Wednesday, July 1, 2020

The Future Looks Brighter


By Alex Eule |  Wednesday, July 1
Push and Pull. Investors will have to get used to days like this, if they haven't already. There was good news about the future just as current conditions get worse. 
Arizona, California, Georgia, and Texas all reported a record number of  daily Covid-19 infections. California is re-closing bars and indoor dining in many of its counties, and New York City said it was delaying its own planned reopening of indoor restaurant spaces. 
That would all be particularly depressing save for one bright spot: Drug giant Pfizer reported positive early results on its vaccine candidate. The vaccine news helped push the S&P 500 up 0.5% on the day, its third-straight day of gains. The Nasdaq Composite jumped nearly 1% to a new record.
Barron's Josh Nathan-Kazis notes that the Pfizer data was received more positively than recent disclosures from other vaccine makers, including Moderna and Inovio Pharmaceuticals. 
The release was more detailed than similar updates from Moderna and Inovio have been. What’s more, the companies made a manuscript of the full results available on a so-called pre-print server, which publishes scientific papers as they await peer review.
Pfizer's stock closed up 3.2%. The initial results came from a testing universe of 45 people. A trial slated to begin later this month will include 30,000 subjects. If all goes well, Pfizer and its German biotech partner BioNTech could manufacture up to 100 million doses of the vaccine by the end of the year and "potentially more than 1.2 billion doses by the end of 2021."
There was mixed news on the job front. Payroll processor ADP said 2.4 million workers were hired in June. That's significant progress from the huge losses early in the pandemic, but the figure was below expectations. Economists had been forecasting an increase of 3 million jobs. ADP, meanwhile, revised its May figure to a gain of 3.1 million jobs. It originally  reported a loss of 2.8 million. 

TDI is accepting comments on consumer choice draft rule


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TDI is accepting comments on consumer choice draft rule

The Texas Department of Insurance (TDI) posted draft rules and forms related to Consumer Choice Benefit Disclosures. TDI is accepting written comments on the draft through 5 p.m. Central time, July 15, 2020.

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The Affordable Care Act Federal Upper Limits Have Been Updated


 
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Medicaid.gov
The updated Affordable Care Act Federal Upper Limits (FUL) calculated in accordance with the Medicaid Covered Outpatient Drug final rule with comment are now available on the Pharmacy Pricing page of Medicaid.gov website. States will have up to 30 days from the July 1, 2020 effective date to implement these updated FULs.  

For further information on the FUL program, please see the Federal Upper Limits page on Medicaid.gov.



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The misunderstood funeral tech that's illegal in 30 states

From mafia propaganda to moral outcry, what's stopping us from embracing water cremation technology?
Steph Panecasio June 1, 2020
When you die, your body is going to decompose. 
It starts from the moment you pass. Your organs begin to shut down. Hair stops growing, skin recedes. Some parts of the body take longer than others, but eventually, as with all things, it all starts to break down.
If you opt for a traditional burial, your remains will spend years nestled within a casket underground, progressing into a deeper state of decomposition. If you opt for a traditional flame-based cremation, you eliminate any further decomposition by burning it to a halt.
But there's also another alternative -- one designed to accelerate the decomposition process through the medium of water. It's known as alkaline hydrolysis, or water cremation. One part spa, one part chemical blend, a few hours of a swirling soak, and your earthly remains are no longer.
"It's basic chemistry," explains Anas Ghadouani, leader of the research group Aquatic Ecology and Ecosystem Studies. "You have organic matter and you add a base to it and it just decomposes. You can write the equation to it. It's very simple."
Despite this, alkaline hydrolysis remains one of the most divisive and misunderstood practices in contemporary funeral technology.
The machine
Alkaline hydrolysis is a form of cremation that uses water and chemicals to break down the human body to its bare minimum. Salts, amino acids, peptides. Like flame-based cremation, it produces ash that can be taken home. Unlike flame-based cremation, it's illegal for use on human bodies in almost 30 states in America. 
The concept itself isn't new. Amos Herbert Hobson of Middlesex, England, patented the first alkaline hydrolysis machine all the way back in 1888. He used it to dispose of animal carcasses. 
In the century and a half since, the technology has evolved, and it has the potential to shake up the death industry. 
The process is straightforward. Bodies are placed in a machine containing a chemical mixture of water and alkali. The mixture is then heated and cycled. Over the course of hours, the body is accelerated through its natural decomposition process, resulting in a residual liquid made up of amino acids, peptides, salt, soap and bones -- the last of which is broken down into white ash.
I was stunned that there was a way to dispose of tissue without burning.
 Joseph Wilson
Joseph Wilson, now founder and CEO of leading alkaline hydrolysis manufacturer Bio-Response Solutions, helped design the first commercial-use human alkaline hydrolysis unit in 2005.
"I was stunned that there was a way to dispose of tissue without burning," said Wilson. "You don't have any external pumps or tanks or chemicals. It's all there at the machine."
There are undeniable benefits to this process. In 2011, a study from the University of Groningen compared conventional burial, cremation, alkaline hydrolysis and cryomation and found that alkaline hydrolysis had the lowest overall environmental footprint. 
The low temperature also means pacemakers and joint replacements can remain inside the body. In flame-based cremation, these are extracted to prevent a reaction -- pacemakers, especially, are incredibly volatile when subjected to extreme heat.
Yet despite the fact that flame-based cremation subjects the remains to intense fire, alkaline hydrolysis is seen as the more graphic option for potential funerals, when both are just as valid. Legal roadblocks and cultural concerns have plagued water cremation since its inception.
And there's a simple reason for that: Alkaline hydrolysis has a reputation shaped by years of misrepresentation. Nobody wants to feel like they're disrespecting their loved ones.
Media, morals and the mafia
Most people's first experience of alkaline hydrolysis is through popular culture.
In the second episode of Breaking Bad, audiences sees drug dealer Jesse Pinkman dissolve a dead body in his apartment's bathtub using hydrofluoric acid he'd sourced from his high school's chemical stores. He returns the next day only to find the acid had eaten through the bathtub itself and floorboards beneath, before finally falling through to the floor below.
Despite the effective cinematics, Breaking Bad is far from realistic. Hydrofluoric acid, while highly corrosive, doesn't have the capacity to completely liquefy remains overnight -- it's at the wrong end of the pH scale. It certainly doesn't have the capacity to eat through a bath and the floor. 
Even if it could, the science doesn't check out -- Mythbusters proved it.
Whether it's a question of gulping down Soylent Green or shunting bodies into acid barrels, television and film haven't been kind to the practice of alkaline hydrolysis.
Outside of television, urban legends have tarred alkaline hydrolysis with further negativity. In 2011, researchers had to debunk claims the Sicilian mafia disposed of human remains in a process called lupara bianca, or white shotgun. Just like in Breaking Bad, the mafia supposedly used acid -- an entirely different, cruder chemical process.
Mafia urban legends and shows like Breaking Bad create a sense of violence surrounding water cremation that simply doesn't hold up. Water cremation, at its core, is no more than the acceleration of a natural process.
The reality: As with almost all aspects of the death industry, there is a level of respect and dignity. You don't see what happens in the retort of a flame-based cremator, but you won't see what happens inside an alkaline hydrolysis machine either. 
Waste not
What remains to be dealt with, however, is what comes out the other side. Ashes are one thing -- you can pop them on the mantle in a decorative urn, sprinkle them at sea or even have them launched into space -- but what about the residual liquid?
One of the biggest roadblocks to the acceptance of alkaline hydrolysis technology is the issue of wastewater. Because of its association with death, the liquid is perceived as too unsanitary to be processed normally. Say it goes through the same recycling plants that supply residential areas, the idea of drinking the essence of a dead body sounds abhorrent. It's hard enough swallowing the idea of recycled sewage water. Remains? Inconceivable. 
But technology already exists to tackle almost any kind of wastewater. 
Sewage water is filtered for reuse in municipal treatment plants. Organic material is broken down in anaerobic digesters, which convert the material into methane or "biogas." Specially designed ultrafiltration systems can even tackle aqueous nuclear waste.
"Any liquid waste that we have, we can deal with," says Ghadouani. 
Yet in Australia, residual liquid from water cremation isn't permitted to be treated via the municipal water treatment facilities or digesters. More worryingly, there's a disconnect here -- and it's one that, for the most part, is behind the closed doors of the funeral industry.
"One of the most common things the public doesn't know," says leading US thanatologist and death educator Cole Imperi, "is that when someone is embalmed, all the blood that comes out of your body, where does that go? It goes down the drain."
Why are you discriminating against one particular disposition method?
 Cole Imperi
In fact, almost all the human waste that comes from hospitals and funeral homes as a result of the embalming process is permitted to be processed through these official channels. 
"So if you're allowing byproducts from funeral homes to go into the municipal water system for treatment, why are you discriminating against one particular disposition method?" Imperi asks. "It's an interesting kind of cognitive dissonance."
Nevertheless, in the few states that allow alkaline hydrolysis -- for animals -- practicing venues must provide their own wastewater filtration treatments and submit them for regular testing. It's expensive and demanding. Venues are scarce.
Jonathan Hopkins, owner and operator of Resting Pets Cremations in New South Wales, Australia, is an alkaline hydrolysis advocate. He and his late wife opened their practice after the pain of a family pet's death opened their eyes to the process as a cremation alternative. 
"My wife was always an animal lover and she just had a really bad experience with the [cremation] company that was serving this area," he said. "So we approached the local council for a pet cremation system." They landed on alkaline hydrolysis.
To ensure the wastewater passed council and environmental regulations, Hopkins created his own treatment system. He began by increasing the machine's existing filtration capacity, with any overflow going into a separate tank. Here, microorganisms remove any remaining bacteria -- much like a septic system.
"With our system, they can see what chemicals are going in, and they can see the effluent coming out. They can test it, they know where it's going," he said. 
Reframing the narrative
Some will always struggle with the concept of alkaline hydrolysis. Certain cultures or religions might always register a stronger connection to conventional burial and cremation methods.
But our human instinct to process death isn't incompatible with water cremation. We could use residual liquid from the hydrolysis process to help nurture the earth. A gardener, for example, could live on in the plants and flowers they once nurtured.
Conceptually, it's not out of the question. "If the liquid waste stream were to be applied to soil as a fertilizer, there could be a role for this as a soil improver." explains Michael Short, a senior research fellow of the Future Industries Institute at the University of South Australia.
On a larger scale, this could even benefit the wider agricultural industry.
"The wastewater stream [would be] a relatively high strength organic waste solution," Short says. "Soils in some Australian regions are generally low in natural organic matter, so adding organics from such waste streams could help to improve overall soil quality and soil carbon stocks."
It may sound strange on first pass, but why not? If it gives someone peace of mind that our loved ones will "live on," the transmutation of alkaline hydrolysis liquid to fertilizer may just be the PR dream the technology has been waiting for.
Alkaline hydrolysis may not be accepted anytime soon. It may take years of building up a more positive association. Maybe even decades.  
It all comes down to whether states and countries are willing to test the waters.
This story is part of CNET's The Future of Funerals series. Stay tuned this week for more. 

https://www.cnet.com/features/the-misunderstood-funeral-tech-thats-illegal-in-30-states/

Insights Report: Five Core Issues for Providers Post-COVID-19


Is the post-COVID-19 world the new normal? Or will things eventually return to the old normal? Of course, none of us know yet. In fact, our POV right now is “no normal” — recognizing that everything is different all at once, and we aren’t sure what will be permanent and what is merely a product of the moment.
Whatever your view, across the board, providers must consider a post-COVID-19 reset. While there may be late outbreaks or a second wave of COVID-19 in some locations, the imperative for all types of providers is to strategically look beyond the chaos and the heroic measures taken to respond to the pandemic this spring. We suggest here that the healthcare system in the United States, and particularly the provider sector, is likely not going to return to a pre-COVID-19 normal. When we look back five years from now, we will understand that we were rebuilding, not simply recovering. Organizations who correctly judge that reality will fare better than those who act solely in a pure “recovery” mode.
There is much yet to be learned about where we have been and where we are going as a medical delivery system. Yet, the events at the beginning of 2020 reveal some definable core issues that every provider organization should now address. More than anything, there is great urgency given the expected competition for the limited options and resources available.
In this paper, we outline five core issues providers should weigh as the post-COVID-19 direction is set. Download the new report here.
Special thanks to Dan Higgins at Denton's law firm, who was a key collaborator for this content and is also a long time trusted partner of ReviveHealth.

Register for CMS’s webinar on new health reimbursement arrangements!


shop marketplace health insurance for small business healthcare.gov

July 15: CMS’s Next

HRA Webinar

Don’t miss your chance to learn more about a new healthcare coverage option available to employers of all sizes: the individual coverage health reimbursement arrangement (HRA) — a new way to provide your employees tax-preferred funds to pay for qualified medical expenses, including the cost of health insurance coverage purchased in the individual market.

The Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight (CCIIO) is hosting this webinar on HRAs. The webinar provides a deeper dive into individual coverage HRAs, focusing on rules and requirements around implementing an individual coverage HRA, including its integration with Medicare, the rules around COBRA, and methods of reimbursing employees' expenses. If you previously attended an HRA 101 webinar, are familiar with the basics of individual coverage HRAs, or just want to learn more, join us for our HRA 201 session on July 15 at 1 p.m. ET.

The presentation will be followed by a Q&A session, where you will be able to ask your HRA-related questions.

Click the button below to register for the webinar!

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We encourage you to share this email and registration link with your colleagues, business partners, and other employers in your community who may be interested in learning more about the new HRA opportunities.

Additionally, if you attended previous HRA webinars and still have unanswered questions or would like to listen to the presentation again, feel free to join us again on July 15.

FCC Designates Chinese Companies as “Posing National Security Threat”

From the story: “With today’s Orders, and based on the overwhelming weight of evidence, the Bureau has designated Huawei and ZTE as national security risks to America’s communications networks — and to our 5G future,” FCC Chairman Ajit Pai said in a statement. “Both companies have close ties to the Chinese Communist Party and China’s military apparatus, and both companies are broadly subject to Chinese law obligating them to cooperate with the country’s intelligence services.”

ABC News