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By Katheryn Houghton and Arielle Zionts, KFF Health News (TNS) Tescha Hawley learned that hospital bills from her son’s birth had been sent to debt collectors only when she checked her credit score while attending a home-buying class. The new mom’s plans to buy a house stalled. Hawley said she didn’t owe those thousands of dollars in debts. The federal government did. Hawley, a citizen of the Gros Ventre Tribe, lives on the Fort Belknap Indian Reservation in Montana. The Indian Health Service is a federal agency that provides free health care to Native Americans, but its services are limited by a chronic shortage of funding and staff. Hawley’s local Indian Health Service hospital wasn’t equipped to deliver babies. But she said staff there agreed that the agency would pay for her care at a privately owned hospital more than an hour away. That arrangement came through the Purchased/Referred Care program, which pays for services Native Americans can’t get through an agency-funded clinic or hospital. Federal law stresses that patients approved for the program aren’t responsible for any of the costs. But tribal leaders, health officials, and a new federal report say patients are routinely billed anyway as a result of backlogs or mistakes from the Indian Health Service, financial middlemen, hospitals, and clinics. The financial consequences for patients can last years. Those sent to collections can face damaged credit scores, which can prevent them from securing loans or require them to pay higher interest rates. The December report , by the federal Consumer Financial Protection Bureau, found these long-standing problems contribute to people in Native American-majority communities being nearly twice as likely to have medical debt in collections compared with the national average. And their amount of medical debt is significantly higher. The report found the program is often late to pay bills. In some cases, hospitals or collection agencies hound tribal citizens for more money after bills are paid. Hawley’s son was born in 2003. She had to wait another year to buy a home, as she struggled to pay off the debt. It took seven years for it to drop from her credit report. “I don’t think a person ever recovers from debt,” Hawley said. Hawley, a cancer survivor, still must navigate the referral program. In 2024 alone, she received two notices from clinics about overdue bills. Frank White Clay, chairman of the Crow Tribe in Montana, testified about the impact of wrongful billing during a U.S. House committee hearing in April. He shared stories of veterans rejected for home loans, elders whose Social Security benefits were reduced, and students denied college loans and federal aid. “Some of the most vulnerable people are being harassed daily by debt collectors,” White Clay said. No one is immune from the risk. A high-ranking Indian Health Service official learned during her job’s background check that her credit report contained referred-care debt, the federal report found. Native Americans face disproportionately high rates of poverty and disease , which researchers link to limited access to health care and the ongoing impact of racist federal policies . White Clay is among many who say problems with the referred-care program are an example of the U.S. government violating treaties that promised to provide for the health and welfare of tribes in return for their land. The chairman’s testimony came during a hearing on the Purchased and Referred Care Improvement Act, which would require the Indian Health Service to create a reimbursement process for patients who were wrongfully billed. Committee members approved the bill in November and sent it for consideration by the full House. A second federal bill, the Protecting Native Americans’ Credit Act , would prevent debt like Hawley’s from affecting patients’ credit scores. The bipartisan bill hadn’t had a hearing by mid-December. The exact number of people wrongfully billed isn’t clear, but the Indian Health Service has acknowledged it has work to do. The agency is developing a dashboard to help workers track referrals and to speed up bill processing, spokesperson Brendan White said. It’s also trying to hire more referred-care staff, to address vacancy rates of more than 30%. Officials say problems with the program also stem from outside health providers that don’t follow the rules. Melanie Egorin, an assistant secretary at the U.S. Department of Health and Human Services, said at the hearing that the proposed legislation doesn’t include consequences for “bad actors” — health facilities that repeatedly bill patients when they shouldn’t. “The lack of enforcement is definitely a challenge,” she said. But tribal leaders warned that penalties could backfire. Related Articles How America lost control of the bird flu, setting the stage for another pandemic How to kick back, relax and embrace a less-than-perfect holiday New childhood leukemia protocol is ‘tremendous win’ Norovirus is rampant. Blame oysters, cruise ships and holiday travel Abortion opponents shift focus to pills with lawsuits, proposed laws and possible federal action White Clay told lawmakers that some clinics already refuse to see patients if the Indian Health Service hasn’t paid for their previous appointments. He’s worried the threat of penalties would lead to more refusals. If that happens, White Clay said, Crow tribal members who already travel hours to access specialty treatment would have to go even farther. The Consumer Financial Protection Bureau report found clinics are already refusing to see any referred-care patients due to the program’s payment problems. The bureau and the Indian Health Service also recently published a letter urging health care providers and debt collectors not to hold patients accountable for program-approved care. White, the Indian Health Service spokesperson, said the agency recently updated the referred-care forms sent to outside hospitals and clinics to include billing instructions and to stress that patients aren’t liable for any out-of-pocket costs. And he said the staff can help patients get reimbursed if they have already paid for services that were supposed to be covered. Joe Bryant, an Indian Health Service official who oversees efforts to improve the referral program, said patients can ask credit bureaus to remove debt from their reports if the agency should have covered their bills. Leaders with the Confederated Tribes of the Colville Reservation in Washington state helped shape the proposed legislation after their citizens were repeatedly harmed by wrongful billing. Tribal Chairman Jarred-Michael Erickson said problems began in 2017, when a regional Indian Health Service office took over the referred-care program from local staff. It “created a domino effect of negative outcomes,” Erickson wrote in a letter to Congress. He said some tribal members whose finances were damaged stopped using the Indian Health Service. Others avoided health care altogether. Responsibility for the Colville Reservation program transferred back to local staff in 2022. Staffers found the billing process hadn’t been completed for thousands of cases, worth an estimated $24 million in medical care, Erickson told lawmakers . Workers are making progress on the backlog and they have explained the rules to outside hospitals and clinics, Erickson said. But he said there are still cases of wrongful billing, such as a tribal member who was sent to collections after receiving a $17,000 bill for chemotherapy that the agency was supposed to pay for. Erickson said the tribe is in the process of taking over its health care facilities instead of having the Indian Health Service run them. He and others who work in Native American health said tribally managed units — which are still funded by the federal agency — tend to have fewer problems with their referred-care programs. For example, they have more oversight over staff and flexibility to create their own payment tracking systems. But some Native Americans oppose tribal management because they feel it releases the federal government from its obligations. Beyond wrongful billing, access to the referred-care program is limited because of underfunding from Congress. The $1 billion budget this year is $9 billion short of the need, according to a committee report by tribal health and government leaders. Donald Warne, a physician and member of the Oglala Sioux Tribe in South Dakota, called the proposed legislation a “band-aid.” He said the ultimate solution is for Congress to fully fund the Indian Health Service, which would reduce the need for the referred-care program. Back in Montana, Hawley said she braces for a fight each time she gets a bill that the referral program was supposed to cover. “I’ve learned not to trust the process,” Hawley said. ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.Manmohan Singh News: Former India cricketers among the likes of Harbhajan Singh, VVS Laxman, Virender Sehwag and Yuvraj Singh took to social media to pay condolences on the demise of former Prime Minister Manmohan Singh. Manmohan Singh passed away on Thursday night at the age of 92 due to age-related medical conditions, AIIMS informed. He had a sudden loss of consciousness at home after which he was rushed to the AIIMS Delhi. "With profound grief, we inform the demise of former Prime Minister Dr Manmohan Singh, aged 92. He was being treated for age-related medical conditions and had sudden loss of consciousness at home on 26th December 2024. Resuscitative measures were started immediately at home. He was brought to the Medical Emergency at AIIMS, New Delhi at 8:06 PM. Despite all efforts, he could not be revived and was declared dead at 9:51 PM," AIIMS said in a press release. Harbhajan took to X and expressed his sadness on the demise of former Prime Minister and wrote, "Saddened by the news of sudden demise of former Prime Minister, a thorough gentleman, and a visionary leader, Dr. Manmohan Singh Ji" Saddened by the news of sudden demise of former Prime Minister, a thorough gentleman, and a visionary leader, Dr. Manmohan Singh Ji 💔💔What truly set him apart was his calm and steady leadership in times of crisis, his ability to navigate complex political landscapes, and his... pic.twitter.com/WKbjrnADJQ "What truly set him apart was his calm and steady leadership in times of crisis, his ability to navigate complex political landscapes, and his unwavering belief in India's potential. Nation will always remember Dr. Saheb for his contributions. My deepest condolences to his family and relatives. Satnam Waheguru," Harbhajan added. "My heartfelt condolences on the passing away of our former Prime Minister Shri Manmohan Singh ji. Om Shanti," Sehwag wrote on X. My heartfelt condolences on the passing away of our former Prime Minister Shri Manmohan Singh ji. Om Shanti 🙏🏼 pic.twitter.com/uPkmiCm5C4 "Sad to learn about the demise of our former Prime Minister Shri Manmohan Singh ji. Heartfelt condolences to his family and loved ones. On Shanti," Laxman wrote on X. Sad to learn about the demise of our former Prime Minister Shri Manmohan Singh ji. Heartfelt condolences to his family and loved ones. On Shanti 🙏🏼 pic.twitter.com/09tKVnUBdf "Sad news of the passing of Dr. Manmohan Singh Ji. A visionary leader and a true statesman who worked tirelessly for India's progress. His wisdom and humility will always be remembered. My heartfelt condolences to his loved ones," Yuvraj wrote on X. Sad news of the passing of Dr. Manmohan Singh Ji. A visionary leader and a true statesman who worked tirelessly for India’s progress. His wisdom and humility will always be remembered. My heartfelt condolences to his loved ones. 🙏 #ManmohanSingh ji Manmohan Singh, born in Punjab in 1932, served two terms as Prime Minister of India- from 2004 to 2014. He took the oath of office for the first time in 2004, after Congress' win in the 2004 Lok Sabha election against Atal Bihari Vajpayee-led NDA. He served his second term from 2009 to 2014. He was then succeeded by PM Narendra Modi in 2014. He retired from the Rajya Sabha earlier this year after serving for 33 years in the house.
(BPT) - Tech gifts are consistently some of the most popular presents to give and receive during the holidays. In fact, according to the annual Consumer Technology Holiday Purchase Patterns report , a record 233 million U.S. adults (89%) will buy tech products during the 2024 holiday season. But with so many devices out there, it can be hard to decide on the perfect option for the loved one on your list. A tablet like the new Fire HD 8 from Amazon offers the versatility of an all-in-one device, with access to streaming, gaming, video chatting, reading or writing all at your fingertips. Fire HD 8 also features a vibrant 8-inch HD display and lightweight, portable design, for high-quality entertainment on the go. Plus, Fire HD 8 comes with three new AI features that can help you get the most out of your tablet experience. Check them out below and learn how they can help you with daily tasks this holiday season and beyond. 1. Meet your personal writing assistant Do you struggle with writing a heartfelt message or finessing a tricky email? Fear not! Writing Assist is here to help. Writing Assist works as part of your Fire tablet's device keyboard and compatible apps, including email, Word documents and social media. In just a few taps, you can transform your writing from good to great. Try Writing Assist's pre-set styles to turn a simple email into a professionally written note. Or, you can ask Writing Assist for grammar suggestions to make your writing more concise, or elaborate on your ideas. You can even "emojify" your writing to add more fun and personality. 2. Learn more in less time Say goodbye to scrolling through pages of information. The new Webpage Summaries feature allows you to learn pertinent information as quickly as possible. Available on the Silk browser on Fire tablets, Webpage Summaries provides quick insights on web articles. In a matter of seconds, this feature will distill the key points in an article or on a webpage into a clear, concise summary of what you need to know. 3. Get creative with your device wallpaper With Wallpaper Creator, you can easily add a touch of creative flair and customization to your tablet's home screen. You can choose from one of the curated prompts to get started on creating a unique background. Or, if you're ready to let your imagination run wild, type a description of what you'd like to see. For example, you can ask for an image of a tiger swimming underwater or a watercolor-style image of a desert landscape in space. Wallpaper Creator will then turn your vision into a reality, delivering a high-resolution image that you can use as your tablet's wallpaper. Celebrate an AI-powered holiday season Writing Assist, Webpage Summaries, and Wallpaper Creator are now available on Amazon's new Fire HD 8 and other compatible Fire tablet devices, including the latest Fire HD 10 and Fire Max 11 tablets. To learn more, or to order a new Fire tablet this gift-giving season, visit Amazon.com .Vietnam’s sweeping administrative cuts trigger investors’ anticipation, worriesWhen Matt Rosati attended the now-defunct Ledgemont High School in Thompson, Grand Valley was a big rivalry. Rosati is now in line take over as GV's football coach. Pending board approval at Monday's Board of Education meeting, the former Perry and West Geauga will lead the Mustangs program. "I'm very humbled to be considered, and look forward to the opportunity to coach GV," Rosati said. "I was really, really blown by the administration. They're very easy to work with." Rosati lives in Montville. "It's 15 minutes from my house," he said. GV Athetic Director Frank Hall said Rosati was the top of his wish-list. "We've had a great relationship for years," Hall said. "The thing about Matt is his ability to build relationships with kids. He's dedicated to helping young kids." Hall said Rosati is scheduled to teach at GVHS. Rosati is in the process of assembling assistant coaches. "I'm very confident with the staff we're putting together," he said. "We have a great staff and volunteers." GV, under Clint Nims, compiled a 7-51 overall record from 2019-24. He stepped down as coach last month. "I want to meet as many of the kids as possible," Rosati said of Mustang student-athletes. "I'm trying to build relationships. Grand Valley has always had talented kids. "I'm confident if we can get the kids, get these athletes, we can do some good things." The offseason process of weight-lifting has already — or is starting to happen. "We're ready to hit the ground running," Rosati said. Even though Rosati is still assessing who is potentially returning and what new players will be added, one aspect is already known. "We want to become very physical on both sides of the ball," he said. "Grand Valley will be tough customers." Rosati coached at West Geauga twice, and Perry. After his first stint at WG. he led the Pirates to a 111-44 overall mark, and six straight Chagrin Valley Conference titles from 2007-20. Perry reached the playoffs 10 times, regional finals on four occasions and state final four once. After a year of retirement, he was back at WG. He remained at that position for three seasons. Rosati is the winningest coach in WG history with 77 victory. He has also coached four undefeated regular seasons. The 2024 season was a challenge for Rosati. According to multiple reports, he was placed on administrative leave for the final three games for unspecified reasons. then reinstated as a teacher and coach. "I was cleared of any wrong doing," Rosati said. "I am so grateful for the support from every person from 35 years ago to today. I'm just so humbled. A negative turned into a positive." The Wolverines finished 2-8 on the season.
Barry Odom begins Purdue career with larger NIL budget and questions about payment dispute at UNLV
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