Latest news with #Parkinson'sDisease
Axios
8 hours ago
- Business
- Axios
Traditional Medicare to add prior authorizations
Medicare is requiring more pre-treatment approvals in its fee-for-service program in a bid to root out unnecessary care, federal regulators announced Friday. The big picture: Traditional Medicare historically hasn't required prior authorizations to access most drugs or services, a major perk for enrollees. Prior authorization in privately-run Medicare Advantage plans has become a hot-button issue, with Congress and federal regulators working to rein in the practice. Federal inspectors found in 2022 that prior authorization in MA prevented some seniors from getting medically necessary care. Major health insurers this week made a voluntary pledge to streamline and improve the prior authorization process across all health insurance markets. State of play: Medicare's innovation center announced that it will solicit applications from companies to run the prior authorization program. Medicare is looking for companies with experience using AI and other tools to manage pre-approvals for other payers, and with clinicians who can conduct medical reviews to check coverage determinations. The program will start Jan. 1, 2026 and run through the end of 2031. It will only apply to providers and patients in New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington. The change will apply to 17 items and services, including skin substitutes, deep brain stimulation for Parkinson's Disease, impotence treatment and arthroscopy for knee osteoarthritis. CMS selected the services based on previous reports and evidence of fraud, waste and abuse, as well as what's already subject to prior authorization in Medicare Advantage. Overuse of skin substitutes to help heal wounds has especially come under fire in recent years. Medicare spent more than $10 billion on the products in 2024 — more than double what was spent the year before, according to the New York Times. CMS noted that it may make other services subject to the prior authorization program in future years. Providers in the geographic areas can choose whether or not they want to submit an authorization request before delivering a service. But if they decide not to, they'll be subject to post-claim review and risk not getting paid for a service that was already delivered. "In general, this model will require the same information and clinical documentation that is already required to support Medicare FFS payment but earlier in the process, namely, prior to the service being furnished," the notice reads. Zoom in: The companies hired to manage the program will be paid based on how much they saved the government by stopping payments for unnecessary services. "Under the model, we will work to avoid any adverse impact on beneficiaries or providers/suppliers," CMS wrote in the notice.
The Advertiser
2 days ago
- Health
- The Advertiser
'Too much of a risk': Mark kept being turned away until he found his people
After having the door slammed in his face time after time as his disability was deemed too "risky", Mark Stephenson finally found his tribe with a volunteer sports organisation. When the father-of-five was diagnosed with Parkinson's Disease and Young Onset Lewy Body Dementia at just 54, he had to give up his beloved career as a Station Officer with the Queensland Fire and Rescue Service, as well as his driver's licence. "It was a bit of an adjustment, being home everyday with nothing to do," Mr Stephenson said, now aged 57. Read more in The Senior The grandfather-of-two told The Senior Lewy Body affects younger people differently than those with more life experience. "For older people, it's more slower in the progression of the disease normally, whereas for younger people, it's quicker. So life expectancy for someone under 60 getting it is three to seven years," he said. After diagnosis, Mark wanted to use his extra time to give back to his community as a volunteer - but over a two-year period all the organisations Mark approached shut their doors to him. They told him he was "too much of a risk", due to the hallucinations he can sometimes have with dementia. After the once-active fireman tried his local sports groups - and was given the same answer - he felt very isolated for the first two years following his diagnosis - only going out if his wife or friends took him. "By this stage, I was starting to lose a lot of mobility. Lewy body attacks the brain and the spinal cord," he said. "I'd pretty much given up and just thought, ok, I'll just sit at home and watch the world go by and wait for the Grim Reaper to knock on the door." But things changed when Mark's wife saw a Facebook ad for wheelchair cricket and "pestered" him too give them a call. The result changed his life. Initally, Mark was worried Sporting Wheelies would shut their door too once they knew of his condition, but they didn't. "It was like, 'G'day, how are you going? Yep, this is a sports wheelchair, jump in one'," he said. "Very welcoming, very inclusive. Pretty much straight away accepted me as part of the community. No-one's judged." Sporting Wheelies in Queensland has given Mark a "sense of purpose" and it wasn't long until he started playing wheelchair basketball, as well as wheelchair AFL. "Sporting Wheelies is also a gateway, so they can put you in touch with wheelchair AFL, the wheelchair rugby league, wheelchair rugby," he said. Through AFL, he is learning new skills, but it's the support and friendship that's been most rewarding. "I'm basically a paraplegic now. But the community down there are able to help you adjust to things very easily, because people down there have lived experience," he said. "And whether it's through accident, through injury or by disease, everyone's in the same boat, just at various stages. So there's a really good support network." Mark wants everyone to be able to have access to sport and specialised wheelchairs, and is hoping Sporting Wheelies will attract donations and corporate sponsorship so it can include more regional areas in Queensland and then into other states. Individuals and organisations can make a 100 percent tax-deductible donation to Sporting Wheelies before June 30 at Share your thoughts in the comments below, or send a Letter to the Editor by CLICKING HERE. After having the door slammed in his face time after time as his disability was deemed too "risky", Mark Stephenson finally found his tribe with a volunteer sports organisation. When the father-of-five was diagnosed with Parkinson's Disease and Young Onset Lewy Body Dementia at just 54, he had to give up his beloved career as a Station Officer with the Queensland Fire and Rescue Service, as well as his driver's licence. "It was a bit of an adjustment, being home everyday with nothing to do," Mr Stephenson said, now aged 57. Read more in The Senior The grandfather-of-two told The Senior Lewy Body affects younger people differently than those with more life experience. "For older people, it's more slower in the progression of the disease normally, whereas for younger people, it's quicker. So life expectancy for someone under 60 getting it is three to seven years," he said. After diagnosis, Mark wanted to use his extra time to give back to his community as a volunteer - but over a two-year period all the organisations Mark approached shut their doors to him. They told him he was "too much of a risk", due to the hallucinations he can sometimes have with dementia. After the once-active fireman tried his local sports groups - and was given the same answer - he felt very isolated for the first two years following his diagnosis - only going out if his wife or friends took him. "By this stage, I was starting to lose a lot of mobility. Lewy body attacks the brain and the spinal cord," he said. "I'd pretty much given up and just thought, ok, I'll just sit at home and watch the world go by and wait for the Grim Reaper to knock on the door." But things changed when Mark's wife saw a Facebook ad for wheelchair cricket and "pestered" him too give them a call. The result changed his life. Initally, Mark was worried Sporting Wheelies would shut their door too once they knew of his condition, but they didn't. "It was like, 'G'day, how are you going? Yep, this is a sports wheelchair, jump in one'," he said. "Very welcoming, very inclusive. Pretty much straight away accepted me as part of the community. No-one's judged." Sporting Wheelies in Queensland has given Mark a "sense of purpose" and it wasn't long until he started playing wheelchair basketball, as well as wheelchair AFL. "Sporting Wheelies is also a gateway, so they can put you in touch with wheelchair AFL, the wheelchair rugby league, wheelchair rugby," he said. Through AFL, he is learning new skills, but it's the support and friendship that's been most rewarding. "I'm basically a paraplegic now. But the community down there are able to help you adjust to things very easily, because people down there have lived experience," he said. "And whether it's through accident, through injury or by disease, everyone's in the same boat, just at various stages. So there's a really good support network." Mark wants everyone to be able to have access to sport and specialised wheelchairs, and is hoping Sporting Wheelies will attract donations and corporate sponsorship so it can include more regional areas in Queensland and then into other states. Individuals and organisations can make a 100 percent tax-deductible donation to Sporting Wheelies before June 30 at Share your thoughts in the comments below, or send a Letter to the Editor by CLICKING HERE. After having the door slammed in his face time after time as his disability was deemed too "risky", Mark Stephenson finally found his tribe with a volunteer sports organisation. When the father-of-five was diagnosed with Parkinson's Disease and Young Onset Lewy Body Dementia at just 54, he had to give up his beloved career as a Station Officer with the Queensland Fire and Rescue Service, as well as his driver's licence. "It was a bit of an adjustment, being home everyday with nothing to do," Mr Stephenson said, now aged 57. Read more in The Senior The grandfather-of-two told The Senior Lewy Body affects younger people differently than those with more life experience. "For older people, it's more slower in the progression of the disease normally, whereas for younger people, it's quicker. So life expectancy for someone under 60 getting it is three to seven years," he said. After diagnosis, Mark wanted to use his extra time to give back to his community as a volunteer - but over a two-year period all the organisations Mark approached shut their doors to him. They told him he was "too much of a risk", due to the hallucinations he can sometimes have with dementia. After the once-active fireman tried his local sports groups - and was given the same answer - he felt very isolated for the first two years following his diagnosis - only going out if his wife or friends took him. "By this stage, I was starting to lose a lot of mobility. Lewy body attacks the brain and the spinal cord," he said. "I'd pretty much given up and just thought, ok, I'll just sit at home and watch the world go by and wait for the Grim Reaper to knock on the door." But things changed when Mark's wife saw a Facebook ad for wheelchair cricket and "pestered" him too give them a call. The result changed his life. Initally, Mark was worried Sporting Wheelies would shut their door too once they knew of his condition, but they didn't. "It was like, 'G'day, how are you going? Yep, this is a sports wheelchair, jump in one'," he said. "Very welcoming, very inclusive. Pretty much straight away accepted me as part of the community. No-one's judged." Sporting Wheelies in Queensland has given Mark a "sense of purpose" and it wasn't long until he started playing wheelchair basketball, as well as wheelchair AFL. "Sporting Wheelies is also a gateway, so they can put you in touch with wheelchair AFL, the wheelchair rugby league, wheelchair rugby," he said. Through AFL, he is learning new skills, but it's the support and friendship that's been most rewarding. "I'm basically a paraplegic now. But the community down there are able to help you adjust to things very easily, because people down there have lived experience," he said. "And whether it's through accident, through injury or by disease, everyone's in the same boat, just at various stages. So there's a really good support network." Mark wants everyone to be able to have access to sport and specialised wheelchairs, and is hoping Sporting Wheelies will attract donations and corporate sponsorship so it can include more regional areas in Queensland and then into other states. Individuals and organisations can make a 100 percent tax-deductible donation to Sporting Wheelies before June 30 at Share your thoughts in the comments below, or send a Letter to the Editor by CLICKING HERE. After having the door slammed in his face time after time as his disability was deemed too "risky", Mark Stephenson finally found his tribe with a volunteer sports organisation. When the father-of-five was diagnosed with Parkinson's Disease and Young Onset Lewy Body Dementia at just 54, he had to give up his beloved career as a Station Officer with the Queensland Fire and Rescue Service, as well as his driver's licence. "It was a bit of an adjustment, being home everyday with nothing to do," Mr Stephenson said, now aged 57. Read more in The Senior The grandfather-of-two told The Senior Lewy Body affects younger people differently than those with more life experience. "For older people, it's more slower in the progression of the disease normally, whereas for younger people, it's quicker. So life expectancy for someone under 60 getting it is three to seven years," he said. After diagnosis, Mark wanted to use his extra time to give back to his community as a volunteer - but over a two-year period all the organisations Mark approached shut their doors to him. They told him he was "too much of a risk", due to the hallucinations he can sometimes have with dementia. After the once-active fireman tried his local sports groups - and was given the same answer - he felt very isolated for the first two years following his diagnosis - only going out if his wife or friends took him. "By this stage, I was starting to lose a lot of mobility. Lewy body attacks the brain and the spinal cord," he said. "I'd pretty much given up and just thought, ok, I'll just sit at home and watch the world go by and wait for the Grim Reaper to knock on the door." But things changed when Mark's wife saw a Facebook ad for wheelchair cricket and "pestered" him too give them a call. The result changed his life. Initally, Mark was worried Sporting Wheelies would shut their door too once they knew of his condition, but they didn't. "It was like, 'G'day, how are you going? Yep, this is a sports wheelchair, jump in one'," he said. "Very welcoming, very inclusive. Pretty much straight away accepted me as part of the community. No-one's judged." Sporting Wheelies in Queensland has given Mark a "sense of purpose" and it wasn't long until he started playing wheelchair basketball, as well as wheelchair AFL. "Sporting Wheelies is also a gateway, so they can put you in touch with wheelchair AFL, the wheelchair rugby league, wheelchair rugby," he said. Through AFL, he is learning new skills, but it's the support and friendship that's been most rewarding. "I'm basically a paraplegic now. But the community down there are able to help you adjust to things very easily, because people down there have lived experience," he said. "And whether it's through accident, through injury or by disease, everyone's in the same boat, just at various stages. So there's a really good support network." Mark wants everyone to be able to have access to sport and specialised wheelchairs, and is hoping Sporting Wheelies will attract donations and corporate sponsorship so it can include more regional areas in Queensland and then into other states. Individuals and organisations can make a 100 percent tax-deductible donation to Sporting Wheelies before June 30 at Share your thoughts in the comments below, or send a Letter to the Editor by CLICKING HERE.
Edinburgh Reporter
19-06-2025
- General
- Edinburgh Reporter
Last chance appeal over dream house cancelled at 11th hour
A last chance appeal by a woman to turn a former bank into a dream home has been cancelled at the 11th hour over an administrative error. Pat Sharp has been fighting to have the former hall, in North Berwick, turned into a retirement home for her and her husband Nigel for eight years after buying it for more than double the asking price. However East Lothian Council's planners have repeatedly rejected applications for the change of use insisting the building has to remain a commercial building in the seaside town centre. Last week Mrs Sharp spoke out publicly for the first time about her fight and heartbreak that her husband, who has Parkinson's Disease, is no longer able to move in. And she said she had no idea what would happen if her latest attempt get permission to convert the building into a house failed at the Local Review Body meeting, scheduled to take place this morning. She said: 'If this fails I don't know what we will do. I spend £100 a month maintaining the gardens of the property and we have invested a lot to maintain and bring the hall itself into a maintained state but I can't go on with it forever.' Mrs Sharp and her husband bought the former bank hall seven years ago for £555,555 with the hope of retiring to the town. The couple had precious memories of time with their granddaughters at the seaside resort after losing their daughter Cheryl to cancer when the girls were very young. Former managing director Nigel, 78, was diagnosed with Parkinson's following his retirement and the hope had been that the house would give him the chance to live in an adapted home in the place they loved. Sadly Nigel is now in full time care and will never be able to live in the house, if it is every approved. Pat said: 'Nigel has been robbed of the chance to spend his final years in what we wanted to be our dream home, looking out over the North Berwick coast and remembering all our wonderful times here. it is devastating.' The Local Review Body was due to meeting this morning to hear the appeal against the latest decision by planners to refuse permission for the change of use of the hall. However late yesterday the council confirmed the meeting had been delayed and would now be held once elected members return from their summer holidays. A spokesperson for East Lothian Council said: 'One of the interested parties was accidentally omitted from our notification process so was not informed of the appeal in time for it to be heard at the Local Review Body meeting on Thursday 19 June. It will be heard at the next available meeting in August. The applicant's agent, interested parties and consultees have all been contacted.' By Marie Sharp Local Democracy Reporter Like this: Like Related
Edinburgh Live
19-06-2025
- Business
- Edinburgh Live
East Lothian gran's plan to turn bank into her dream home halted over 'admin error'
Our community members are treated to special offers, promotions and adverts from us and our partners. You can check out at any time. More info A last chance appeal by a gran to turn a former bank into a dream home has been cancelled at the 11th hour over an administrative error. Pat Sharp has been fighting to have the former hall, in North Berwick, turned into a retirement home for her and her husband Nigel for eight years after buying it for more than double the asking price. However East Lothian Council's planners have repeatedly rejected applications for the change of use insisting the building has to remain a commercial building in the seaside town centre. Last week Mrs Sharp spoke out publicly for the first time about her fight and heartbreak that her husband, who has Parkinson's Disease, is no longer able to move in. And she said she had no idea what would happen if her latest attempt get permission to convert the building into a house failed at the Local Review Body meeting, scheduled to take place this morning. She said: "If this fails I don't know what we will do. I spend £100 a month maintaining the gardens of the property and we have invested a lot to maintain and bring the hall itself into a maintained state but I can't go on with it forever." Mrs Sharp and her husband bought the former bank hall seven years ago for £555,555 with the hope of retiring to the town. The couple had precious memories of time with their granddaughters at the seaside resort after losing their daughter Cheryl to cancer when the girls were very young. Former managing director Nigel, 78, was diagnosed with Parkinson's following his retirement and the hope had been that the house would give him the chance to live in an adapted home in the place they loved. Sadly Nigel is now in full time care and will never be able to live in the house, if it is every approved. Pat said: "Nigel has been robbed of the chance to spend his final years in what we wanted to be our dream home, looking out over the North Berwick coast and remembering all our wonderful times here. it is devastating." The Local Review Body was due to meeting this morning to hear the appeal against the latest decision by planners to refuse permission for the change of use of the hall. However late yesterday the council confirmed the meeting had been delayed and would now be held once elected members return from their summer holidays. A spokesperson for East Lothian Council said: 'One of the interested parties was accidentally omitted from our notification process so was not informed of the appeal in time for it to be heard at the Local Review Body meeting on Thursday 19 June. It will be heard at the next available meeting in August. The applicant's agent, interested parties and consultees have all been contacted.'
Time of India
10-06-2025
- Health
- Time of India
Death of 74-year-old takes Covid toll to 3
Kolkata: The city reported another Covid-related death on Tuesday. A 74-year-old man with multiple comorbidities died at Woodlands Hospital, a day after he tested positive for the virus. Tired of too many ads? go ad free now This is the third known Covid-related death in the state this year though the health department is yet to link the last two deaths with Covid. According to sources, the Andul resident was admitted to a Howrah hospital about two weeks ago with complaints of UTI and inflammation in the urinary bladder. After undergoing treatment at the hospital, he was discharged and was at home for about 10 days. On Monday evening, the deceased's family rushed him to the Alipore hospital with complaints of acute respiratory problems, and he was already on high-flow nasal cannula at the time of admission. Doctors found that the senior citizen had pneumonia. His swab sample tested positive for Covid-19. He died on Tuesday. Sources in the hospital said that he was also suffering from hypertension and Parkinson's Disease. At present, the hospital has two more Covid patients — both senior citizens. Two Covid patients are currently admitted at the Alipore hospital — an 85-year-old man from Sarat Bose Road and a 65-year-old man from Maheshtala.
