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fortune gems download Renuka Rayasam | (TNS) KFF Health News In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online baby message boards and other social media forums , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the Patient Advocate Foundation . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the American College of Obstetricians and Gynecologists . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to spread out one-time payments over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the Peterson-KFF Health System Tracker . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the 100 million U.S. people with health care debt, 12% attribute at least some of it to maternity care, according to a 2022 KFF poll . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said Joy Burkhard , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the timing of the pregnancy , plan benefits, and health complications, said Erin Duffy , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said Sabrina Corlette , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, Lacy Marshall , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Related Articles Your cool black kitchenware could be slowly poisoning you, study says. Here’s what to do Does fluoride cause cancer, IQ loss, and more? Fact-checking Robert F. Kennedy Jr.’s claims US towns plunge into debates about fluoride in water Older Americans living alone often rely on neighbors or others willing to help Nationwide IV fluid shortage could change how hospitals manage patient hydration Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.NOTICE TO DISREGARD -- Wrap Technologies, Inc.

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By Alexandra Alper and Karen Freifeld WASHINGTON (Reuters) -In its latest jab at Beijing, the U.S. will empower companies like Google and Microsoft to act as gatekeepers worldwide for highly sought-after access to AI chips, two people familiar with the draft plan said. Under the scheme, to be released as soon as this month, these companies would have to comply with strict requirements, including reporting key information to the U.S. government and blocking Chinese access to AI chips. That would permit them to offer artificial intelligence capabilities within the cloud overseas without a license, the sources said. The new rules, some of whose details are being reported for the first time, show officials are scrambling in the waning days of the Biden administration to streamline the process for approving AI chip exports while also preventing bad actors from accessing them. The U.S. fears China could harness the power of AI to supercharge its military, unleash powerful cyber attacks or even train a bioweapon. The Commerce Department declined to comment on the content and timing of the new regulations. Sources cautioned the administration’s plans may change. Alphabet’s Google and Microsoft did not immediately respond to requests for comment. The measure takes a page from a national security agreement Microsoft inked with the U.S. government in April allowing it to provide AI technology to Emirati firm G42, the people said. Under the new draft rules, other companies beyond those with gatekeeper status will compete for licenses to import a smaller number of high-end Nvidia and AMD AI chips in each country, one of the sources said. Nvidia, which makes the world’s most powerful AI chips, said it is ready to work with the administration on the rules. AMD did not immediately respond to a request for comment. Exempted from the caps would be 19 allied countries like the Netherlands and Japan plus Taiwan, which would have unlimited access to the AI chips or the capability they provide, two of the sources said. Also outside the framework would be a list of nuclear embargoed countries, including Russia, China, Iran and Venezuela, which are already blocked from acquiring U.S. AI semiconductors and would remain so. The caps could upset some countries, however. Geoffrey Gertz, a former White House official now at the Center for a New American Security, said a global program of country caps “would likely raise significant concerns from U.S. partners and allies around the world, who are wary of the United States acting as a unilateral arbiter on who gets to access advanced chips critical for AI.” The U.S. government is conducting a final review of an “Artificial Intelligence Diffusion” rule drafted by the Commerce Department, according to a government posting this week, indicating it may be closing in on publication. Three sources said the posting referred to the AI caps. The Information Technology Industry Council, an advocacy association whose members include AMD and Google, is concerned the Biden administration is rushing the complex rule out without industry input that could head off adverse consequences. “If reports are accurate, such changes would dramatically expand the scope of export controls and have significant global implications,” Naomi Wilson, the council’s senior vice president of Asia and global trade policy, said in a statement. The rules build on a program unveiled in September that gives permission to pre-approved data centers overseas to receive AI chips without a license, two sources said. To achieve that status, data centers must provide information about customers, business activities, access restrictions and cybersecurity. (Reporting by Alexandra Alper and Karen Freifeld; additional reporting by David Shepardson; editing by Chris Sanders, Chizu Nomiyama and Rosalba O’Brien) Disclaimer: This report is auto generated from the Reuters news service. ThePrint holds no responsibility for its content. var ytflag = 0;var myListener = function() {document.removeEventListener('mousemove', myListener, false);lazyloadmyframes();};document.addEventListener('mousemove', myListener, false);window.addEventListener('scroll', function() {if (ytflag == 0) {lazyloadmyframes();ytflag = 1;}});function lazyloadmyframes() {var ytv = document.getElementsByClassName("klazyiframe");for (var i = 0; i < ytv.length; i++) {ytv[i].src = ytv[i].getAttribute('data-src');}} Save my name, email, and website in this browser for the next time I comment. Δ document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() );PHILADELPHIA (WPVI) -- Franklin Institute celebrating 200 years with brand new experiences The Franklin Institute was founded in 1824 in Philadelphia to honor the legacy of Benjamin Franklin. Two centuries later it remains a destination for science and technology education, recognition and inspiration for future generations. The landmark building on the Benjamin Franklin Parkway has been the home for The Franklin Institute Museum since it opened in 1934. It was one of the first hands on science museums in the country and remains a leader in that industry of "informal" science education. Continuing the mission of the Institute since it opened inspiring a passion for learning about science and technology. In celebration of 200 years the museum is undergoing a modernization project that will reimagine the core galleries that make up the Franklin Institute. Wondrous Space opened last November as the first part of the project. Body Odyssey and the Hamilton Collections Gallery are the newest additions. Body Odyssey is the new home for the iconic Giant Heart. The artifact that has been at the museum since 1954 is now surrounded by a larger discussion on whole body health. The new exhibition features interactives that will take learners inside the field's most groundbreaking technology and aims to inspire new generations of workers in the medical industry. The Hamilton Collections Gallery is centered around the largest artifact at the Franklin Institute, the Baldwin 60,000 Locomotive. The new space has brought the museum's vast archives to the public in cases that show of the many treasures. The inaugural exhibition in the gallery is '200 Stories for 200 Years.' It is a curated collection of the museum's most important pieces since the it opened in 1824. The Franklin Institute | Facebook | Instagram 222 North 20th Street, Philadelphia, PA 19103 Thanksgiving Day Parade Preview The 6abc Dunkin Thanksgiving Day Parade is ready for its 105th year. Witness the long tradition of balloons, floats, and marching bands along the Benjamin Franklin Parkway. Special guests like Darlene Love will bring Christmas vibes with her hit song "Christmas Baby Please Come Home". One of "Abbott Elementary's" favorite teachers, Lisa Ann Walter, will join us this year, riding in style on a float. There will be music for everybody, with performances from The Sharpe Family, Ladies of Chic, Funky Bunch, and the Sugar Hill Gang. Watch classic holiday performances like " The Nutcracker " by The Philadelphia Ballet and The Walnut Street Theatre's production of Elf . TV personalities Kelly Ripa, Mark Consuelos, Ryan Seacrest, and Carson Kressley will also make an appearance. Spend the day with the 6abc crew to experience a magical parade filled with bands, mascots, and holiday cheer. Philly Cake Lady makes 3-D cakes at 4 Every Occasion Cakes & Cupcakes Anitria Odum started 4 Every Occasion Cakes and Cupcakes 11 years ago after a mid-life career change. The medical field did not inspire her, so she left to find her passion. In her years as a wedding planner, she says her brides were always asking for specialty cookies. When she did not know anyone who made them, she set out to learn on her own. A serendipitous class at a local craft store was focused on cookies, so even though she wanted to do specialty cakes instead, she took the cookie class anyway. One frustrating night of homework for class led her to online videos, and one after another, she says over time that is the way she learned to decorate cakes. Since then, she has become an instructor herself, and has legions of regular customers for all of her baked goods, especially the custom 3-D cakes. The cakes look amazingly realistic, and need to be ordered at least 2 weeks in advance. 4 Every Occasion Cakes & Cupcakes Bakery | Facebook | Instagram 1821 Cottman Avenue, Philadelphia, PA 19111 215-722-2250 custom cakes: by appointment only shop hours: Wednesday-Saturday, 10:00am-2:00pm pop-ups: follow social media for dates and locations Sharing Excess connects those who have extra with those who need more The Philadelphia Wholesale Produce Market is the largest fully enclosed and refrigerated produce terminal in the world, a place where you can buy fresh fruits and vegetables from across the globe. When vendors have more of a particular item than they can sell, or perhaps produce that's misshapen, they give it to the food rescue organization, Sharing Excess. Workers inspect each piece of produce. Anything past its prime goes to compost; the rest is packed and prepared for delivery to one of over 300 community organizations that distribute food to communities all over the city. Evan Ehlers officially founded Sharing Excess in 2018 but the idea took root 2 years earlier when he was a student studying entrepreneurship at Drexel University. He had 50 leftover meal swipes on his dining account. At the same time, he says he was seeing people suffering from hunger on a daily basis. So he swiped all of the meals out, loaded them into his car and gave them to people living on the street in Center City. He also started researching and found "that nearly 38% of the food we produce in the U.S. goes to waste.: His first step was to convince his classmates to donate their unused meals too. Then he started connecting with grocery stores to pick up whatever perishable foods hadn't sold that day, and he started calling shelters, churches and other organizations addressing hunger and food insecurity in our area. Sharing Excess now rescues and re-distributes over a million pounds of food each week, partnering with grocery stores, restaurants and farmers. Evan credits his mother for his empathy. A Colombian immigrant who, he says, taught him how important it was to be grateful for what he had. He describes his parents as beyond proud, and says he is just getting started. His hope is to expand Sharing Excess nationwide and one day all over the world. Sharing Excess | Website | Facebook | Instagram Philadelphia Wholesale Produce Market | Website | Facebook | Instagram 6700 Essington Ave, Philadelphia, Pa. 19153 6abc Dunkin' Holiday Food Drive: Particpate here George Balanchine's The Nutcracker coming to Academy of Music Paid Sponsor Partnership: Philadelphia Ballet The holiday classic, George Balanchine's The Nutcracker , returns to the Academy of Music on December 6. Angel Corella, Artistic Director for Philadelphia Ballet, calls the ballet the number one holiday tradition in Philadelphia. "It's very exciting," says Corella. "The dancers in the Philadelphia Ballet, they're wonderful." He says that the holiday feeling will overtake you in the theater when you hear the music of The Nutcracker for the first time. Tchaikovsky's famous score helps tell the story of Marie and her brother, Fritz. Corella says they're celebrating Christmas with their parents, who are hosting a beautiful party with many guests when Marie's Uncle Drosselmeyer brings a special gift. "This gift that is a Nutcracker, and Marie falls in love with it completely," says Corella. But Fritz takes the Nutcracker and breaks it, leaving Marie upset. Corella says Drosselmeyer kind of fixes it before the party's end, and once the guests leave, Marie goes to bed. That's when everything in the room becomes gigantic, including the Nutcracker. "Rats, they start to come in, and then the Nutcracker comes in and defends her," he says. "The Mouse King comes in also and tries to attack her." Once victory is won, the Nutcracker takes Marie to the Land of Candy. "And that's where they actually get to meet the Sugar Plum Fairy, her Cavalier. They get to see all the different dancers from all the different countries," he says. In the end, Marie returns home. "And we don't really know if it was a dream or if it was reality," says Corella. Philadelphia Ballet will perform 30 shows, with $10 tickets on opening night, December 6, and a sensory-friendly performance after Christmas. Corella says The Nutcracker is a wonderful ballet to share with someone who has never been to the ballet. "It's magical," he says. George Balanchine's The Nutcracker runs December 6 - 29 at the Academy of Music. Philadelphia Ballet presents George Balanchine's The Nutcracker | Tickets Academy of Music 240 S. Broad Street, Philadelphia, PA 19102

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France's new Prime Minister Francois Bayrou attends the handover ceremony at the Hotel Matignon in Paris. Photo: Reuters President Emmanuel Macron earlier named Bayrou as his fourth prime minister of 2024, tasking his centrist ally with steering France out of its second political crisis in six months. He replaces Michel Barnier, who was ousted by lawmakers last week for trying to pass a cost-cutting 2025 budget. Bayrou, a three-time presidential candidate who has long warned of French fiscal profligacy, inherits the same rowdy parliament that felled Barnier. His proximity to the deeply unpopular Macron may also hurt him. In a speech alongside Barnier on Friday (local time), Bayrou acknowledged the challenge. "Nobody knows the difficulty of the situation better than I do... I am not unaware of the Himalaya that stands before us," he said. "I believe that this issue, the deficit and debt, is an issue that poses a moral problem, not just a financial one." Efforts to rein in the deficit, expected to close the year at over 6% of gross domestic product, lie at the heart of France's political malaise. The festering crisis has raised doubts about whether Macron will complete his second presidential term until 2027, lifted French borrowing costs and left a power vacuum in the heart of Europe, just as Donald Trump prepares to return to the White House. Bayrou's immediate priority will be passing a special law to roll over the 2024 budget, with a nastier battle over the 2025 legislation looming early next year. Bayrou told reporters he wanted to move quickly, but France's stark political divisions mean even the basic task of naming his cabinet could drag on. The Socialists, irked that the president ignored their demands for a leftist prime minister in favour of a "Macronista", said they would not join Bayrou's coalition, and could even seek to topple him if he tries to ram through the budget. The pro-Barnier centre-right said it would wait to see Bayrou's proposals before deciding whether to join him, Laurent Wauquiez, the head of the Republican Right grouping in the National Assembly, wrote on X. Far-left France Unbowed party leaders said they would be immediately seeking to remove Bayrou, while far-right National Rally (RN) party chiefs said they were willing to give him the benefit of the doubt for the time being. IMPOSSIBLE JOB? Bayrou, the founder of the Democratic Movement (MoDem) party which has been a part of Macron's ruling alliance since 2017, has been the longtime mayor of the southwestern town of Pau. His rustic roots are a key component of his political character. The mixed reactions to Bayrou's appointment suggest he will likely be living day-to-day, at the mercy of Macron's opponents, for the foreseeable future. Barnier's three-month premiership was the shortest in modern French history. Macron will hope Bayrou can stave off no-confidence votes until at least July, when France will be able to hold a new parliamentary election. But getting there won't be easy. An early test will come with the 2025 budget bill negotiations, expected to start in January. Barnier's bill, which aimed for 60 billion euros in savings to assuage investors increasingly concerned by France's deficit, was deemed too miserly by the far-right and left. The government's failure to find a way out of the gridlock has seen French borrowing costs push higher. XTB Research Director Kathleen Brooks said Bayrou's appointment was unlikely to have a major impact on French bonds. However, she said the CAC 40 French stock index .FCHI was underperforming German stocks by a three-decade margin. "With France still mired in political turmoil, narrowing this gap is an uphill struggle, even with a new PM," she wrote. Macron named Bayrou as justice minister in 2017 but he resigned only weeks later amid an investigation into his party's alleged fraudulent employment of parliamentary assistants. He was acquitted of fraud charges this year.