (95% CI, 54%-73%). Earlier data revealed that selpercatinib also elicited a CNS ORR of 91% (95% CI, 59%-100%); at a median follow-up of 9.6 months, the median PFS with the agent was 18.4 months (95% CI, 12.9-24.9).23 Were looking at an 18-month PFS, which is like what we see for EGFR and osimertinib [Tagrisso]this is great, Neal underscored. Regarding [adverse] effects, there is peripheral edema, headaches, and some VEGF-associated toxicities, but they are generally manageable.

Later that year, in September 2020, the FDA gave the green light to pralsetinib (Gavreto) for use in adult patients with RET fusionpositive NSCLC based on findings from the phase 1/2 ARROW trial (NCT03037385).24 At a data cutoff of May 22, 2020, the ORR was 61% (95% CI, 50%-71%) among 87 patients who previously received platinum-based chemotherapy; the ORR was 70% (95% CI, 50%-86%) among 27 treatment-nave patients.25 Data from a post-hoc analysis of the trial indicated that the ORR was 51% (95% CI, 34%-68%) in those with a history of CNS involvement and prior platinum-based treatment.

Pralsetinibhas similarly high efficacy and response rates in virtually all patients who receive it. [We also see] shrinkage of brain metastases. Both agents appear to be effective in the CNS, Neal said. As such, I would recommend selpercatinib or pralsetinib for the first-line treatment of these patients, as well as the consideration of chemotherapy and probably immunotherapy in the next-line setting.

NTRK was identified across many tumor types, including about 0.1% of NSCLCs. I think we have had 2 patients, ever, at Stanford who have been diagnosed with it, Neal explained. It is very, very rare in lung cancer, but there are a couple of FDA-approved therapies [for those whose tumors harbor it].

In November 2018, larotrectinib (Vitrakvi) was granted an accelerated approval from the FDA for use in adult and pediatric patients with select solid tumors that have a NTRK gene fusion.25 Data from an analysis that incorporated findings from 12 patients with NSCLC who were enrolled to 2 clinical trials (NCT02122913; NCT02576431) showed that at a median follow-up of 12.8 months, larotrectinib (Vitrakvi) elicited an ORR of 75%, and the median DOR had not yet been reached (range, 3.9+ to 25.9+).26

Larotrectinib works in almost all patients with lung cancer, as well as other NTRK-positive tumors, Neal noted. It comes with adverse effects, like edema and pyrexia.

Entrectinib has also been indicated for use in the treatment of adult and pediatric patients aged 12 years or older with solid tumors that harbor an NTRK fusion.12 The indication is specific to those who have a known acquired resistance mutation, are metastatic or where surgical resection is likely to result in severe morbidity and have progressed on therapy or have no alternative treatments.

Integrated data from ALKA-372-001, STARTRK-1, and STARTRK-2 showed that among 10 patients with NTRK-positive NSCLC, the ORR with entrectinib was 70.0% (95% CI, 34.75%-93.33%), the median DOR was not yet evaluable (95% CI, 10.4-NE), and the median PFS was 14.9 months (95% CI, 4.7-NE). Notably, the BICR-assessed intracranial response achieved with the agent was 66.7%.14

Additionally, LOXO-195 (BAY 2731954) is a selective TRK inhibitor that is currently under exploration in a phase 1 study (NCT03215511), where it has already demonstrated preliminary efficacy in those with resistance to prior TRK inhibitors mediated by TRK kinase mutations.27 Among 20 patients with a TRK kinase mutation, the ORR with the agent was 45%.

If you have a patient with a NTRK-positive tumor, I recommend a clinical trial after progression through standard therapy and regular chemotherapy. Do not miss [this target], but I do think you will find it doing RNA or DNA sequencing, when you are looking for everything else.

NRG1 rearrangements contain EGF-like binding domain of NRG1, or the ERBB3 ligand. The rearrangement is relatively uncommon, according to Neal, who added that the frequency is uncertain but likely occurs in less than 1% of those with NSCLC, and in never smokers.

They can probably best be detected by RNA-based testing, Neal added. Afatinib has a little bit of response, 25%, but Im not sure that I would recommend it off label yet.

The fully human anti-HER3 monoclonal antibody seribantumab is under exploration in patients with solid tumors harboring an NRG1 fusion as part of the phase 2 CRESTONE trial (NCT04383210). Tarloxotinib bromide, an irreversible EGFR/HER2 inhibitor is under investigation in patients with NSCLC harboring EGFR exon 20 insertion and HER2-activating mutations, as well as other solid tumors with NRG1/ERBB gene fusions, as part of the phase 2 RAIN-701 trial (NCT03805841). Lastly, the HER2/HER3 bispecific antibody zanocutuzumab (MCLA-128) is being evaluated in patients with solid tumors harboring an NRG1 fusion as part of a phase 1/2 trial (NCT02912949).

I am excited that some other agents [are under exploration, as well], Neal concluded. Lets just say anti-HER3 inhibition looks like a possible way to target these [fusions].

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Efforts to Effectively Target Rare Oncogenes Propel Progress in Lung Cancer - OncLive

SUNNYVALE, CAAttacking the ignorant Luddites who questioned the wisdom and necessity of the program, the nations top tech leaders issued a statement Thursday calling their industrys plan to create an army of AI-controlled bulletproof grizzly bears an unavoidable and inevitable part of progress. Lets be real: Sentient machines that control thousand-pound bears with razor-sharp titanium claws are going to happen no matter what we do, so we might as well be the ones who do it, said Meta CEO Mark Zuckerberg, who, along with leaders such as Alphabets Sundar Pichai and Amazons Jeff Bezos, signed a letter pushing back against critics who had described the Grizzly Project as dangerous, unnecessary, and damaging to humanity. Any kind of regulation on this front will only hinder Americas ability to design and mass-produce high-quality indestructible grizzlies, which is the way the world is headed. You cant stop progress, and you cant really separate deadly bears that shoot acid from their mouths from the technology that helps people every day. Besides, these grizzlies have many nonlethal uses. Do you want to deny an elderly woman a powerful machine-bear hybrid that can carry her groceries and dispense her medication just because it also has the potential to kill millions of human beings? At press time, Congress had approved $8 billion in research grants for the Grizzly Project after hearing China was well on its way to developing fire-breathing pandas.

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Tech Leaders Justify Project To Create Army Of AI-Controlled Bulletproof Grizzly Bears As Inevitable Part Of P - The Onion

Theres an exercise I do in my law firm diversity, equity, and inclusion (DEI) trainings. I call it the Ten-Year Challenge. I show a slide with race, ethnicity, and gender stats for large law firms 10 years ago. Then I show stats from this year. Then I ask my group, What has changed?

The answer? Not much.

To quote Bloombergs law firm DEI report from November 2021:Nine out of 10 top leaders (either CEO or managing partner) are White and 81% of top leaders are male. Of attorneys who lead firm-wide practice groups or departments, 27% are White women, 6% are minority men, 4% are minority women, and the remainder are White men.

We arent moving backwards. But we arent moving forward as quickly as we could be. At Inclusion Nation, weve worked with many law firms on DEI. Here are five of the biggest reasons I see for our slow progress on racial and ethnic diversity in large law firms.

If the business case for diversity were the magical understanding that firm leaders needed, we would have solved DEI a generation ago. It is not.

People are not widgets. Putting a return value on investment in a human life is not how we start. Not every client is pushing for a diverse team, and not every matter implicates the transforming population of the workplace. Your case for diversity doesnt need to have an extensive historical backing or be based solely on realizations from the global racial reckoning of summer 2020.

It can be as simple as this: Prioritize the success of people who work in your law firm because you hired them, and they should have an equal chance to succeed.

Yes, we should look outside of ourselves for solutions, but we should also remember that our profession is unique. Law firms can be hierarchical and traditionalist. Practice groups, and even partners, are often silos within firms.

Lawyers have never been taught how to manage peopleever. Attrition rather than retention can be beneficial to profits-per-partner. And Big Law has a large proportion of employeesincluding many women and people of colorwho are often not considered in most firms diversity work because they dont have JDs.

Your diversity consultant or in-house professional doesnt have to have a legal background, but they should have some grounding in law-firm life to recognize what can workand what will never workin Big Law.

The best law firms delivering DEI success are ones that allow their DEI professionals the runway to succeed. Those firms do not limit which attorneys the DEI professionals can work with, or second-guess the professionals approaches because they dont fit the culture of the firm.

They succeed at balancing a hands-off approach (you figure it out!) and a micromanager approach (heres what 16 different partners believe you should do) and choose not to take the slippery slope approach to DEIif we do this, then all these terrible actions will inevitably result.

I should also mention that many Big Law DEI professionals are women, and women of color, and the biases and stereotypes I discuss in my trainings apply there as well. If you are already biased to believe someone is not competent because of the identity they have, then you are already inclined to underestimate and undervalue them.

If youre hiring someone to do an extraordinarily difficult job, give the person you chose the resources, the confidence, and the time to succeed.

One of our most popular workshops at Inclusion Nation is where stakeholders work together to identify the root cause of specific DEI challenges, then design a testable four-part solution to address it. You know what they often find? Many of the solutions are programs already in place that can be adjusted to fit diversity needs.

What do you already do for talent acquisition? Succession-planning? Business generation? We call it using a DEI lens. You partner with law schools for on-interviews. How can you do that with a DEI lens? You made accommodations for remote workers. How can you do that with a DEI lens? You coach high performers. How can you do that with a DEI lens?

You already have existing talent development initiatives. Re-design them with a DEI lens.

Imagine you are a person of color. None of the partners you work with are of the same race or ethnicity as you.

None of them went to the same schools as you. Some of them were in sororities and fraternities, but they have never heard of yours.

None of them grew up in neighborhoods like yours. You like different music, fashion, movies, TV shows, and sports. You celebrate different holidays. You have different family structures. You have different opinions on social justice.

And there are comments you hearwhere are you really from, youre so well-spoken, what interesting hair, your names hard to pronouncewhat we politely call microaggressions. You look at the culture of a firm that says its inclusive and feel like inclusive does not include you. It. Is. Exhausting.

The best law firms are ones that know that new hires, at whatever level they enter the firm, will feel that exhaustion. Those firms ensure through onboarding, employee resource groups, thoughtful mentoring matches, personal development plans, and invested executive committee members, that both attorneys and business professionals can feel like they can belong here. That is the real work of change.

This article does not necessarily reflect the opinion of The Bureau of National Affairs, Inc., the publisher of Bloomberg Law and Bloomberg Tax, or its owners.

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Michelle Silverthorn is a licensed attorney, founder, and CEO of Inclusion Nation. She practiced for large law firms in New York and Chicago before transitioning to the diversity field, where she has trained thousands of lawyers about bias, race, equity, and belonging in the workplace. She is author of the book: Authentic Diversity: How to Change the Workplace for Good.

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Law Firm Diversity: Five Reasons for Slow Progress - Bloomberg Law

Can global businesses meet ethical standards for behavior even as theyre struggling to survive?

The initials ESG for environmental, social and governance present supply chains with a huge responsibility. They must simultaneously ensure the humane treatment of workers throughout the supply chain, make progress toward the goal of net-zero emissions, and generally practice good corporate governance. Oh, and by the way they need to make a profit. Which is becoming increasingly difficult in these days of pandemic, congested supply lines, rising inflation and uncertain demand. On this episode we discuss balancing all of these priorities with John Ferguson, practice lead for globalization, trade and finance with Economist Impact, a new arm of The Economist Group that aims to achieve progress on major global issues. We discuss whether companies commitment to ESG extends beyond good intentions, and the obstacles that stand in the way of doing good while doing well. Hosted by Bob Bowman, Editor-in-Chief of SupplyChainBrain.

Show notes:

An Economist Impact report on Sizing the Energy Transition.

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Podcast | The ABCs of ESG: Are Supply Chains Making Progress? - SupplyChainBrain

The ban on surprise billing in health insurance programsincluding the federal employee/retiree FEHB programthat took effect at the start of this year is not an absolute one and its implementation is still a work in progress, according to the Kaiser Family Foundation.

The foundation, which produces reports and recommendations on health insurance issuesand which is not associated with the Kaiser health-care providersaid the change in law creates important new protections against being hit with unexpected charges for unknowingly getting care from providers outside of their plans network.

Such billing can occur, for example, in emergency and other urgent care settings when enrollees dont have time to check whether facilities are in-network, or when they receive care at an in-network facility from providers who are out of network. The foundation had found in a 2019 survey 39 percent of respondents had received an unexpected medical bill in the prior 12 months, 13 percent of those for $2,000 or more.

The 2020 No Surprises Act, passed with bipartisan support, bans surprise billing for emergency services, bans high out-of-network cost-sharing for emergency and non-emergency services, bans out-of-network charges for ancillary care (such as for anesthesiologist or assistant surgeon) at an in-network facility, and bans other out-of-network charges without advance notice.

The law is highly complex, however, setting coverage and billing standards for a specific subset of private insurance claims that could number 10 million annually. Providers are permitted to ask consumers to waive their NSA protections in some cases, the analysis said.

While audits of health carriers will provide some oversight of their compliance, that will involve various federal and state entities and it remains to be seen how these new systems will work, independently and in coordination.

To a large extent, oversight and enforcement will rely on complaints. In order to complain, though, consumers will need to understand that they should not be overbilled for emergency services or for non-emergency out-of-network services while they are in in-network hospitals and facilities, it said.

Finally, it remains to be seen if any other tools will be employed to monitor trends in the incidence of surprise medical bills, and how effectively the law may work to protect consumers from surprise bills and reduce their out-of-pocket costs, it said.

Annual Leave, One of Top Benefits to Federal Employees

Benefits Upon Passing of a Federal Employee or Retiree

Retirement Income Myths

Guidance Issued on Marijuana and Federal Employee Security Clearances

The Federal Retirement Deal (Its a Very Good One!)

TSP Outlines Strings Attached to Upcoming Investment Window

Leaving Federal Service? Go Out With Class

When Should a Federal Employee Apply for Social Security Benefits?

Federal Retirement Mistakes to Avoid

Federal Retirement: When Age Isnt Just a Number

FERS & CSRS: What Happens to Your Annuity if You Come Back?

2022 GS Locality Pay Tables here

FERS Retirement Guide 2022

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Ban on Surprise Billing in Health Plans a Work in Progress, Analysis Says - FEDweek

BERLIN, February 11. /TASS/. Progress in the Minsk negotiation process, which has not happened in the last eight years, can be achieved only with a united position of all participants in the Normandy format (Russia, Germany, Ukraine, France), Deputy Chief of Staff of the Presidential Executive Office Dmitry Kozak said following the meeting of political advisers to the leaders of the Normandy format on the settlement of the Ukrainian conflict.

"Without a common position in the Normandy format, there will be no agreement in the Minsk negotiation process, it has not happened in eight years," he said.

"Any existence of disagreements on the interpretation of the key provisions of the Minsk agreements in the Normandy format has a negative, destructive effect on the negotiations within the contact group," Kozak said.

He noted that in accordance with the Minsk agreements, all issues "should be resolved within the Minsk negotiation process, in the trilateral contact group, where Ukraine and certain regions of the Donetsk and Lugansk regions of Ukraine are represented".

The previous talks of political advisers to the leaders of the Normandy format countries were held on January 26 in Paris. The first face-to-face meeting of representatives of all four countries in more than a year, held at the Elysee Palace, lasted 8.5 hours.

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Minsk negotiation process has not seen progress for 8 years Kozak - TASS

During the 150th Executive Board (EB) of the WHO, agenda items on the Immunization Agenda 2030 (IA2030), Infection prevention and control and the Global road map on defeating meningitis by 2030 were grouped together for discussion. A total of 40 speakers, including 33 delegates from Member States (including regional statements from EMRO, AFRO and the EU), and 7 non-state actor organizations took the floor.

Twelve Member States from the six WHO regions made specific supportive statements on the Global road map on defeating meningitis by 2030 report (EB150/3).

These statements strongly supported the implementation of the road map and expressed their commitment. Several Member States highlighted progress made to date and the specific challenges which with the implementation of the road map will be overcome. The importance of establishing coordination mechanisms and political frameworks was also stressed.

Member States warmly welcomed and supported the establishment of a Strategic Support Group to facilitate the implementation of the road map and raise the profile of meningitis on the global health agenda.

Member States also underscored the relevance and need to integrate meningitis prevention and control into Primary Health Care, to enhance vaccination activities as well as diagnostics and treatment activities by expanding capacity at the peripheral level.

In her statements, the Deputy Director-General highlighted how innovative the road map was, as it addressed meningitis not only as an infectious disease that can often be prevented and treated, but also with a strong focus on support and care for people living with disabilities after an episode of meningitis.

In his closing remarks, the Director-General also highlighted how essential it was to integrate prevention, early diagnostics and treatment activities into primary health care, to defeat meningitis.

________________________________

Note

List of Member States that made interventions during the discussion: Angola, Argentina, Bangladesh, Botswana, Brazil, Canada, Chile, China, Colombia, Denmark, Dominican

Republic, Ecuador, France, Guinea Bissau, India, Japan, Malaysia, Mexico, Namibia, Norway, Oman, Philippines, Singapore, Spain, Syrian Arab Republic, Republic of Korea, Russian Federation, Tajikistan, Timor-Leste, Thailand, Tunisia, United Kingdom, United States of America.

List of non-state actors that made interventions during the discussion:

PSI Public Services International, IFMSA International Federation of Medical Students' Associations, ICN International Council of Nurses, IPSF International Pharmaceutical Students' Federation, WaterAid International, GHC Global Health Council, Inc., MMI Medicus Mundi International Network Health for All

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Executive Board reviews progress in the implementation of the global road map on defeating meningitis by 2030 - World Health Organization

Posted February 6, 2022 | 1:30 PM

For customers in the Progress Village area of South-Central Hillsborough County

The Hillsborough County Water Resources Department today rescinded a precautionary boil water notice that affected some customers in the Progress Village area of South-Central Hillsborough County.

The precautionary boil water notice that was issued on Friday, Feb. 4 for Hillsborough County's potable water system customers in the Progress Village area of South-Central Hillsborough County is no longer in effect for any resident or commercial business.

The notice was lifted today after bacteriological samples showed the water meets quality standards. The general boundary of the impacted area was Interstate 75 to the east, Camden Field Parkway to the north, Riverview Drive to the south, and South 78th Street to the west.

Hillsborough County Water Resources had issued the precautionary boil water notice on Friday, Feb. 4 after the minimum water pressure in the County's water distribution system dropped below the regulatory level due to a line break.

View map of the impacted area

Customers who have questions can call Hillsborough County Water Resources Department at (813) 744-5600.

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Precautionary Boil Water Notice Issued for an Area in Progress Village - Hillsborough County

A Massachusetts teenager who was seriously injured during a hockey game is working hard in his rehabilitation in order toward his goal of walking again. Jake Thibeault, of Fitchburg, broke two vertebrae in his back and suffered a small brain bleed in an on-ice collision that happened during a junior hockey tournament held over Labor Day weekend this past year.Thibeault had screws and rods inserted at Worcester's UMass Memorial Medical Center to stabilize his spinal cord, but the injury left the 18-year-old Milton Academy student was paralyzed from the waist down. He next went to Spaulding Rehabilitation Hospital in Boston's Charlestown neighborhood and is now in outpatient rehabilitation at Journey Forward in Canton five months after his injury."The hope is what they call neuroplasticity," Thibeault said. "I'm trying to rewire it and teach my brain that I can move my legs through (a certain) way."Thibeault travels an hour each way four days a week to Journey Forward, which specializes in helping people with paralysis regain movement, in addition to his two days of standard rehab every week.His therapy at Journey Forward focuses on building strong core muscles, including one exercise where Thibeault is brought to a standing position and catches a weighted ball with one hand."The theory here is we're not going to focus on the legs first. We're going to focus on the core first," said Mike Thibeault, Jake's father. "We're going to work our way down rather than up.""My core is just so much stronger in a way that I can stabilize my body," Jake Thibeault said. In another exercise, Jake Thibeault crawls on all fours across floor mats, pushing his hardest for every inch. But he said the current struggle to get across those mats is big progress from where he was a month ago, when he was incapable of doing so."They were just like, 'Oh, just try by yourself,' and I made it two mats," he said. "And I was like, 'Oh, OK. Holy cow!'"Dan Cummings, president and founder of Journey Forward, said his facility is the only one in Massachusetts where this type of specialized therapy is offered.Cummings himself was once paralyzed from the waist down, suffering an accident when he dove into a lake at the age of 19. Doctors told him that he would never walk again, but he was able to take his first step on his own seven years later.Thibeault endures those grueling, hours-long rehabilitation sessions at Cummings' facility in an effort to reach an ambitious goal. Thibeault said he is determined to walk on his own during his graduation from Milton Academy in June."I'm trying it. I am, so that's the goal," Thibeault said with a smile. "I go to battle with something I hope no one else ever has to, but here I am, and I have to work hard just like I did in hockey."Multiple fundraisers have been held to help the Thibeault family in the months since Thibeault's on-ice injury, including one by Boston Bruins legend Ray Bourque.A GoFundMe page has been set up for Thibeault and his family to help pay for rehabilitation needs, housing construction and various medical costs and expenses. Unfortunately, insurance does not cover any of the cost of Thibeault's rehab sessions at Journey Forward.Thibeault said he has been taking his high school classes from home since his injury. Milton Academy has been making accommodations to Thibeault's dormitory at the school, and he hopes to move back on campus sometime in the spring.

A Massachusetts teenager who was seriously injured during a hockey game is working hard in his rehabilitation in order toward his goal of walking again.

Jake Thibeault, of Fitchburg, broke two vertebrae in his back and suffered a small brain bleed in an on-ice collision that happened during a junior hockey tournament held over Labor Day weekend this past year.

Thibeault had screws and rods inserted at Worcester's UMass Memorial Medical Center to stabilize his spinal cord, but the injury left the 18-year-old Milton Academy student was paralyzed from the waist down.

He next went to Spaulding Rehabilitation Hospital in Boston's Charlestown neighborhood and is now in outpatient rehabilitation at Journey Forward in Canton five months after his injury.

"The hope is what they call neuroplasticity," Thibeault said. "I'm trying to rewire it and teach my brain that I can move my legs through (a certain) way."

Thibeault travels an hour each way four days a week to Journey Forward, which specializes in helping people with paralysis regain movement, in addition to his two days of standard rehab every week.

His therapy at Journey Forward focuses on building strong core muscles, including one exercise where Thibeault is brought to a standing position and catches a weighted ball with one hand.

"The theory here is we're not going to focus on the legs first. We're going to focus on the core first," said Mike Thibeault, Jake's father. "We're going to work our way down rather than up."

"My core is just so much stronger in a way that I can stabilize my body," Jake Thibeault said.

In another exercise, Jake Thibeault crawls on all fours across floor mats, pushing his hardest for every inch. But he said the current struggle to get across those mats is big progress from where he was a month ago, when he was incapable of doing so.

"They were just like, 'Oh, just try by yourself,' and I made it two mats," he said. "And I was like, 'Oh, OK. Holy cow!'"

Hearst Owned

Dan Cummings, president and founder of Journey Forward, said his facility is the only one in Massachusetts where this type of specialized therapy is offered.

Cummings himself was once paralyzed from the waist down, suffering an accident when he dove into a lake at the age of 19. Doctors told him that he would never walk again, but he was able to take his first step on his own seven years later.

Thibeault endures those grueling, hours-long rehabilitation sessions at Cummings' facility in an effort to reach an ambitious goal. Thibeault said he is determined to walk on his own during his graduation from Milton Academy in June.

"I'm trying it. I am, so that's the goal," Thibeault said with a smile. "I go to battle with something I hope no one else ever has to, but here I am, and I have to work hard just like I did in hockey."

Multiple fundraisers have been held to help the Thibeault family in the months since Thibeault's on-ice injury, including one by Boston Bruins legend Ray Bourque.

A GoFundMe page has been set up for Thibeault and his family to help pay for rehabilitation needs, housing construction and various medical costs and expenses. Unfortunately, insurance does not cover any of the cost of Thibeault's rehab sessions at Journey Forward.

Thibeault said he has been taking his high school classes from home since his injury. Milton Academy has been making accommodations to Thibeault's dormitory at the school, and he hopes to move back on campus sometime in the spring.

Read more here:

Massachusetts teenager paralyzed from waist down by hockey injury making progress in recovery - WCVB Boston