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Articles by John Barnes
California DMHC Signals Heightened Scrutiny of Health Plan Dispute and Grievance Practices-Key Takeaways for Healthcare Providers
The California Department of Managed Health Care (DMHC) recently announced two significant enforcement actions against major commercial health plans—Health Net of California, Inc. and Anthem Blue Cross—resulting in $450,000 and $15 million penalties,...
Unlock Ethereum’s Potential: Claim Arbitrum and Optimism Rewards
John Barnes · Follow 3 min read · -- Explore Arbitrum and Optimism airdrops in 2024. Learn how to check eligibility, claim rewards, and contribute to Ethereum’s leading Layer 2 networks. Layer 2 solutions are changing the game in blockchain scalability, and Arbitrum and Optimism are at the forefront. These Ethereum Layer 2 networks promise fast, low-cost transactions without compromising security.
Antigenic drift and subtype interference shape A(H3N2) epidemic dynamics in the United States
Influenza-like illness and virological surveillance data We obtained weekly epidemiological and virological data for influenza seasons 1997–1998 to 2018–2019, at the U.S. HHS region level. We defined influenza seasons as calendar week 40 in a given year to calendar week 20 in the following year, with the exception of the 2008–2009 season, which ended in 2009 week 16 due to the emergence of the A(H1N1)pdm09 virus (Goldstein et al., 2011).
Atmosphere | Free Full-Text | The Recovery and Re-Calibration of a 13-Month Aerosol Extinction Profiles Dataset from Searchlight Observations from New Mexico, after the 1963 Agung Eruption
All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables. For articles published under an open access Creative Common CC BY license, any part of the article may be reused without permission provided that the original article is clearly cited. For more information, please refer to https://www.mdpi.com/openaccess.
Aetna Emergency Department Reductions: What Providers Should Know | JD Supra
Aetna recently announced that it is rolling out a national protocol under which it will be reviewing both physician and hospital emergency department claims that include Level 4 or 5 evaluation and management (E&M) codes, and after that review, "may adjust your payment if the claim details don't support the level of service billed." The process will apply to both fully insured and self-funded benefit plans, and will go into effect on July 8, 2024.
Aetna Emergency Department Reductions: What Providers Should Know
Aetna recently announced that it is rolling out a national protocol under which it will be reviewing both physician and hospital emergency department claims that include Level 4 or 5 evaluation and management (E&M) codes, and after that review, "may adjust your payment if the claim details don't support the level of service billed." The process will apply to both fully insured and self-funded benefit plans, and will go into effect on July 8, 2024.
Aetna Emergency Department Reductions: What Providers Should Know
Aetna recently announced that it is rolling out a national protocol under which it will be reviewing both physician and hospital emergency department claims that include Level 4 or 5 evaluation and management (E&M) codes, and after that review, "may adjust your payment if the claim details don't support the level of service billed." The process will apply to both fully insured and self-funded benefit plans, and will go into effect on July 8, 2024.
Antigenic drift and subtype interference shape A(H3N2) epidemic dynamics in the United States
Abstract Influenza viruses continually evolve new antigenic variants, through mutations in epitopes of their major surface proteins, hemagglutinin (HA) and neuraminidase (NA). Antigenic drift potentiates the reinfection of previously infected individuals, but the contribution of this process to variability in annual epidemics is not well understood. Here we link influenza A(H3N2) virus evolution to regional epidemic dynamics in the United States during 1997—2019.
No Surprises Act: Washington State Rethinks IDR Transition Amid Federal Court Showdown | JD Supra
[co-author: Wei Wei]* Washington State's Office of the Insurance Commissioner (OIC) is delaying its transition to the federal No Surprises Act (NSA) Independent Dispute Resolution (IDR) process for at least six months. As a result of this decision, out-of-network providers in Washington State will be able to continue using the state-regulated process for resolving out-of-network billing disputes.
No Surprises Act: Washington State Rethinks IDR Transition Amid Federal Court Showdown
Washington State's Office of the Insurance Commissioner (OIC) is delaying its transition to the federal No Surprises Act (NSA) Independent Dispute Resolution (IDR) process for at least six months. As a result of this decision, out-of-network providers in Washington State will be able to continue using the state-regulated process for resolving out-of-network billing disputes.
No surprises act: CMS halts idr process after Texas court ruling
On February 10, 2023, the Centers for Medicare and Medicaid Services (CMS) instructed Independent Dispute Resolution (IDR) entities to hold all payment determinations in out-of-network disputes until CMS issues further guidance. IDR entities were further instructed to recall any payment determinations issued after February 6, 2023.
Association of mRNA Vaccination With Clinical and Virologic Features of COVID-19 Among US Essential and Frontline Workers
[Skip to Navigation] Figure 1. Viral Load and Plaque-Forming Units of SARS-CoV-2 Infection by Virus Lineage, Vaccination Status, and COVID-19 Characteristics Figure 2. Estimated Viral Load Over the Course of SARS-CoV-2 Infection for Both Vaccinated and Unvaccinated Participants by Virus Lineage and Symptomatic vs Asymptomatic Infections Viral load over the time course of infection for vaccinated and unvaccinated participants with at least 3 specimens.
Killing of 8 gray wolves at Michigan ranch spurs controversy, criticism
Eight gray wolves were killed last summer at an Upper Peninsula ranch, according to a new government report, an unprecedented number for a single locationin Michigan. A U.S. Department of Agriculture Wildlife Services report issued in January provides details of the killings not made public by the Michigan Department of Natural Resources, which approved permits for the shootings.
Flooding in Haiti spurred escape plan for captive west Michigan missionaries
Hart — Heavy December rainstorms helped west Michigan missionaries held captive two months in Haiti by a notorious gang to escape. Each night, guards stationed outside a house where the group was being held used a power strip to plug in and charge their phones. But flooding last month caused the guards to relocate the charging station to the other side of the building, allowing for the captives to slip out, said Ray Noecker of Shelby, whose family had been among the abducted.
Two members of kidnapped Michigan missionary family released, sources say
Hart — Two of the three hostages released by a Haitian gang Sunday night are from Michigan, according to two sources, while four Michigan residents remain kidnapped. The Michigan family, a mother and five children, was taken hostage Oct. 16 after leaving an orphanage outside Port-au-Prince. They were in a van with a group of 11 other Anabaptist missionaries from the United States and Canada when they were captured.
The University of Exeter Press
The Beginnings Of The Cinema In England,1894-1901: Volume 1 - 1894-1896 By Describing in detail one of the most inventive periods in the history of English cinema, the volumes in this celebrated series are already established as classics in their field. Each volume details the highlights of a single cinematic year, including details of production, manufacturers of equipment, dealers and exhibitors.
Hart community prays for missionaries kidnapped in Haiti
Hart — Danielle Horst shifted left, then right, in her prayer circle as she cradled her 8-month-old daughter, Kianna, in her left arm. Danielle brushed tears from her eyes as she bowed her head, a white bonnet typical of her faith on her head. Another baby was on her mind, the same age as hers.
Several linked to Michigan's worst suspected wolf poacher face charges
John Barnes, Special to The Detroit News Published 10:58 p.m. ET July 3, 2020 | Updated 11:02 p.m. ET July 3, 2020 A sheep farmer who appears to have posed holding a large, dead wolf on his Upper Peninsula farm might now regret the snapshot. So might his father, who waited off-camera to remove the trophy so the trapper and his wife could turn its fangs, pelt and skull into jewelry and lodge décor, authorities say.
Michigan DNR missed chance to test worker diagnosed with TB a year later
A suspected deer-to-human tuberculosis outbreak in Michigan’s wildlife disease laboratory may have begun a year earlier than the state had acknowledged, Bridge Magazine has learned. The timing matters because the state’s failure to initially test one worker means the Department of Natural Resources may have missed an opportunity to identify the contagious respiratory disease before four additional workers tested positive last summer.
How the DNR ensnared Michigan's worst suspected wolf poacher
Pickford — The undercover officer followed Kurt Johnston Duncan to his “bait pen,” about 200 yards from his cabin along a marsh. Two bald eagles lay among the deer remains. One eagle was still in an illegal snare meant for a gray wolf or another predator. “What do you do, ya know?” the officer said. The Department of Natural Resources seized wolf skulls and teeth, three dead bald eagles, jewelry supplies and illegal snares from Duncan's cabin and grounds.
Student Voice: When TikTok and Tiger King are more important than homework
Back to student voices archive June 9, 2020 Student Voice: When TikTok and Tiger King are more important than homework Produced by PBS NewsHour Student Reporting Labs Editor’s note: Six high school students from PBS NewsHour Student Reporting Labs’ (SRL) Homegrown Fellowship program produced this video about what life has been like under quarantine. Read fellow John Barnes’ accompanying piece and answer the questions: How have you coped with being at home during quarantine?
Michigan safety regulators launch probe of TB outbreak at state DNR lab
“She was a wreck … nervous as heck,” said Kevin Karpinsky, senior labor relations specialist with Service Employees International Union 517M. The student had returned to her home to the Upper Peninsula and was nearly overlooked for testing, he added. “Basically that whole season was horrible, a perfect storm of things occurring that were out of the control of the individual,” Karpinsky said. He said after the TB outbreak, the union had considered a walkout to shut down the lab.
Chainsaws, convicts and hope: Inside Michigan's prison-to-work pipeline
Recidivism rates typically represent ex-cons who are re-arrested within three years. Statewide, the rate was 26.7 percent statewide last year, an all-time low, the department announced March 4. Fewer than 5 percent of the 700 vocational grads have re-offended, Gautz said, acknowledging it's barely three years since the first villagers graduated. DTE Energy so far has hired five workers from the tree trimming program. One has been re-arrested.
Integrating genotypes and phenotypes improves long-term forecasts of seasonal influenza A/H3N2 evolution
Abstract Seasonal influenza virus A/H3N2 is a major cause of death globally. Vaccination remains the most effective preventative. Rapid mutation of hemagglutinin allows viruses to escape adaptive immunity. This antigenic drift necessitates regular vaccine updates. Effective vaccine strains need to represent H3N2 populations circulating one year after strain selection.
Keeping the lakes at bay: High water levels take toll on infrastructure
Whitehall and Montague are former lumber and tannery settlements on opposite sides of where the White River enters White Lake, five miles from Lake Michigan. There is one bridge between them. Today, the communities are intertwined as if by that single strand. Fourth of July parades march from one downtown to the other. School-of-choice students pass on the bridge, about 100 each way, the area chamber's chief says.
Five Michigan DNR workers contracted tuberculosis, likely from testing deer
“This was distributed to more than 200 employees and not marked confidential,” Minzey wrote. “There was no investigation conducted. I was never presented with the charges nor given an opportunity to respond to these charges.” Two previous job evaluations obtained by Bridge rated Minzey as “high performing,” and praised him for being attuned to the political dimensions of DNR’s work.
Michigan DNR said it killed wolves to protect humans; Bridge Magazine got the emails
ONTONAGON — Bouncing along a sodden farm pasture, Brad Johnson stopped his state vehicle when he came upon the newborn calf, or what remained of it. The veteran wildlife handler had been to this patch of farmland in the western Upper Peninsula several times the previous fall, when a dozen calves from the Dykstra beef ranch were reported missing. Gray wolves were suspected in those disappearances.
Dana Nessel to review Michigan DNR handling of wolf kill records
Michigan Attorney General Dana Nessel is reviewing whether state officials improperly blocked or delayed the release of public records relating to their efforts to have protected gray wolves killed three years ago, her office told Bridge Magazine.
Bridge: The state DNR claimed killing wolves protected humans. Internal emails say otherwise.
Bouncing along a sodden farm pasture, Brad Johnson stopped his state vehicle when he came upon the newborn calf, or what remained of it. The veteran wildlife handler had been to this patch of farmland in the western Upper Peninsula several times the previous fall, when a dozen calves from the Dykstra beef ranch were reported missing. Gray wolves were suspected in those disappearances.
State overstated threat from gray wolves that led to deaths of three
Killing western Great Lakes wolves is not permitted under the U.S. Endangered Species Act unless human safety is at risk. Violations carry a maximum criminal penalty of one year in jail and a $100,000 fine, or $200,000 per organization. (Photo: AP) The Michigan Department of Natural Resources is now admitting it misled a federal agency into killing three endangered gray wolves in 2016, following a Detroit News investigation that raised questions about the shoot.
Government's motivation questioned in Michigan wolf killing
Killing western Great Lakes wolves is a federal crime unless human safety is at stake.(Photo: Dawn Villella / AP, Dawn Villella / AP file) The government deemed a wolf pack so dangerous two years ago that a federal sharpshooter killed three endangered gray wolves, ostensibly to protect a family, in a rare use of that authority at a remote Upper Peninsula cattle farm.
Violence not 'on radar' for authorities before rural Michigan feud turned deadly
Wendell Popejoy Jr. stands with his lawyer Jeff Kortez to hear his sentence of life in prison for the murder of his neighbor Sheila Bonge on Nov. 5 in 20th Circuit Court in Grand Haven.(Photo: Katy Batdorff, Special to The Detroit News) Nunica — A Lake Michigan westerly wind muffled the killer's approach, as did the victim's droning snow blower. Wendell Popejoy Jr. slipped between two front-yard pines toward his neighbor. Driving snow scoured the barren hayfield.
Loss of life and limb: Michigan's weakened trees pose deadly threat
The emerald ash borer is taking a deadly toll in Michigan, and not just on trees. Weakened ash are toppling and shedding limbs with greater frequency since a tree-killing bug stowed in cargo from Asia to Detroit 16 years ago, experts say. And they're hitting people — with tragic results. “It’s just that we have a lot of ash trees in the state and a high proportion have died, and you run the possibilities.
Deadly Parallels: HIV/AIDS Funders Bring Hard-Learned Lessons to the Opioid Crisis
If you think of a Venn diagram mapping two crises—the HIV/AIDS epidemic and opioid use—there would be a significant amount of overlap. They are analogous, in many ways: in terms of scope; the ways in which society has responded—or, more aptly, not responded—to them; and the populations most affected. The good news is that there is much we have learned from the past 30 years fighting HIV/AIDS that can be applied to the opioid crisis.
In west Michigan neighbor feud, some side with suspected killer
Nunica — The day after Christmas, amid arctic cold and drifting snow, Wendell Popejoy executed his longtime neighbor with a bullet to the back of her head, police say. Her offense: “Shelia (sic) was snow blowing the easement driveway out in front of his residence,” a sheriff’s detective told a judge, according to a court transcript.
DNR: Wasting disease shifted in Michigan’s deer herd
A deadly disease that threatens to decimate Michigan’s whitetail deer population has shifted northwest from the Lansing area, some 100 miles, new test results show. All but one of the new cases of chronic wasting disease in the just-ended 2017 firearm season were discovered in free-ranging deer killed in Montcalm and Kent counties, 40 total, according to the Department of Natural Resources. One case was found in nearby Mecosta County.
Chronic wasting disease threatens Michigan deer herd
Sidney — Robert MacDonald gestures south with his right hand, past his property to where a sick deer was killed. A hunter came to his door days earlier, warning neighbors. “He said, ‘Something was wrong with my deer. I took it in, and it had the disease,’” said MacDonald, 70, of Sidney in Montcalm County. There is a black cloud on the horizon as an estimated 600,000 deer hunters ready their guns for Michigan’s firearms opener on Wednesday.
A Grand Rapids Story
The statement hangs in the air. The new year is not yet three days old. Outside, temperatures bottom in the teens. It is January 3, 2012, in West Michigan, 30 miles inland from the world’s fifth-largest lake. On this day, Teresa Weatherall Neal is not yet superintendent of one of the state’s largest school districts. She is not yet interim superintendent. That will come the next day. She knows; the public does not.
Michigan beef farmer in lone battle with wolves
Ontonagon County — The gray wolf stands its ground, staring. Its muzzle hides jagged incisors. Tom Dykstra, who owns this Upper Peninsula cattle farm, pauses. Eyes lock; his blue, the wolf’s amber-brown. Maybe 30 yards. They stare, neither moving for 15-20 seconds. An eternity. It is a Friday in September. Dusk is falling. Dykstra is about a mile from the farmhouse, checking on his cows. The light-colored wolf, brownish gray, finally turns. This three-square-mile farm is like no other in Michigan.
High-end lodge offers hunters comforts of home, shot at record deer
Lupton— On 800 acres of rolling forest land in northeast Michigan’s Ogemaw County, trophy deer wander for the taking — if you have the cash. Nine-, 10- and 11-point bucks — record-book deer — make their homes within the enclosed confines of Valhalla Lodge, one of the newest and most exclusive game preserves in Michigan. Hundreds of thousands of hunters prepare to descend on more than one million Michigan deer Tuesday, the start of the two-week firearm season.
With Molly and Grace
With Molly and Grace Childhood cancer blinded Grace Schmid in one eye, but a wise mother has been there to guide her every step of the way. Molly Schmid holds her daughter, Grace. Molly works in Spectrum Health's Human Resources department. She specializes in onboarding new employees. (Chris Clark | Spectrum Health Beat) Grace hugs her aunt, Jennifer Schmid, RN. Grace is a survivor of retinoblastoma, a type of eye cancer that afflicts perhaps one in 20,000 children.
Residents try to save last Old Mission Peninsula school
Old Mission Peninsula –— Atop a finger of land surrounded on three sides by Grand Traverse Bay, the Old Mission Peninsula School harbors perhaps the most beautiful view of any elementary in the state. The school is perched on the spine of the peninsula, on Island View Road. Cherry trees and vineyards fall down rolling hills toward both arms of the bay. Most tourists pass without seeing it.
Breast cancer patient hopes others heed her story
‘They are amazed at how well I’m doing,’ Linda Kazemier says. The Taxol is working, hanging aside its drip-kit sidekicks Benadryl and sodium. Linda Kazemier and her five-wheeled IV stand are on the third floor at Spectrum Health Cancer Center’s Lemmen-Holton Pavilion. She received word this morning that she would need two more treatments, three hours each, and a little longer before she can undergo breast cancer surgery. “It’s kind of a bummer,” she says, rolling her hazel eyes to the left.
Bulletin Board Eyes: Born at less than 3 pounds, Spectrum Health doctors help el pequeño
You pass their messages, posted in bustling, busy places. Some are people on paper, with fliers posted on bulletin boards. Others use digital bulletins—Facebook and gofundme.com. This special Health Beat series profiles people with bulletin board eyes. Meet baby Scott Philip. The diaper is about 5 inches at the waist, tiny. So is its wearer. He is the little one—el pequeño—among the smallest infants sent home from the Spectrum Health Helen DeVos Children’s Hospital.
Michigan forest offers visitors a peek at elusive elk
There were three elk in the distance. One was bedded, two upright. And then there were 10. The largest elk rose. It was a hazy 8 a.m. in July and 66 degrees. This is the Pigeon River Country State Forest, home to the largest elk herd east of the Mississippi and a prime spot at a prime time for those who want to view these magnificent animals. Scott Whitcomb, Department of Natural Resources unit manager there, said 75 percent of their visitors or callers want to know where they can see elk.
Large Upper Peninsula mining plan slated for public debate; DNR wary
Some 350 million years ago, Michigan was covered by a warm, shallow saltwater sea. Prehistoric animals and plants lived and died and their remains piled one atop another. Over time, they became rock made of sediment. The mineral is not far underground. Michigan's Upper Peninsula is rich with limestone, which grows ever deeper as you move south toward the Lake Michigan shoreline. It is useful in the manufacture of largely construction material.
Wolf attacks on livestock and dogs in 2014 jump to one of the highest levels in more than a decade
Attacks by wolves on livestock and dogs saw a significant spike in 2014 compared to the previous year, records show. The 35 attacks are the fourth-highest number in the past 13 years. The 2014 tallies are through Dec. 22, the latest figures available. Some attacks involved multiple casualties. That's 10 more livestock attacks and five more dog attacks than the year before. In all, 26 cattle and 17 hunting dogs were confirmed killed in 2014.
Charges OK'd against hunters accused of videotaping dogs mauling a coyote, hitting another with a truck
Criminal charges have been authorized against two Upper Peninsula hunters accused of urging hunting dogs to attack a wounded coyote and videotaping the squealing animal, court records show. The hunters also were investigated after both allegedly videotaped a wounded coyote deliberately hit by one of the hunters' truck, an MLive.com Freedom of Information Act request found. Both incidents were witnessed by one of the men's 12-year-old son, according to records.
New Michigan wolf hunt in question; supporters are angry, critics are 'ecstatic'
A federal judge's order to reinstate wolves as an endangered species in the Great Lakes area was cheered by Michigan wolf supporters and decried by a farmer who has had significant cattle losses. "Basically what this decision shows is that entrusting the state with the management of wolves is a failed experiment," said Jill Fritz, state director for The Humane Society of the United States and director for Keep Michigan Wolves Protected.
Attorney General Bill Schuette 'bullies,' says outgoing prominent Republican: There are 'dinosaurs' in Lansing
Michigan Attorney General Bill Schuette speaks after U.S. Attorney Carmen Ortiz, right, announced indictments of 14 owners and employees from the New England Compounding Center Wednesday, Dec. 17, 2014, in Boston. More than 750 people in 20 states were si "There are some dinosaurs in Lansing … and we all know what happens to dinosaurs,' said term-limited state Rep. Joe Haveman, R-Holland.
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