Black women in Latin America, the Caribbean and the United States are more likely than their white counterparts to report denial of medication or physical and verbal abuse in health care settings.

Karnataka: Karnataka Examinations Authority (KEA) has
invited online applications for admission to UG MBBS, BDS, BAMS, BUMS and BHMS courses for the year 2023.

Detailed schedule –

Commencement of online registration and application entry

14-07-2023 After 6.00 pm

Last date to complete the online application entry process by
fee

paid candidates.

before 11.59 pm on 21-07-2023

Last date to pay the Registration fees.

22-07-2023 – up to 6.00 pm

Submission of Special Category Certificates (only by
Karnataka candidates - NCC, Sports, Defence, Ex-defence, Scouts &

Guides, CAPF, Ex-CAPF, AGL) Only at KEA, Bangalore.

As per the schedule

Kannada Language Test only for Horanadu and Gadinadu
Kannadiga Candidates (only to newly registered candidates, those CET-2023
candidates who have already appeared for the Kannada examination on 22-05-2023
are not eligible to appear for Kannada Language Test once again)

25-07-2023

From 3.00 pm to 4.00 pm

Medical Examination to Physically Disabled candidates -
only for Karnataka candidates – including those who have already appeared for the medical examination for UGCET-2023 should also compulsorily appear for
UGNEET-2023 medical examination.

25-07-2023

(10.00 am to 1.00 pm) Medical Examination At KEA,
Bangalore

Report at 9.30 am

Verification of Documents - Karnataka candidates - Read
the instructions in the following pages and also hosted separately in the KEA
Website with regard to document verification and follow the instructions.

Will be notified

Verification of Documents – non-Karnataka candidates -
Read the instructions on the following pages and also hosted separately on
the KEA Website with regard to document verification and follow the
instructions.

-

Downloading of Verification Slip - Read the instructions
in the

following pages.

Will be notified

Instructions issued -

Registration of the application form for appearing in the UGNEET
2023 is online only at the website http://kea.kar.nic.in Application forms
CANNOT be submitted in offline / printed copy by post. No request for a change of
details in the online application will be entertained.

The prescribed registration fee of Rs. 500 (for Karnataka
SC/ST/Cat-1/PWD/ GM/2A/2B/3A/3B candidates), Rs. 2500 for Non-Karnataka
candidates, and Rs. 5500 (for NRI Ward/NRI/OCI/PIO/Foreign Nationals
candidates) should be remitted through payment gateway provided using a Credit
Card or a Debit Card issued by banks in India or through Internet banking or by
downloading bank challan.

Registered but unverified/unregistered candidates will not
be allowed for any admission either through KEA or by the College as after the
mop-up round, the list of registered and verified but un-allotted candidates
will be sent by KEA to colleges to fill up vacant seats if any. (As per GOI
instructions).

A candidate may have the option to select Medical / Engineering
etc; seat in other boards like JEE, MCC, KPCF and KEA etc. In case such a candidate wishes to confirm the seat selected from other boards, then such
candidate who has also been allotted a seat through KEA has to surrender the
seat allotted by KEA before the last date fixed for modifying of options of the Second Round of seat allotment, failing which it may amount to blocking of the seat
and KEA may initiate action/proceedings against such candidates.

If a candidate decides to surrender the seat, he/she has
to surrender the seat only to KEA in writing. Merely not reporting to the
selected/allotted college should not be presumed by the candidate that he/she has surrendered the seat to KEA.

A candidate who had obtained a Medical / Dental seat in any
of the previous years and not surrendered the seat before the last date fixed
for entry of options for the final round of seat allotment and candidates already
studying Medical / Dental and selected Medical / Dental seat from other boards
will not be eligible for allotment of a Medical / Dental seat during 2023.

Candidates who do not pass all the subjects in the
qualifying examination and candidates, who do not possess the required academic
eligibility, will not be eligible to be considered for verification of
documents and allotment of Medical and Dental seats.

A candidate who passes all the subjects in the qualifying
examination in 2023 and later withdraws from one or more subjects for reappearing in
the qualifying examination for improving his performance will not be considered
for allotment of seats.

The SC / ST/Category-I / 2A, 2B, 3A, and 3B and other
eligibility criteria is applicable to Karnataka candidates who are eligible to
claim eligibility for Government seats under clauses (a), (b), (f), (h), (j),
(k) (l) and (o) and the same is not applicable to eligibility clauses (c), (d),
(e), (g), (i), (m) and (n) to claim Government Seats and Government quota
seats. Reservation of seats in certain categories such as Rural, Kannada etc
and in Special Categories such as NCC, Sports etc, is applicable only to
Karnataka candidates who are eligible for Government seats and Government Quota
seats.

Further, as per the letter dated 13-07-2023 of Karnataka
AYUSH Department, the seat matrix for 85% of seats available for admission in
Government and Government Aided Institutions (except 15% All India Quota) and
in Private Institutions all seats (including State Quota, All India Quota and
Management / NRI quota) available for UG courses in Private Ayurveda, Unani and
Homeopathy Colleges of Karnataka state shall be allotted through KEA.
UGNEET-2023 eligible candidates can also register online for Ayurveda, Unani
and Homeopathy seats. However, non-Karnataka candidates are eligible only for
the notified seats.

The options entered by the candidate for the first round
will remain the same for the subsequent round of seat allotment. The candidates
will not be allowed to enter options again. Entry of options by the candidates
will begin only after the seat matrix is notified by the Government.

After the entry of options is completed, based on the
options entered by the candidates in the order of merit and by following the
Roster System, MOCK ALLOTMENT will be carried out as per the procedures
explained in this Information Bulletin. This Mock Seat Allotment is only an
INDICATIVE seat status which the candidate may or may not get in the real
allotment. It will help the candidate to revise, update, add or delete already
the entered options.

The seat matrix notified by the Government for each
discipline will be adopted for allotment seats, course-wise, college wise and
category wise seat matrix notified by Government will be hosted on the KEA
Website for the information of the candidates and parents.

The allotment of seats will be conducted in two rounds, and
each round consists of three phases, and each phase consists of a number of
iterations.

The candidates have to be present personally for the counselling
process; no one can represent the candidate under any circumstances. Only one
person (Parent / nearest relative) can accompany the candidate. The entry pass
for mop-up round should necessarily have the details of the accompanying
person.

The candidates have to compulsorily pay the prescribed fees
in the form of a demand draft drawn in favour of “The Executive Director, KEA”
payable at Bangalore. Candidates can bring multiple demand drafts for different
denominations. Online payment or Cheques or Cash is not allowed. Candidates
will not be allowed to select the seats without the demand drafts for the
required fees. Candidates are advised to visit KEA Website for seat
availability / vacant seats for mop-up round allotment before participating.

Detailed information about the schedule for the first round, second
round and mop-up round etc., and other counseling-related procedures/guidelines will be published later on the KEA Website.

Instructions to Karnataka UGCET-2023 registered candidates -

1. Select the link on the KEA Website for UGNEET-2023 registration.

2. Select “UGCET-2023 registered candidates”.

3. Enter UGNEET-2023 Roll Number.

4. Complete the registration details.

5. UGCET-2023 online application details will be displayed.

6. Verify the details in each TAB.

7. Do the changes if required. (edit the application / additional claims)

8. Before selecting the declaration take the draft print and verify the entries and do the changes if required. Once the declaration is done, changes cannot be made.

9. Select the declaration and complete the process.

10. Pay the fees. Take the final print.

Also Read:BOPEE Begins Online Registration Process For NEET PG, NEET MDS Courses, check out details

UGNEET-2023 – document verification -

Admission to Medical, Dental, Ayurveda, Unani and Homeopathy courses for the year 2023, Verification of Documents will be conducted at Karnataka Examinations Authority, 18th Cross, Malleshwaram, Bangalore. The Karnataka candidates who are required to appear for document verification should produce a KEA UGNEET-2023 application printout, verification slip, UGNEET-2023 Score Card, and all other required original documents along with any valid Identity Card (Driving License / Voter ID / Passport / PAN / Aadhar Card).

The candidates should produce all the required original documents as detailed in the UGNEET-2023 Information Bulletin and attend the document verification based on All India Rank only. Candidates have to be personally present as per the schedule for document verification, and no one can represent them. Please read the instructions hosted on the KEA Website regarding participation in document verification.

Karnataka candidates -

Candidates, who have assigned ranks in UGCET-2023 and completed their document verification as per CET-2006 Admission Rules, and those who are not claiming any additional reservation need not appear for verification of documents once again for Medical / Dental / Ayurveda, Unani, Homeopathy courses.

However, if any such candidate is eligible to claim reservation as per Government of Karnataka norms or Linguistic Minority or Religious Minority or NRI ward seats or candidates eligible to claim seats under Category-2 to Category-8 in St. John Medical College, Bangalore, then they have to claim such reservations in the online application form and they have to appear for document verification with such relevant certificates/documents.

Further, candidates who have already claimed Linguistic Minority /Religious Minority / NRI WARD in the UGCET-2023 application should also appear for document verification with all the relevant original certificates/documents.

No separate document verification is required for Category-1 (All India Open Merit) and Category-9 (Karnataka State Open Merit) of St. John Medical College, Bangalore.

Non-Karnataka candidates -

Non-Karnataka candidates will not be eligible for reservation. Hence, in the UGNEET-2023 examination, if they have scored the required minimum 50th percentile or above, fixed for the ‘GENERAL (UR)’ category as per the qualifying criteria, then only they are eligible to register for admissions through KEA or for any other seats in the State of Karnataka. Please note that SC/ST/OBC eligibility criteria are applicable to Karnataka SC/ST/OBC candidates only.

Non-Karnataka candidates those who have qualified in UGNEET 2023 and registered with KEA, need NOT appear for verification of documents. However, if any non-Karnataka candidates were eligible to claim NRI Ward, Religious Minority or eligible to claim seat under Category-2 to Category-8 in St. John Medical College, Bangalore, then they have to appear for verification of documents with all the original necessary documents at KEA, Bangalore as per the following schedule.

Category-1 (All India Open Merit) of St. John Medical College, no separate verification is required.

The non-Karnataka candidates, who are required to appear for document verification, should produce a KEA UGNEET-2023 application printout, UGNEET-2023 Score Card and all other required original documents as detailed in the UGNEET-2023 Information Bulletin. Any valid Identity Card (Driving License / Voter ID / Passport / PAN / Aadhar Card).

Horanadu and Gadinadu candidates and those who have qualified in UG NEET-2023 but have not attended the UGCET-Kannada Language Test on 22-05-2023, such candidates have to appear for Kannada Language Test in Bangalore on 25-07-2023 (3.00 pm to 4.00 pm) as notified to become eligible to claim Government seats.

Qualifying Criteria of UGNEET-2023 –

Category

Qualifying Criteria

Marks Range

UR/EWS

50th Percentile

720-137

OBC

40th Percentile

136-107

SC

40th Percentile

136-107

ST

40th Percentile

136-107

UR / EWS & PH

45th Percentile

136-121

OBC & PH

40th Percentile

120-107

SC & PH

40th Percentile

120-107

ST & PH

40th Percentile

120-108

Academic Eligibility for all seats

For Admission to 1st Year

Eligibility

Criteria for Determination

of Merit / Rank

In Qualifying Examination, the candidate

should have

In NEET-

Examination

Passed in 2nd PUC / 12th Std /

Equivalent Exam with English
as one

of the Languages and obtained a

Minimum of 50% of Marks in

aggregate in Physics, Chemistry,

Declared as

Based on

Medical /

Biology subjects. (*40% for SC, ST,

qualified in

UGNEET-2023

Dental /

Cat-1, 2A, 2B, 3A and 3B category

UGNEET-2023 *

All India Rank.

Ayurveda /

candidates)

Unani /

*Other eligibility criteria and

Homoeopathy

conditions as mentioned in UGNEET-

courses

2023 Information Bulletin.

*The SC / ST/Category-I / OBC eligibility criteria are applicable to Karnataka

candidates who are eligible
to claim Government seats under clauses
(a),

(b), (f), (h), (j), (k), (l) and (o), and the same is not applicable to clauses (c),

(d), (e), (g), (i), (m) and (n) i.e.,
Eligibility Clauses to claim Government

Seats.

Eligibility clauses have also been released. The detail related to each clause is enclosed in the notice below.

Candidates must retain the following documents with them as reference for future correspondence -

1. At least two printouts of the finally submitted Online Application.

2. UGNEET-2023 Admit Card and UGNEET-2023 Score Card.

3. 2 passport-size identical photograph which is uploaded in the Online Application.

Classification of seats –

These seats are classified into four categories, namely -

1. G - Government Seats

2. P - Private Seats

3. N - NRI Seats

4. Q - Others Seats

The details related to each seat are enclosed in the notice below.

Compulsory rural service for one year –

1. All candidates who take admitted to Medical course shall under go one year of compulsory rural service in a Government hospital as per Karnataka Compulsory Service Training by Candidates Completed Medical Courses, Act 2012 as amended in 27/09/2017 and Karnataka Compulsory Service by Candidates Completed Medical courses (Counseling, Allotment and Certification) (Amendment) Rules, 2017.

2. The candidates will be entitled to only temporary registration till completion of such service. Until they complete the same, they will not be entitled to permanent registration.

3. All the candidates who will be allotted Medical Seats through KEA, both in Government and Private Medical colleges, should compulsorily submit sworn affidavit to the Principal of the respective college at the time of admission (on a hundred Rupees e-stamp paper signed by the candidate and the parent as per the format hosted on the KEA Website) regarding one-year rural service after completion of the course.

To view the notices, click on the links -

https://medicaldialogues.in/pdf_upload/eligibility-clauseskannada-214291.pdf

https://medicaldialogues.in/pdf_upload/e-brochure-ugneet-2023-14-07-2023kannada-214290.pdf

Also Read:MCC Releases Tentative Schedule For NEET Counselling 2023, check out details

The World Health Organization (WHO) released its official statement this week on the potential health risks of aspartame, with a committee classifying the non-sugar, low-calorie sweetener as "possibly carcinogenic to humans."

Many industry experts, however, are speaking out in defense of aspartame, which is commonly used in diet sodas, chewing gum, some dairy products and many other low-calorie foods and beverages.

The International Agency for Research on Cancer (IARC), a cancer-focused organization within WHO, was the agency that called out the sweetener’s potential cancer risk.

BYPRODUCT OF SUCRALOSE, A CHEMICAL IN SPLENDA, FOUND TO CAUSE 'SIGNIFICANT HEALTH EFFECTS' IN NEW STUDY

The IARC uses five different levels of cancer risk: Group 1, "carcinogenic to humans"; Group 2A, "Probably carcinogenic to humans"; Group 2B: "Possibly carcinogenic to humans"; Group 3, "Unclassifiable as to carcinogenicity in humans"; and Group 4, "Probably not carcinogenic to humans."

Aspartame was placed in Group 2B based on "limited evidence" of causing cancer in humans and animals — particularly a type of liver cancer, the press release stated.

In the same announcement, the Joint Expert Committee on Food Additives (JECFA), another group within WHO, seemed to contradict the IARC’s classification.

"JECFA also considered the evidence on cancer risk, in animal and human studies, and concluded that the evidence of an association between aspartame consumption and cancer in humans is not convincing," the press release stated.

The acceptable daily intake (ADI) of aspartame remains 40 milligrams per kilogram of body weight, JECFA also said. That amount is the equivalent of nine cans of 12-ounce diet soda per day for a 150-pound person.

(The FDA recommends an even higher ADI, at 50 milligrams per kilogram of body weight.)

UTERINE CANCER DEATHS COULD SOON OUTNUMBER DEATHS FROM OVARIAN CANCER, ONCOLOGIST SAYS: ‘WE NEED TO DO BETTER’

"Our results do not indicate that occasional consumption should pose a risk to most consumers," Dr. Francesco Branca, director of the Department of Nutrition and Food Safety at the WHO, stated during a press conference in Geneva.

Dr. Mona S. Jhaveri, a biotech scientist and cancer researcher in Ridgefield, Connecticut, told Fox News Digital that the likelihood of getting cancer depends on the types and the number of carcinogens that one is exposed to, as well as genetic factors. 

"Carcinogens can work either alone or in combination with other substances," she said. 

Often, she added, "people who are subject to multiple carcinogens can increase their risk of getting cancer exponentially."

Many industry experts maintain that aspartame is still safe for consumption — including the FDA, which released a statement refuting the cancer risk.

"The FDA disagrees with IARC’s conclusion that these studies support classifying aspartame as a possible carcinogen to humans," the statement read. 

"FDA scientists reviewed the scientific information included in IARC’s review in 2021 when it was first made available and identified significant shortcomings in the studies on which IARC relied."

"We note that JECFA did not raise safety concerns for aspartame under the current levels of use and did not change the acceptable daily intake (ADI)."

Additional agencies, including the European Food Safety Authority and Health Canada, have also deemed aspartame to be safe at the current recommended levels, the FDA added.

"Aspartame is one of the most studied food additives in the human food supply," the FDA stated. 

"FDA scientists do not have safety concerns when aspartame is used under the approved conditions."

Dr. Arnold Baskies, a New Jersey-based surgical oncologist and past chairman of the National Board of Directors of the American Cancer Society — he's also a member of the Coalition for Safe Food and Beverage Choices Expert Advisory Committee — pointed out that the WHO agencies, IARC and JECFA, reviewed previous research. They did not review new evidence.

"The WHO Joint Expert Committee on Food Additives’ (JECFA) review says that aspartame is safe for human consumption," Baskies said in a statement provided to Fox News Digital. "JECFA is the authoritative international agency when it comes to food safety."

The FDA relies on JECFA’s assessments as part of its process of determining the safety and risks of foods and beverages, Baskies noted.

POPULAR ARTIFICIAL SWEETENER, ERYTHRITOL, COULD RAISE RISK OF HEART ATTACK AND STROKE: STUDY

"It is irresponsible to needlessly scare or confuse people," he said. "If there was any cause for concern, they would have adjusted the current acceptable daily intake (ADI)."

The Calorie Control Council (CCC) in Atlanta, Georgia, also spoke out in defense of aspartame as a safe food additive.

"The JECFA ruling not only confirms the four decades of science concluding aspartame is safe, but also provides real-life ‎context around the safe consumption of this ingredient," said Robert Rankin, president of the CCC, in a statement sent to Fox News Digital.

Any risk is highly unlikely given the JECFA’s guidelines for recommended daily intake, Rankin also said.

"The average 150-pound person would need to consume about 14 12-oz. cans of diet beverages or about 74 packets of aspartame-containing tabletop sweetener every day over the course of their life to raise any safety concern," Rankin said.

"Obviously, that level of consumption is not realistic or recommended, nor is it ‎aligned with the intended use of these ingredients."

Regarding IARC describing aspartame as "possibly cancer-causing," Rankin stated that IARC is not a regulatory agency or food safety authority, and said that its classification is "misleading, inaccurate and [constitutes] fearmongering."

He said, "IARC looks for substances that could potentially cause cancer without considering actual dietary intake, and has found many things, such as drinking hot water and working at night, to be probably carcinogenic."

ULTRA-PROCESSED FOOD CONSUMPTION LINKED TO HIGHER RISK OF DEATH FROM OVARIAN, BREAST CANCERS: NEW STUDY

"It is not only wrong, but potentially damaging to certain populations to position IARC’s report alongside true scientific and regulatory agencies like JECFA, the Food and Drug Administration, and the European Food Safety Authority," Rankin added.

Dr. Ernest Hawk, head of the Division of Cancer Prevention and Population Sciences at The University of Texas MD Anderson Cancer Center, also spoke to Fox News Digital about aspartame’s safety.

"IARC classified aspartame as ‘possibly carcinogenic to humans’ based on limited evidence for cancer in humans and experimental animals, and limited evidence that it might behave as a carcinogen," he said. 

"Because all of the evidence was limited, aspartame was added to WHO’s list of possible carcinogens."

The list begins with 126 agents known to be carcinogenic in humans (including tobacco and alcohol) and 94 agents that are "probably carcinogenic" — followed by 322 agents that are "possibly carcinogenic," Hawk explained.

"Aspartame will now be included in that final group, but keep in mind that none of those have been convincingly proven to cause cancer," he added.

The FDA, the National Cancer Institute, the American Institute for Cancer Research and the American Cancer Society all have evaluated the same evidence in the past, and all of them concluded that there was no clear evidence that artificial (non-nutritive) sweeteners cause cancer when consumed at typical levels, Hawk said.

While he believes that the WHO agencies did a careful review and have the public’s best interest in mind, Hawk called for additional research on the long-term health risks of consuming non-sugar sweeteners.

The FDA and other health agencies do not agree that aspartame is a cancer risk, so some medical professionals recommend using sugar instead of artificial sweeteners.

"Although it’s approved by regulatory bodies, potential risk factors are associated with preferring aspartame over sugar," noted Jhaveri.

SUGAR SUBSTITUTES NOT ADVISED FOR WEIGHT LOSS OR DISEASE PREVENTION, SAYS WORLD HEALTH ORGANIZATION

"Sensitivities or allergies to aspartame can result in adverse reactions, and excessive consumption may contribute to weight gain due to heightened cravings for sweet edibles," she said.

For some people, aspartame may cause physical symptoms that include headaches, dizziness, digestive ailments and allergic responses, Jhaveri noted.

"Avoiding aspartame when possible and opting for natural sugars in fruits and vegetables is prudent," she said. 

In May, the WHO advised against the use of non-sugar sweeteners like aspartame for the purposes of controlling body weight or lowering the risk of non-communicable diseases.

"Replacing free sugars with NSS does not help with weight control in the long term," said Branca, the WHO’s director for nutrition and food safety, in a press release at the time. 

SUGAR SUBSTITUTES MAY INTERFERE WITH LIVER’S ABILITY TO DETOXIFY, RESEARCHERS SAY

For the general public, Hawk recommended "paying attention to the science" as it continues to develop regarding the possible health consequences of artificial sweeteners.

"In the meantime, continue to work on consistently eating a balanced, healthy diet that contains whole foods that are high in nutrient density," he suggested.

People with a rare inherited disorder called phenylketonuria (PKU) should avoid aspartame, medical experts say.

Those with PKU don’t have the enzyme to break down an amino acid called phenylalanine, so it builds up in the body. 

Consuming foods and drinks with aspartame can cause dangerous levels of phenylalanine that can lead to serious health issues, according to the Mayo Clinic’s website.

CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER

Aspartame-containing products will include a warning on the label stating "PHENYLKETONURICS: CONTAINS PHENYLALANINE." 

Anyone with PKU should avoid any food or drink with this warning.

Aspartame hazard and risk assessment results released

Cristina Mitchell

14 Jul 2023

On the filing of the instant anticipatory bail application on 06-07- 2023, under Section 497, CrPC by the applicant, an interim bail was granted to her on the basis of the averments made in the application with a direction to the prosecution to file a report in the case as well as objections to the application by or before 08-07-2023.

Medical Dialogues team had earlier reported that it came to light that the doctor used fabricated dates of birth certificates to gain admission in the MBBS course at GMC Jammu under the nose of the government. The accused used her two dates of birth, i.e. 08.04.1964 and 08.04.1965, to cheat the government and gain admission to the college.

The matter could not have been revealed until a written complaint filed by Manu Gupta against the doctor came to the fore, alleging that she had tampered with her age documents to get an undue advantage for getting admission to the MBBS course in the GMC Jammu as she was underage at that time.

The same got filed on the said date and the case was also heard on the same date finally and was reserved for order, which was issued on July 10  by Special Judge Anti-Corruption Jammu. 

Also read- GMC Jammu Principal Under Scanner For Tampering Date Of Birth In Documents

“The law on the concept of anticipatory bail is quite well settled. It is enjoined upon the criminal courts that while deciding anticipatory bail, a fine balance is required to be struck between the individual’s right to personal freedom and free movement to that of the right of investigation of the police”, said Special Judge Anti-Corruption Court, Tahir Khurshid Raina.

“As per the facts revealed in the report and the CD file, there is no two opinion with regard to existence of two different date of births, conveniently used by the accused on two different occasions i.e one for getting admission in MBBS and second when got appointed as Assistant Surgeon”, the court said, adding “so the offence of fraud, forgery and misconduct under Prevention of Corruption Act are prima facie made out”.

The Court observed, "A doctor by profession, who happened to be earlier a teacher in the Medical College and presently at a high pedestal in the hierarchy is consciously continuing her alleged fraud, with two date of birth certificates, using conveniently at different occasions, makes the alleged offence of high gravity".

During preliminary verification, a questionnaire was sent to her by the Crime Branch, Jammu on 09-05-2021, to know from her as what were the documents she submitted with the application form for admission in the MBBS, also copies of the documents were sought from her and she stated that she did not remember and the documents must have been attached with the form. However, it was astonishing to note that when the investigating agency raided at her residence, it found the original admission file of her carrying no age proof attached with it, the court added.

“How come she was having the custody of the original admission file of her which dates back to 1981, supposed to be in the concerned admission section of the college. Why only the age proof is missing from it when it is the foundational document on the basis of which she claimed her eligibility and later got admission in the MBBS course. So obviously, she by misusing her position as Principal, managed to get the old file and then either has destroyed the document or is in her custody”, the court further said.

“By refusing to respond fairly to Crime Branch and keeping the admission file in her custody speaks of her influence, potential and tendency to tamper with the evidence, who instead of cooperating with the investigating agency as a bonafide public servant even fled away and was not available at her office or home when the investigating agency raided at both the places”, the court said.

Accordingly, court refused to extend the interim bail granted vide order dated 06-07-2023 and dismissed the anticipatory bail application.

To view the official order, click on the link below: 

https://medicaldialogues.in/pdf_upload/shashisudanvsjkut-214211.pdf

Also read- DOB Fabrication Case: GMC Jammu Principal Gets Interim Bail

View the full post Health authorities monitor Monkeypox in Trinidad and Tobago on NOW Grenada.

The Host

Julie Rovner
KFF Health News

@jrovner

Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

It took more than two years, but the Biden administration has finally kept a promise made by then-candidate Joe Biden to roll back the Trump administration’s expansion of short-term, limited-duration health plans. The plans have been controversial because, while they offer lower premiums than more comprehensive health plans, they offer far fewer benefits and are not subject to the consumer protections of the Affordable Care Act.

Also this week, the FDA for the first time approved the over-the-counter sale of a hormonal birth control pill. With more states imposing restrictions on abortion, backers of the move say making it easier to prevent pregnancy is necessary now more than ever.

This week’s panelists are Julie Rovner of KFF Health News, Alice Miranda Ollstein of Politico, Amy Goldstein of The Washington Post, and Rachel Cohrs of Stat.

Panelists

Alice Miranda Ollstein
Politico

@AliceOllstein

Read Alice's stories

Amy Goldstein
The Washington Post

@goldsteinamy

Read Amy's Stories

Rachel Cohrs
Stat News

@rachelcohrs

Read Rachel's stories

Among the takeaways from this week’s episode:

• The FDA’s much-anticipated approval of the first over-the-counter hormonal birth control pill followed the advice of its outside advisory committee. The pill, Opill, will be available on shelves without age restrictions.
• The Biden administration announced moves to limit so-called junk plans on insurance marketplaces. The Trump administration had dropped many restrictions on the plans, which were originally intended to be used for short-term coverage gaps.
• As the nation continues to settle into a post-Dobbs patchwork of abortion laws, the Iowa Legislature approved a six-week ban on the procedure. And an Idaho law offers a key test of cross-border policing of abortion seekers, as other states watch how it unfolds.
• In other news, Georgia’s Medicaid work requirements took effect July 1, implementing new restrictions on who is eligible for the state-federal program for people with low incomes or disabilities. And the Supreme Court’s decision on affirmative action has the potential to shape the health care workforce, which research shows could have implications for the quality of patient care and health outcomes.

Also this week, Rovner interviews KFF Health News’ Bram Sable-Smith, who reported and wrote the latest KFF Health News-NPR “Bill of the Month” feature, about a patient who lacked a permanent mailing address and never got the hospital bills from an emergency surgery — but did receive a summons after she was sued for the debt. If you have an outrageous or exorbitant medical bill you want to share with us, you can do that here.

Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:

Julie Rovner: KFF Health News’ “Doctor Lands in the Doghouse After Giving Covid Vaccine Waivers Too Freely,” by Brett Kelman.  

Rachel Cohrs: ProPublica’s “How Often Do Health Insurers Say No to Patients? No One Knows,” by Robin Fields, and Stat’s “How UnitedHealth’s Acquisition of a Popular Medicare Advantage Algorithm Sparked Internal Dissent Over Denied Care,” by Casey Ross and Bob Herman.  

Amy Goldstein: The New York Times’ “Medicare Advantage Plans Offer Few Psychiatrists,” by Reed Abelson.  

Alice Miranda Ollstein: The Wall Street Journal’s “America Is Wrapped in Miles of Toxic Lead Cables,” by Susan Pulliam, Shalini Ramachandran, John West, Coulter Jones, and Thomas Gryta.  

Also mentioned in this week’s episode:

• Stat’s “How One Medical School Became Remarkably Diverse — Without Considering Race in Admissions,” by Usha Lee McFarling.
• The New York Times’ “With End of Affirmative Action, a Push for a New Tool: Adversity Scores, by Stephanie Saul.

click to open the transcript

Transcript: The Long Road to Reining In Short-Term Plans 

KFF Health News’ ‘What the Health?’Episode Title: The Long Road to Reining In Short-Term PlansEpisode Number: 305Published: July 13, 2023

[Editor’s note: This transcript, generated using transcription software, has been edited for style and clarity.]

Julie Rovner: Hello and welcome back to “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News. And I’m joined by some of the best and smartest health reporters in Washington. We’re taping this week on Thursday, July 13, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So here we go. Today we are joined via video conference by Alice Miranda Ollstein of Politico.

Alice Miranda Ollstein: Good morning.

Rovner: Rachel Cohrs of Stat News.

Rachel Cohrs: Hi, everybody.

Rovner: And Amy Goldstein of The Washington Post.

Goldstein: Good to be with you.

Rovner: Later in this episode, we’ll have my interview with KFF Health News’ Bram Sable-Smith, who wrote the latest KFF Health News-NPR “Bill of the Month.” The hospital that provided care to this month’s patient couldn’t find her to send her a bill, but the debt collectors sure could. But first, this week’s news. Actually, it’s more like the last month’s news because we actually haven’t talked about news in a while. So we’re going to try to hit a bunch of items in sort of a lightning round. Let’s start with something we knew was coming. We just didn’t know exactly when. Last week, the Biden administration finally cracked down on short-term health plans. Those are the ones that are not subject to the strict rules of the Affordable Care Act. Amy, you wrote about this. What are short-term plans, and why have they been so controversial?

Goldstein: Well, short-term plans — they’re called short-term limited-duration plans, and really terrible argot, but that’s their name. They’ve been around as an alternative to plans that are meeting the rules of the Affordable Care Act. They were originally designed for people to use as small bridges between, say, when they lost a job and they were about to get a new job and they needed something in the interim to provide health coverage. Republicans, during the time that they were trying very hard several years ago to get rid of as much as the Affordable Care Act as they could — they didn’t succeed at a lot of that, but they did succeed during the Trump administration at lengthening the time that people could have these plans. So they extended them from what had been a three-month maximum during the latter part of the [Barack] Obama administration to 12 months, and then they were renewable for up to three years. And Democrats began calling these “junk plans,” saying that people didn’t exactly know what they were buying, that the premiums were low but the benefits were small and if people got sick and really needed a lot of care they could be stuck paying for a lot of it on their own.

Rovner: And these were the very plans that the ACA was kind of designed to get rid of, right, where people would say, I have this great health plan, it only costs me $50 a month — but by the way, it only provides $500 worth of care.

Goldstein: Well, there’s that. And the other thing that the ACA was designed to do is treat people with preexisting conditions equally. And these plans do not have to do that. Some do, but they’re not required to. So President [Joe] Biden, since he was candidate Biden running for the 2020 election, has been saying for quite a while that he was going to knock down the duration of these plans, and some of his fellow Democrats have been leaning on him: “Why haven’t you done it yet?” And last week, he finally did. He didn’t bring it exactly to where the Obama administration had it, but he brought them down to three months with a one-month extension, so a total of four months.

Rovner: And I guess the resistance here is that they’re still kind of popular, right, for people who think they would rather pay very low premiums for very few benefits?

Goldstein: Well, the catch is that we don’t really know how popular they are because there aren’t very reliable data on how many people have these. But the presumption is that some people like them.

Rovner: All right, well we will see what happens with this time they’re trying to crack down. Let us move on to abortion and reproductive rights. We will start with the breaking news. The Food and Drug Administration just this morning approved Opill, which is the first over-the-counter birth control pill. Alice, we’ve known this was coming, right?

Ollstein: Yes, we did. We thought it would be a little later in the summer. But the decision itself reflects what the FDA’s outside advisory panel strongly recommended, which is to make these pills available over the counter without a prescription and without an age restriction, which was one looming question over this process.

Rovner: Yeah, I guess, Rachel, I mean, the issue here has been can women be trusted enough to know when they shouldn’t take birth control pills because they are contraindicated for some people?

Rachel Cohrs: Right. And I think that certainly it’s important to read through the information. There’s a question as to whether women will do that. And one part of the release that stood out to me is that the specific type of pill that this is requires women to take it around the same time every day, which is not necessarily the case for all birth control pills. And I think there’s a little bit more flexibility than there used to be with this kind of pill. But it is just important that all of this communication happens. And if there’s not a doctor or pharmacist in the middle, I think it will be kind of interesting to see how this plays out in the real world.

Rovner: Well, while this could definitely help people prevent pregnancy who don’t want to get pregnant, there’s certainly a lot of action still in the states around abortion. We’re going to start in Iowa, which since the last time we spoke has done basically a 360 on abortion. Last month, the state Supreme Court deadlocked on whether to reinstate a 2018 ban on almost all abortions. That left a lower court order blocking the ban intact, so abortion remained legal in Iowa. But anti-abortion Gov. Kim Reynolds refused to take no for an answer. She called a special session of the state legislature, which on Tuesday essentially repassed the 2018 ban. It’s supposed to take effect as soon as the governor signs it, which could be as soon as Friday. But first it goes back to court, right, Alice?

Ollstein: Right. As with all of these things, there’s just a lot of back-and-forth before it’s final. Groups have already filed a lawsuit. And, you know, because the courts’ sort of mixed treatment of the previous version of this, we sort of don’t know what’s going to happen. But the law could go into effect and then be blocked by courts later or it could be blocked before it goes into effect. There’s a lot of different ways this could go, but this is one of several states where new restrictions are coming online. We’re more than a year out from the Dobbs decision now, and things are not settled at all. Things are still flipping back and forth in different states.

Rovner: Yeah, there’s a lot of states where old restrictions came into effect and then were blocked and now they’re putting new restrictions and they might be blocked. Well, turning to another “I” state, this time Idaho, where the legislature this spring passed a first-in-the-nation bill attempting to criminalize the act of helping a minor cross state lines for an abortion, even if the abortion is legal in the state the minor travels to. Now, abortion rights supporters have filed a first-in-the-nation lawsuit to block the first-in-the-nation law. This could have really big ramifications. This is different from a lot of what’s going on in a lot of the other states, right?

Ollstein: Yeah. Over the last year, there’s been a lot of fear on the left of states reaching across their borders to try to police abortion. And it hasn’t really happened yet that we have seen. And so this, I think, is a key test of whether more states will attempt to go in this direction. You know, a lot of blue states passed sort of shield laws for patients, for providers, for data, out of fear that more red states would attempt more cross-border policing. But that really hasn’t materialized broadly yet.

Rovner: I remember Missouri was the one that was talking about it, right, to make it a crime if —

Ollstein: Right.

Rovner: I know they didn’t do it, but they were talking about if women went particularly to Illinois, which is now one of these abortion havens, and came back, they would try to prosecute them, although that never really came to be.

Ollstein: Exactly. And so it’s interesting that even really conservative states with big Republican majorities, most have not gone down this road yet. And so I imagine a lot of them are watching how this case goes.

Rovner: Well, as long as we’re talking about states that start with “I,” let’s turn to Indiana, where Planned Parenthood reports that all of their appointments for abortions are taken between now and when that state’s near-total ban takes effect in a few weeks. This points out something I think often gets missed in these sort of score card maps of states that have bans and restrictions, which is there’s a lot of states where abortion is technically still legal but realistically not available, right?

Ollstein: The difference between being technically legal and available is nothing new. This was true prior to Dobbs as well. There were lots of states that only had one abortion clinic for the entire state. There were, like, six of those. And so, you know, you may have the right to have the procedure on paper, but if there’s only one place you could go and you’re not able to physically get there or they don’t have an appointment within the time window you need, you’re out of luck; that right isn’t, you know, meaningful for you. And so that’s becoming, you know, more true as abortion access is eliminated in a lot of the country and more and more people are depending on fewer and fewer states.

Rovner: And fewer and fewer clinics in fewer and fewer states. Well, finally, an update on the one-man nomination blockade by Alabama Republican Sen. Tommy Tuberville, who we talked about in March. He has stopped approval of basically all Defense Department personnel moves, including routine promotions, in protest of the Biden administration’s policy of providing leave and travel expenses for servicewomen to get abortions if they’re stationed in states where it’s illegal. Now, for the first time in more than 150 years, the Marine Corps has no approved commandant. Any idea which side’s going to back down here? Rachel, this is backing up the entire legislative calendar in the Senate, right?

Cohrs: It is. And I think some of the coverage this week has highlighted just how there hasn’t really been a willingness among Republican leadership to really put the pressure on Tuberville. But honestly, I don’t know when this stops for him. Having temporary leadership in all these positions isn’t kind of the impetus for him to say that he’s made his point. And I think there are also questions about — there may be more education required about exactly what the difference is between a temporary leader and a permanently installed leader. Obviously, the decisions that they’re making every day are life-and-death and are different than the leadership positions we see over at something like the NIH [National Institutes of Health], where, you know, I think it is —

Rovner: Which is also held up. But that’s another story.

Cohrs: Right, another story. But I just don’t see where this ends quite yet, unless there’s some will from Republican leadership to really bring him in line. And they just haven’t summoned that yet.

Rovner: I imagine there’ll be a vote on this when they get to the defense bill, right, which —the defense authorization, which is going to come up, I think, in both houses in the coming weeks. I mean, one would think that if there’s a vote and he loses, he might back down. I’m just guessing here. I guess we’ll have to wait and see what happens with that. All right. Well, it’s also been a busy couple of weeks in other social policy. On the one hand, a new federal law took effect that makes it easier for people to get accommodations to be able to do their jobs while pregnant. And Maine is going to start offering paid family and parental leave, although not until 2026. That makes it the 13th state to enact such a policy. On the other hand, Georgia is the first state to implement work requirements for Medicaid. Amy, the last time we discussed this, federal judges had tossed out Medicaid work requirements and Republicans in Congress were unsuccessful in getting those requirements back into the debt ceiling compromise. So how come Georgia gets to do this?

Goldstein: Well, I’ve begun to think of Medicaid work requirements as whack-a-mole, if you remember the arcade game in which you knock down an animal with a mallet only to have it pop up unexpectedly somewhere else. So, as you say, work requirements was something that Republicans were very eager to institute in 2017, 2018, when the Trump administration’s Center for Medicare & Medicaid Services encouraged states to adopt them. And there were basically plans to give people Medicaid at the time, mainly people in Medicaid expansion groups, if they worked or went to school or did community service for at least 80 hours a month. As you say, that was knocked down both by a district court and then a federal circuit court. And it looked like that was that, particularly when the Biden administration came along and undid the Trump administration’s regulation that had allowed states to submit proposals, the waivers for these kinds of plans. Well, lo and behold, Georgia said they wanted to do this. They said they wanted to do it in a little bit different way, because, for the first time ever, Georgia was going to be a partial expansion state for Medicaid, allowing people to get onto Medicaid if they had incomes up to the poverty level but not up to the full expansion poverty level that the ACA allows. And the Biden administration didn’t like that so much. And that partial expansion was to be twinned with work requirements. The Biden administration didn’t —

Rovner: For that expansion group, though, right? Not for everybody.

Goldstein: Just for that partial expansion group. The Biden administration didn’t like that so much. But last summer, a judge in Georgia said, no, she thinks this is OK. And the reason was that, unlike the other states, if this was pegged to a partial expansion, any expansion with work requirements would increase the number of people with Medicaid. So that was sort of in her judge judgment — I shouldn’t say the judge’s judgment — consistent with the purposes of the program. So Georgia has gone ahead, and the beginning of this month they allowed people to start enrolling in something called Georgia Pathways to Coverage. And we’ll have to see how it goes.

Rovner: Yeah. And just to be clear, I mean, Alice, you did some stellar work back a couple of years ago about Arkansas, about people losing coverage because of the work requirements, even if they were working, just because of how hard it was to report the work hours, right?

Ollstein: Absolutely. I mean, it’s kind of what we’re seeing now with the Medicaid unwinding, is that, you know, people just aren’t able to know what’s going on, aren’t able to be reached, fall through the cracks, can’t navigate the bureaucracy, and lose coverage that they should be entitled to. So we saw that happen, and I think to Amy’s point, the administration seems to be taking a very different stance on states like Arkansas, you know, which already had expanded Medicaid and then went to impose a work requirement, whereas Georgia didn’t have it before and this is kind of a compromise because it’s like, well, more people will be insured if we allow this to go forward total, you know, so maybe it’s better than nothing, although a lot of folks on the left are very opposed to the concept of work requirements, citing data that the people who are on Medicaid who can work are already working — the vast, vast, vast majority. And those who are not working, either they are caring for a child or someone with disability, or they themselves have a disability, or they’re a student. You know, there’s all these categories of why folks are unable to work.

Rovner: But in this expansion group, one would assume that if they’re earning up to the federal poverty line, they have some source of income. So one would assume that many of them are working. But I think it’ll be really interesting for researchers to watch to see, you know, a sort of a proof of concept in either direction with this.

Goldstein: And let me quickly mention a couple of things. Georgia’s rules are actually in some ways the same as what other states had tried to do previously. But in other ways, this is the strictest set of work requirements that anyone has tried in a couple of ways: People have to meet these work requirements up to age 64, which is older than other states had done for the most part. There’s also no exemption if you’re taking care of a child or taking care of an older family member. So how well people, in addition to the bureaucratic hoops that Alice was talking about, which are of grave concern to some of the people who oppose this in Georgia — there’s also a question of who’s going to actually be able to qualify for this.

Rovner: While we are on the subject of court decisions, one of the odd court decisions that I think has happened over the past few weeks is a federal district court decision out of Louisiana barring many officials in the Biden administration, including the surgeon general and the head of the CDC [Centers for Disease Control and Prevention], from talking to social media sites, particularly about things like medical misinformation. This feels like something I had not seen before in terms of actually trying to ban the administration from talking to private companies based on First Amendment concerns, which is what this is.

Cohrs: Right. Well, I mean, the First Amendment protects speech from interference from the government —

Rovner: Right

Cohrs: — which has always been, you know, this gray area with these independent platforms. And I think this issue, you know, has obviously become highly politicized. It came up several times when Rochelle Walensky, the former CDC director, was testifying on the Hill. So I think certainly we’ve seen this trend overall in these highly political court decisions and this strategy that certain litigants are taking where they’re trying to find defendants in a certain jurisdiction that’s going to be advantageous to them. So it will certainly be interesting to see how this plays out in the future and makes its way through the court system, but certainly is an eye-popping precedent. Like you mentioned, we don’t usually see something like this.

Rovner: And I wanted to mention, I think also because this is yet another of these judges that the right has found that are likely to agree with them. Like we’ve seen now: The judges in Texas, we now have one in Louisiana. Sort of kind of watch that docket. While we are still on the subject of courts, 2023 was the first year in the last decade or so that there was not a major health-related decision in the last big cases decided by the Supreme Court. But it seems like one of those non-health cases, the one essentially striking down affirmative action, might have some major implications for health care after all, particularly for medical education, right?

Cohrs: Yes. Some of my colleagues did some I think great follow-up reporting on this. And I think the idea is that there has been research that has shown that when patients are able to see a doctor of their same racial background, that it does have positive implications for their care. And there has also been studies of schools where there have been bans on race-conscious admissions showing that there is a decrease in medical school students from underrepresented backgrounds traditionally. And so I think that cause and effect is concerning for people, that if there are fewer medical students — there already aren’t a representative amount — from underrepresented groups, that could trickle down to, again, just exacerbating so many of these inequities that we see in health care provision. I know there was just a big study on the maternal mortality outcomes that came out recently as well. And I think all of these things are tied together. And I think Axios reported on one interesting potential loophole, was using proxy measures, like where someone went to school or their parents’ background, something like that, to try to ensure diversity from that lens. But I think it certainly is going to make these medical schools recalculate how they’re doing admissions and make some hard choices about how to maintain diversity that can be beneficial for patients.

Rovner: One thing that I think has come up in all of these discussions is the fact that the University of California-Davis has done an interesting job of creating a very diverse medical school class, even though race-conscious admissions have been banned in California for years. So I think a lot of schools are going to be looking sort of to see what UC Davis has done and perhaps emulate that. And I will put one of the UC Davis stories in the show notes for everybody. All right. Finally in this week’s news, the drug industry has filed a lawsuit challenging the Medicare drug price negotiation program that’s just now starting to get off the ground. Rachel, you wrote about this. How does pharma think it can block price-setting for Medicare that Medicare does for pretty much everything else that Medicare pays for? They set prices for hospitals and doctors and medical equipment. Why are drugmakers thinking that they’re special?

Cohrs: Right. So, again, this is four lawsuits as well, not just one: two from two trade groups and two drugmakers. And they’re each kind of using different arguments. But I think the big picture here is if the government called it price-setting, I don’t think pharma would have as much of an argument, but they’re calling it a negotiation. And I think one of the drugmakers’ key claims is that by signing these contracts to enter into this process, they’re tacitly admitting that this price that they come up with in this process is, quote-unquote, “fair.” And, you know, they don’t want to agree to that because then it makes the price that they’re charging everyone else look unfair on the other side of the coin. And I think there’s also these really high penalties for these companies who decide not to participate; I mean, tens of millions of dollars on the first day is the kind of number that we’re seeing for some of these companies that have filed lawsuits. And I think there’s also the option for them to take all of their drugs off of the market. But I think there’s a question with the timeline of whether they could have even done that before the law was passed. So the big picture from the drugmaker side of things is that the penalties are so high for them not to participate and that the government is framing this as a negotiation when it really is just price-setting, like Medicare does in so many other areas. So I think one interesting development that happened this week was that the [U.S.] Chamber of Commerce filed a motion for a preliminary injunction, which could make all of these lawsuits move much faster and really put a stop to the program. We hadn’t seen either of these lawsuits request a motion like that. And I think they requested a ruling by Oct. 1, which is when the first kind of round of 10 drugmakers would have had to sign their contracts with Medicare. So I think this certainly is picking up speed and urgency as we’re moving toward that Sept. 1 selection date.

Rovner: I didn’t even notice. Are these lawsuits all filed here in Washington, D.C., or —

Cohrs: No, they are not. As we’ve seen, the drugmakers are very strategic in where they filed. I think Merck did file in D.C., but the chamber filed in Ohio; it had some of their local chapters join in as well. I think we saw another company file in New Jersey. So I think they are kind of hedging their bets and trying to get rulings from as many different jurisdictions as they can.

Rovner: Find a judge who’s willing to slap an injunction on this whole thing.

Cohrs: Yes.

Rovner: Which we will talk about when and if it happens. All right. That is this week’s news, or at least as much as we have time to get to. Now, we will play my “Bill of the Month” interview with Bram Sable-Smith, and then we will be back with our extra credits. We are pleased to welcome back to the podcast Bram Sable-Smith, who reported and wrote the latest KFF Health News-NPR “Bill of the Month.” Bram, so nice to see you again.

Bram Sable-Smith: Always a pleasure to be here.

Rovner: So, this month’s patient was, like a lot of young people, an uninsured 23-year-old when she ended up in the emergency room. Tell us who she is and what kind of medical care she needed and got.

Sable-Smith: Yeah, that’s right. Her name was Bethany Birch. And, in addition to being uninsured, she was also unemployed at the time, and she had had pain in her diaphragm for eight months. It prevented her from eating. She lost about 25 pounds in that time. And when she went to the emergency room, she found out she needed her gallbladder removed.

Rovner: And got it, right?

Sable-Smith: And got it. Yeah, she got that surgery almost immediately. Because she hadn’t been eating food — her food resistance — it meant she could get in for surgery right away.

Rovner: And that cured her? Yes?

Sable-Smith: It did cure her. Yes, she felt a lot better.

Rovner: So now we’re talking about the bill. The hospital tried to send her the bill, but apparently it couldn’t find her. Is this a common thing, and why couldn’t they find her? One presumes she gave them an address when she presented at the emergency room.

Sable-Smith: She did give them an address, but by the time she was discharged, she had lost her housing. Her home situation was unstable. So just that brief visit to the hospital, by the time she left, she had no more house to live in. And she did end up crashing with her family for several months. And, eventually, she did update her address with the post office. But by the time she had done that, it was after the hospital had sent the three bills to her for her visit.

Rovner: So the hospital doesn’t get any response, and they do what we know hospitals do. They sued for nonpayment. And the debt collection firm did manage to find her. So then what happened?

Sable-Smith: Well, she went to court, and like so many people who end up in court with medical debt, she did not have a lawyer representing her. She met with a representative from the debt collection firm, and she worked out a payment plan to pay her bill, plus court costs, in $100 monthly installments. But at the time, Tennessee had a default interest rate on judgments like the one that Bethany had of 7%. So the judge tacked on a 7% interest rate to her bill.

Rovner: So, yeah, and that was presumably a lot for her to carry. What finally happened with the bill?

Sable-Smith: Well, she paid her $100 monthly payments for over four years. It totaled about $5,200 she paid in that time. But at the same time, the interest rate was accruing. And so she owed an additional $2,700 on top of the initial bill that she had gotten. From her perspective, it was just impossible. She wasn’t digging out of this debt. So she started getting help from a family friend, who’s a billing expert, who took on her case. They asked the hospital and the debt collection firm to settle her debt because she had already paid so much. But they were unsuccessful in doing so. They sent their bill to us. We started reporting the story. Then they asked again to settle her debt by paying an additional $100 on top of what she had already paid. And this time they agreed. And so she settled her debt and she got a balance-zero statement.

Rovner: Amazing how just one phone call from us can do some work. Now, as somebody who is unemployed and, as you pointed out, uninsured at the time she got the care, Bethany should have been eligible for the hospital’s financial assistance policy. Why didn’t she get help before the debt ballooned with court costs and all that interest?

Sable-Smith: Well, the simple answer is that she never applied. But, as we know, it’s much more complicated than that. So given her status as single, uninsured, unemployed, it’s very possible that she would have qualified for financial help, maybe even for free care altogether. But the onus was on her as a patient to apply. And we know her situation was unstable. You know, she went through a period of homelessness. She didn’t have a lot of expendable money at the time. It’s a long process to apply for these programs. There’s a lot of forms. It can be cumbersome. And that prevents a lot of people from applying to these programs. So advocates push for something called presumptive eligibility, where the hospital takes the onus of applying away from patients and they automatically put them through the process. And this hospital that Bethany went to, they actually have switched to that presumptive eligibility model, just not in time to help her case.

Rovner: So what’s the takeaway here? I guess everybody has to be a proactive patient, not just with your medical care, but especially with your bills. What happens to a patient who finds themselves in a similar situation?

Sable-Smith: Well, you know, from a consumer standpoint like that, one takeaway is to ask for financial help. A lot more people qualify than you might think. You might not think you qualify, but it’s very possible you could. And then from a policy perspective, hospitals switching to presumptive eligibility — that’s something that they’re able to do. And also, some states have pushed to ban or even limit interest payments on this kind of medical debt. So that’s something that other people are considering as well.

Rovner: Or you can write to us, and we will show you how in our show notes.

Sable-Smith: That’s always a possibility, too.

Rovner: Bram Sable-Smith, thank you so much.

Sable-Smith: Yeah, thanks for having me.

Rovner: OK, we’re back, and it’s time for our extra credit segment. That’s when we each recommend a story we read this week we think you should read too. As always, don’t worry if you miss it. We will post the links on the podcast page at kffhealthnews.org and in our show notes on your phone or other mobile device. Rachel, why don’t you go first?

Cohrs: OK, I’m cheating a little bit and I’m doing a double feature. So the first story for my extra credit is headlined “How Often Do Health Insurers Say No to Patients? No One Knows.” It’s in ProPublica by Robin Fields, and I think it’s just a great feature on the idea that Obamacare entitled the government and patients to more information about how often insurers deny care to patients. And the government hasn’t really pursued that information. And even, like, state health insurance commissions aren’t providing the information they’re collecting. And Robin just had such a difficult time getting any sort of information from anyone, even though we’re legally entitled to it. So I thought that was just kind of a great highlight of this next area of criticism of the health insurance industry, which, and I think that —

Rovner: I would say, all this focus on premiums and not as much focus on what you actually get for those premiums.

Cohrs: Exactly. So true. I think there’ve been some high-profile examples, great reporting. And I thought that meshed well with some reporting from my colleagues Casey Ross and Bob Herman, who wrote a follow-up to some of their prior reporting titled “How UnitedHealth’s Acquisition of a Popular Medicare Advantage Algorithm Sparked Internal Dissent Over Denied Care.” Again, looking at how algorithms in this one privatized Medicare program, which is growing in size and enrollment across the country, was actually overruling clinicians’ decisions about how long patients should be receiving care in facilities. And if the algorithm says they should be done, then they’re done. And I think it definitely sparked some concerns from people in the company who were willing to speak to them just because they were so concerned about this trend.

Rovner: Alice.

Ollstein: I have a very impressive investigation from The Wall Street Journal. There are five bylines, and we will post the link. This is about lead-covered telecom cables owned by AT&T, Verizon, other companies that have been left to decay and leach into the environment all around the country. This documents how the companies knew about them but have not moved to clean them up and get rid of them. They are impacting water sources. They are near playgrounds where children are, and it goes into the very disturbing health impacts of lead exposure. This is something the country has made a lot of progress on when it comes to paint and other sources, but obviously we still have a long way to go.

Rovner: Yeah, because there’s not enough things to be worried about environmentally, here is something else. It is very good reporting.

Rovner: Amy.

Goldstein: My extra credit this week is from The New York Times, by Reed Abelson, with the headline “Medicare Advantage Plans Offer Few Psychiatrists.” And this isn’t a giant story, but I think it is at the nexus of two very important questions: one, the long-standing question of whether privatized Medicare is better or worse for people who are older Americans on Medicare than the traditional version of Medicare; and the question of are people getting enough access to mental health care? And I guess what struck me is that there’s been so much attention lately to the question of access to mental health services for younger Americans, and this looked at the question of access to mental health services for older Americans. And what this story, based on a study, talks about is that the study found that more than half of the counties, the researchers who did this study found, is that those counties did not have a single psychiatrist participating in Medicare Advantage and that a lot of these plans have what’s called “narrow” or “skinny” networks, where a very small fraction of the available psychiatrists in a community were in that plan’s network. Now, [there are] people who are criticizing that study saying, well, you can’t look at just psychiatrists; there are other people who provide competent mental health care. But I think it just raises the question of who is getting what they need.

Rovner: Indeed. Well, my story this week is also about just plain good reporting. It’s called “Doctor Lands in the Doghouse After Giving Covid Vaccine Waivers Too Freely.” It’s by Brett Kelman of KFF Health News. But it’s about some old-fashioned reporting by another outlet, Nashville’s NewsChannel 5. It seemed that during the height of the covid vaccine rollout, when lots of places were requiring proof of vaccines and lots of people didn’t want to get them, the doctor in question, named Robert Coble, was providing waivers through a website without much —OK, any — oversight. How did they prove it? By obtaining a waiver for a reporter’s black Labrador retriever, Charlie. Earlier this spring, Coble quietly surrendered his medical license to the state Department of Health. Journalism works. OK, that is our show for this week. As always, if you enjoy the podcast, you can subscribe wherever you get your podcasts. We’d appreciate it if you left us a review; that helps other people find us too. Special thanks, as always, to our producer, Francis Ying. Also as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can still tweet me. I’m @jrovner. I’m on Threads too, @julie.rovner.

Rovner: Amy.

Goldstein: I’m @goldsteinamy.

Rovner: Rachel.

Cohrs: I’m @rachelcohrs on Twitter and @rachelcohrsreporter on Threads.

Rovner: Alice.

Ollstein: @AliceOllstein.

Rovner: We will be back in your feed next week. Until then, be healthy.

Credits

Francis Ying
Audio producer

Emmarie Huetteman
Editor

To hear all our podcasts, click here.

And subscribe to KFF Health News’ ‘What the Health?’ on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

USE OUR CONTENT

This story can be republished for free (details).

Santo Domingo.- The Ministry of Public Health in the Dominican Republic has stated that there is no proven evidence of fentanyl circulation in the country. The director of the Department of Mental Health, Alejandro Uribe, explained that institutions such as the National Institute of Forensic Sciences (Inacif), the National Drug Control Directorate (DNCD), and the Comprehensive Care Center for Dependencies (Caidep) have not recorded any cases of fentanyl use or circulation.

Uribe emphasized that if these institutions have not detected any fentanyl cases through laboratory tests or typical symptoms, it indicates that the drug is not present. However, he acknowledged that fentanyl is a concern and emphasized the need for vigilance and a strategy to prevent its infiltration.

Mental Health is actively monitoring suspicious cases in emergency rooms, and efforts are being made to develop specific tests to detect fentanyl. Currently, tests are being sent to a laboratory in the United States to rule out false positive results for heroin. The cost of each test is $78, and negotiations are underway to facilitate the process and receive timely results.