HOUSTON
Provider Reimbursement Disputes Go Back to 1984 Following Supreme Court’s Regulatory Reset
By Evan Schrode, J.D.
Onecould forgive the healthcare industry for thinking someone drove Doc Brown’s DeLorean time machine through One First Street when it awoke on Friday, June 28, to a blast from the past.
No, Ronald Reagan is not the President; Bruce Springsteen’s Born in the U.S.A. album is not this summer’s biggest musical hit; and we have all known for some time who we are going to call when a poltergeist marauds through town. But on June 28, 2024, the United States Supreme Court sent the healthcare industry and its chief regulator, the Department of Health and Human Services (“HHS”) and its Centers for Medicare and Medicaid Services (“CMS”), back to 1984 when it decided in Loper Bright Enters. v. Raimondo and Relentless, Inc. v. Department of Commerce and overruled Chevron U.S.A. Inc. v. Nat. Res. Def. Council, Inc., in a 6–3 decision.
The Supreme Court’s decision clarifies one thing – that courts, not agencies, have the ultimate authority to interpret Congressional statutes. The new Loper Bright framework poses many questions to the reimbursement landscape and is likely to result in increased provider challenges to agency action, and more success for providers in those challenges. Below are some provider considerations in key reimbursement areas given the new
regulatory framework.
How Can Providers Use this Change for Medicare Reimbursement and Appeals?
1. Contractor overpayment demands. There may be new opportunities for providers to limit the Medicare contractors’ ability to use statistical extrapolations or statistically valid random sampling (“SVRS”) to recover substantial alleged overpayments from providers. For some providers, these overpayments spell a death-knell on their business. Providers may now challenge the government’s use of extrapolation, including the methodologies that contractors will implement under the Medicare Program Integrity Manual and other Medicare guidance, to argue that such extrapolation, as implemented, overinflates a provider’s payment error, is unreliable or statistically invalid, or is otherwise problematic. These challenges may lead to courts developing their own criteria for when and how extrapolation should be used.
2. Settlement potential. Medicare contractors may now be willing
to utilize the settlement authority conferred upon them by federal law to resolve overpayment demands rather than risk losing during the appeal process. Although many providers have found CMS’ settlement conference facilitation initiative to be an unhelpful alternative dispute resolution process following an overpayment demand appeal, particularly given they only apply when the overpayment is not based on a statistically valid sample, the government may become more willing to offer such settlements if providers succeed in restricting CMS’ ability to utilize extrapolated overpayments.
3. Self-audits and potential refunds. CMS’ requirements that providers review and refund potential overpayments may now be subject to heightened scrutiny and new interpretation, including the timeliness of identifying and returning such overpayments and what constitutes an overpayment. Notably, the statute granting CMS
Ross Burris, J.D. Polsinelli, PC
Oncology Research The Importance of Well-Woman Visits for Gynecologic Cancer Prevention
RBy Christine Lee, M.D., Texas Oncology
The Woodlands
egular well-woman visits are important for maintaining overall health and early detection of potential issues, including gynecologic cancers. These appointments offer comprehensive care that goes beyond reproductive health, providing an opportunity to address lifestyle, preventive measures, and risk management. Well-woman visits can be appropriate for teen girls, adult women, and transgender or non-binary people who have a female reproductive system.
Despite busy schedules, skipping these appointments can lead to missed opportunities for early detection and intervention for gynecologic cancers,
especially since many are initially asymptomatic and early treatment is critical for the best outcomes. What does a well-woman visit consist of?
A well-woman visit is a routine check-up that includes a thorough evaluation of one’s health, screening for potential issues, and counseling on maintaining a healthy lifestyle. These visits are tailored to one’s age, health history, and risk factors, ensuring a personalized treatment approach. Well-woman exams can include breast and pelvic exams, screenings for sexually transmitted infections (STIs), and discussions about contraception and sexual health.
Early detection of gynecologic cancers
Gynecologic cancers, which include cervical, ovarian, uterine, vaginal, and vulvar cancers, can pose significant health risks but are often more treatable when detected early.
According to the American
Cancer Society, in 2024, over 116,000 women in the United States are expected to be diagnosed with gynecologic cancer, and more than 30,000 will die from these diseases. In the state of Texas in 2024, 7,800 women will be diagnosed with cervical, ovarian, or uterine (endometrial) cancer.
• Cervical Cancer: Approximately 13,820 new cases of cervical cancer will be diagnosed in the U.S., with over 4,300 deaths. Most frequently found in women between the ages of 35 and 44, cervical cancer is rarely found in women younger than 20. Routine Pap smears and
HPV (human papillomavirus) tests during well-woman visits can detect precancerous changes in cervical cells, allowing for early treatment. HPV, the most common sexually transmitted infection in the United States, is a virus that causes more than 90% of all cervical cancers, and risk can be significantly reduced with appropriate vaccinations.
• Ovarian Cancer: Ovarian cancer is difficult to detect early. This cancer mainly develops in older women, with about half of the
Hurricanes, Extreme Weather Can Cause Post-Traumatic Symptoms or Other Mental Health Concerns
By Leila Lopez Marks
The
Hurricane Beryl is long gone, but powerful emotions rage in its wake. Stress, anger, fear, depressioncoupled with triple digit temperatures and no A/C for thousands - can trigger psychological symptoms.
Storm and weather-induced post-traumatic symptoms can be real and are something to be prepared for, especially with the active hurricane season predicted, said Dr. Namrata Vasquez, a psychologist at Houston Methodist.
Even if you don’t meet criteria for PTSD (post-traumatic stress disorder) or a formal psychiatric disorder, a lot of folks after natural disasters report higher levels of psychological distress, hypervigilance, anxiety and depressive symptoms,” Vasquez said. “You can imagine a lot of people feel less control
over their lives and that can result in depressive symptoms including hopelessness or helplessness.”
A study following Hurricane Harvey in 2017 showed that people displaced from their homes, or otherwise limited in resources (AC, food, water) exhibited higher levels of distress and PTSD symptoms. Furthermore, more than 25% of participants in the study reported clinically significant symptoms of PTSD.
Some strategies to cope with potential stressors or protect your mental health during the season may include:
• Follow national and local preparation guidelines. Be prepared ahead of time. Have an emergency evacuation plan, have an emergency supply of non-perishable food and plenty
of drinking water. If possible, purchase a backup power source such as a generator to power essentials such as the refrigerator.
• Have a communication plan in place with your loved ones, knowing how to contact one another or meet up safely if needed.
• Reach out to people you trust for additional social support (family, health care providers, friends and community leaders).
Although natural disasters have long existed, the research examining the psychological effects of weather-related
trauma has grown notably in the last several years and will continue to be relevant. Learning how to prepare before potential events, develop and practice effective methods of coping, establish strong sources of social support, and maintain good mental and physical health are imperative to getting through large-scale weather events like Hurricane Beryl. If you are struggling with psychological symptoms following Hurricane Beryl, consider reaching out a mental health provider (therapist, counselor, social worker).
Mental Health A Novel and Unique Neural Signature for Depression Revealed
By Baylor College of Medicine
As parents, teachers and pet owners can attest, rewards play a huge role in shaping behaviors in humans and animals. Rewards –whether as edible treats, gifts, words of appreciation or praise, fame or monetary benefits – act as positive reinforcement for the associated behavior. While this correlation between reward and future choice has been used as a well-established paradigm in neuroscience research for well over a century, not much is known about the neural process underlying it, namely how the brain encodes, remembers and translates reward cues to desired behaviors in the future.
and investigator at the Jan and Dan Duncan Neurological Research Institute (Duncan NRI) at Texas Children’s Hospital, identified beta frequency neural activity in the anterior cingulate cortex (ACC) of the brain’s frontal lobe as the key neural signature underlying processes associated with recognizing rewards and determining subsequent choices and, thus, shaping future behaviors.
Furthermore, the study, published in Nature Communications, reports this neural signature is altered in patients with depression, opening an exciting possibility of using these neural signals as a new biomarker and a potential innovative avenue for therapy.
Anhedonia is a cardinal symptom of depression and other psychiatric conditions
Human beings derive pleasure through various physical or mental activities, sensory experiences and interactions with family and
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friends. However, individuals with depression often experience feelings of hopelessness, sadness or despair for prolonged periods due to disengagement and anhedonia – a medical term meaning loss of the ability to feel joy or contentment in activities and things that they once found pleasurable, all of which has a profound negative impact on their quality of life.
A recent study led by Dr. Sameer Sheth, professor and vice chair of research in the Department of Neurosurgery at Baylor College of Medicine, director of the Gordon and Mary Cain Pediatric Neurology Research Foundation Laboratories We’re rewarding eligible Texas members with a 5% dividend. Does your malpractice liability insurer do
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Anhedonia is also associated with other psychiatric and neurological disorders such as schizophrenia and bipolar disorder, substance abuse disorder, anxiety and Parkinson’s disease. Traditional antidepressants and standard treatments often
fail to adequately address this symptom in individuals with severe treatment-resistant depression and other conditions. A better understanding of anhedonia can guide the development of targeted and more effective treatments for depression and related conditions.
Reward bias response is regulated by beta activity in the frontal lobe
To identify the underlying neural basis for anhedonia, Sheth and team recorded and analyzed neural activity from four brain regions of 15 patients
you. Not Wall Street. That’s why we’re able to award a 5% earned dividend to our eligible Texas members this year. Altogether, we’re returning $14.7 million to doctors in 2024, which brings the total dividend payments we’ve shared with physicians to $470 million.
Hospital News
MD Anderson and Rice Launch Cancer Bioengineering Collaborative
Initiative Aligns Expertise to Advance Bioengineering Research to Improve Early Detection and Treatment of Cancer
The University of Texas MD Anderson Cancer Center and Rice University today announced the creation of the Cancer Bioengineering Collaborative to develop innovative technologies and bioengineering approaches to improve cancer research, diagnosis and treatment.
Led by Rice’s Gang Bao, Ph.D., and MD Anderson’s Jeffrey Molldrem, M.D., the initiative aims to foster collaboration between
the two institutions on fundamental and translational cancer research, to develop new technologies for cancer detection and therapy, and to secure external funding in support of further research and training.
Envisioned as a hub for accelerating the journey from laboratory research to clinical application, the Cancer Bioengineering Collaborative leverages the two institutions’ complementary strengths to drive discovery and innovation in
Memorial Hermann Appoints Jason Glover CEO of Memorial Hermann-Texas Medical Center Adult Services
Memorial Hermann Health System has announced Jason Glover is appointed CEO of Memorial Hermann-Texas Medical Center Adult Services, effective September 23.
Glover brings more than a decade of health care and management experience. After joining Memorial Hermann in 2013 as an administrative fellow, Glover advanced to leadership roles at Memorial Hermann Greater Heights Hospital, Memorial
Hermann Sugar Land Hospital and Memorial Hermann The Woodlands Medical Center where he served as Vice President, Operations until his January 2024 appointment as interim CEO, Memorial Hermann-Texas Medical Center.
“Jason is committed to driving high-quality outcomes for patients, families and the communities we serve,” said Erin Asprec, Executive Vice President and Chief Operating Officer. “He is a compassionate and collaborative leader who fosters a
five key research areas:
• Cell therapies: Developing more effective cell-based immunotherapies, including chimeric antigen receptor- and T cell receptor-based approaches
• Nanotechnologies: Using nanoparticles for targeted cancer detection and therapy
• Cancer vaccines: Incorporating advanced biomaterials, synthetic biology and nanoparticle delivery systems to develop therapeutic cancer vaccines
• Artificial intelligence: Leveraging advanced computing tools for high-precision analysis of samples to identify new targets and inform therapeutic design
• Molecular imaging: Deploying advanced molecular imaging techniques to enhance diagnostic and therapeutic tools
“There is tremendous potential in bringing together experts in engineering and cancer as part of this focused, collaborative framework that is truly unique, not only owing to the complementary nature of the
positive and inclusive culture for employees, providers, clinical staff, community stakeholders and our academic partners.”
Glover’s responsibility and oversight will include partnering with faculty and team members to support Mischer Neuroscience Institute, Larry D. Johnson Heart and Vascular Institute, Red Duke Trauma Institute, Specialty Surgery and Memorial Hermann | Rockets Orthopedic Hospital, in addition to all other services that provide care for the Memorial Hermann-Texas Medical Center adult population.
“I’m grateful for the opportunity to continue working with the talented medical staff and team at Memorial Hermann-Texas Medical Center, and I’m honored that our leadership has placed their
respective strengths but also because this is the first formal joint research initiative of its kind between the two institutions,” said Bao, department chair and Foyt Family Professor of Bioengineering, professor of chemistry, materials science and nanoengineering and mechanical engineering, and Cancer Prevention and Research Institute of Texas (CPRIT) scholar.
In support of its goals, the collaborative will launch new joint efforts, including a seed grant program to facilitate collaboration between investigators at Rice and MD Anderson; a monthly seminar series focused on cancer bioengineering; annual retreats to showcase cutting-edge research and
trust in me to continue my tenure at Memorial Hermann’s academic medical center,” Glover said. “I look forward to supporting our entire team as we work together to advance health and provide high-quality care to each individual we have the privilege to serve.”
In addition to operational oversight for key inpatient and outpatient services, Jason provided invaluable guidance and leadership to multiple capital projects, including an expansion at Memorial Hermann Sugar Land and a $250+ million expansion project at Memorial Hermann The Woodlands. His unique experience and proven success in culture, quality and growth will be invaluable as Memorial Hermann-TMC continues its longstanding service to the Greater Houston community.
Jeff Molldrem, M.D. (left) and Gang Bao, Ph.D. (right)
see Hospital News ...page 13
The Framework
Kelsey-Seybold’s Rice Village Clinic Welcomes Local Officials for Ribbon Cutting
Kelsey-Seybold Clinic – Rice Village welcomed Mayor of City of West University Place Susan Sample; and Sophie Elsner, director, Harris County Precinct One, Office of Commissioner Rodney Ellis, on June 19th with a ribbon-cutting ceremony. Conveniently located in the historic Rice Village shopping district, Rice Village Clinic expands access to coordinated, evidence-based women’s healthcare. Rice Village Clinic replaces the former Kelsey-Seybold Clinic –Woman’s Center.
From left: Brinda Springfield, Senior Director of Ambulatory Care, Kelsey-Seybold Clinic; Kalen Cassel, Director of Ambulatory Care, Kelsey-Seybold Clinic; Connie Davidson, Clinic Administrator, Kelsey-Seybold Clinic – Rice Village; Mayor Susan Sample, City of West University Place; Michael Leung, M.D., F.A.C.O.G., OB/GYN, Kelsey-Seybold Clinic – Rice Village; Sophie Elsner, director, Harris County Precinct One, Office of Commissioner Rodney Ellis,; Michael Abreu, Senior Manager-Public Sector, Labor & Trust, KelseyCare.
Texas A&M School of Engineering Medicine Holds White Coat Ceremony
By Krystel Johnson
Texas A&M School of Engineering
Medicine (ENMED) held a White Coat Ceremony for 48 students, marking the induction of the school’s sixth class on Wednesday, July 24. The event took place in the ENMED Tower’s auditorium, with an alternative viewing area on the 17th floor, offering stunning panoramic views of the Texas Medical Center for family and loved ones.
During the ceremony, each student was presented with a white coat and an engineering caliper, signifying their unique journey in the innovative Engineering Medicine (ENMED) dual-degree program. This program integrates medical and engineering education, producing Physicianeers — medical doctors with advanced
engineering skills.
Dr. Anthony Atala, the Founding Director of the Wake Forest Institute for Regenerative Medicine, delivered the keynote address. As a practicing surgeon and renowned researcher in regenerative medicine, Atala shared his insights and inspired the incoming class.
Following the keynote speech, the students recited the Hippocratic Oath, led by Dr. Ericka Greene, Associate Dean of Clinical & Integrative Programs. This tradition reaffirms their commitment to ethical medical practice and patient care.
This year’s ceremony included a special commissioning ceremony for one student into the United States Army, highlighting their commitment to both medicine and service to the
country.
The class of 2028 comprises 18 females and 30 males, with an impressive average undergraduate GPA of 3.83 and an average MCAT score of 515. This marks the start of our first group of E2ENMED students, including six from the Texas A&M E2ENMED program.
The E2ENMED program is a highly competitive Early Assurance Program that prepares Texas A&M undergraduate students for the ENMED program through activities and research focused on innovation and entrepreneurship.
The White Coat Ceremony is
an esteemed tradition marking the transition of students into the medical profession. Receiving their first white coat, a symbol of the medical profession for over a century, encourages new medical students to uphold the highest values and standards as they begin their education. This annual event signifies their dedication to patient care and ethical practice.
This event commemorates Dr. Pettigrew’s final white coat ceremony as the inaugural dean of the Texas A&M University School of Engineering Medicine.
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Dr. Roderic Pettigrew, inaugural dean of Texas A&M School of Engineering Medicine, congratulates a student after receiving their white coat
New Breakthrough in Alzheimer’s Research: UTMB Researchers Develop Nasal Spray Treatment for Alzheimer’s Disease
Researchersat the University of Texas Medical Branch recently discovered a significant advancement in the fight against neurodegenerative diseases such as Alzheimer’s disease and dementia. The study, published today in Science Translational Medicine, introduces an innovative nasal spray treatment that has shown promising results in clearing harmful tau protein build-up and improving cognitive functions in aged mice models with neurodegenerative diseases.
“This nasal spray approach opens new avenues for non-invasive delivery of tau therapeutic antibodies directly to the brain, and it holds promise for many neurodegenerative diseases.” said Dr. Rakez Kayed, lead author and professor at the Department of Neurology at UTMB.
Tau is a microtubule-associated protein found in human brains that helps stabilize microtubules, part of the framework that gives the cell its shape and helps it stay organized, in neurons. In healthy brains, tau proteins help keep things in order. But in neurodegenerative diseases, they can become abnormally twisted and form tangles that disrupt neuronal function and lead to cognitive decline. Current tau immunotherapies have struggled with efficacy due to their limited ability to penetrate intracellular compartments where these tau buildups reside.
Kayed and his team developed a specific type of antibody, TTCM2, which selectively recognizes and targets toxic tau buildup. The antibody was packaged in particles to enhance its delivery to the brain via the nasal
route. This method bypasses the blood-brain barrier, a significant hurdle in neurodegenerative disease treatment, ensuring rapid and effective delivery of the therapy.
“Our research highlights the potential of nasal tau immunotherapy to effectively target intracellular tau aggregates– a primary driver of neurodegeneration and cognitive decline in diseases like Alzheimer’s and other tauopathies,” added Kayed. “This method not only improves the delivery of therapeutic antibodies but
also enhances their efficacy in clearing tau aggregates and improving cognitive functions”.
An essential aspect of this approach is that it involves TRIM21, an intracellular receptor for antibodies and E3 ligase, known for mediating the clearance of antibody bound pathogens like viruses. In the study, TRIM21 facilitated the clearance of antibody bound intracellular tau aggregates,
see Alzheimer’s...page 13
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City of Houston Recognizes Kelsey-Seybold Clinic for 75 Years of Excellence with Proclamation
City of Houston Mayor John Whitmire presented Kelsey-Seybold Clinic with a signed proclamation of July 16 for 75 years of service to the Houston community. Kelsey-Seybold leadership, including chairman and CEO Tony Lin, M.D., Chief Operating Officer Kenneth Janis, and Medical Director for Healthcare Innovation Donald Aga, received the proclamation on behalf of the clinic.
“It is our honor to take care of Houstonians, including the city of Houston’s employees and their families,” said Dr. Lin, “Thank you for giving us this opportunity to serve you, and we look forward to the next 75 years.”
Kelsey-Seybold Clinic leadership accepts the proclamation presented by City of Houston leadership.
Kelsey-Seybold has many locations in the Houston area, including its flagship Berthelsen Main Campus, and new clinics in West University, Eldridge, Rice Village and
Tanglewood.
“I can’t think of anyone in Houston with a more easily recognizable name than Kelsey-Seybold Clinic,” said Mayor Whitmire.
The 75th anniversary marks a significant milestone for Kelsey-Seybold, prompting reflection
on past achievements and anticipation for the promising future ahead. The proclamation acknowledges and honors the unwavering commitment of Kelsey-Seybold Clinic providers and staff in the city of Houston.
From left to right: Kenneth Janis, M.H.A./M.B.A., chief operating officer, Kelsey-Seybold Clinic; Martha Castex-Tatum, city of Houston city council member, District K; Tony Lin, M.D., chairman and CEO, Kelsey-Seybold Clinic; John Whitmire, city of Houston mayor; Donald Aga, M.D., Medical Director for Healthcare Innovation.
WFinancial Forecast
It’s Hurricane Season –Are You Prepared?
By Grace S. Yung, CFP
Midtown Financial Group, LLC
ith the 2024 hurricane season now in full swing, we have already seen the devastating effects of wind, rain, flying debris and power loss. The National Oceanic and Atmospheric Administration (NOAA) predicts an above-average hurricane season this year, making it crucial to prepare. Just one inch of
may cover some hurricane damage but typically does not include flooding. Consider purchasing a separate flood insurance policy. The sooner you get coverage, the better because there is a waiting period for effectiveness.
Insurance Considerations:
Standard home insurance policies often exclude flooding from storm surges. FEMA’s National Flood Insurance Program (NFIP) offers flood insurance through over 50 companies and NFIP Direct, but premiums can be higher than private insurance. NFIP coverage may be limited, not covering improvements like finished walls and
floodwater can cause up to $25,000 in damage, highlighting the importance of protecting your home and assets from severe weather.
Preparing for a Storm
When an oncoming storm or hurricane is predicted, it’s vital to prepare as soon as possible. Here are some key steps:
1. Board Up Windows and Doors: Use hurricane shutters if available, or board up windows and doors to prevent wind and debris damage.
2. Secure Outdoor Items: Move outdoor furniture, grills, and other items inside to prevent them from becoming projectiles. This will reduce potential out-of-pocket expenses related to damages.
3. Check Insurance Coverage: Ensure you have proper insurance. Standard homeowner’s insurance
floors, and reimbursement can take longer.
Responding to Storm Damage
If your home and possessions are damaged in a storm, follow these steps:
1. Document the Damage: Take an inventory of the damage. Photographs can be crucial for insurance claims, especially if you have “before” photos for comparison.
2. Understand Responsibility: Know who is responsible for damages, such as when a neighbor’s tree falls on your house. Your neighbor may not be responsible.
3. File Insurance Claims: Include evidence like photos and any documentation of spoiled food
Mental Health
Continued from page 5
with medication-resistant epilepsy who were undergoing invasive monitoring to localize the zone from where their seizures originated.
As their brain activity was being monitored, these patients performed a perceptual discrimination task called the probabilistic reward task (PRT), a well-validated behavioral task that objectively measures anhedonia by observing subtle changes in behavior related to reward.
“We found that the unequal assignment of reward between two correct responses in this task produced a response bias toward the more frequently rewarded stimulus,” said lead author Dr. Jiayang Xiao, who conducted this study as a graduate student in the Sheth lab. “We found that based on feedback, most individuals modified their subsequent responses to make choices that were likely to get rewarded,
Hospital News
Continued from page 6
further stimulate new collaborations; and hosting international leaders in cancer and bioengineering research.
“From fundamental discoveries in cancer science, tumor immunology and patient care to innovative engineering advances in drug delivery systems, nanostructures and synthetic biology,
Alzheimer’s
Continued from page 9
thereby enhancing the therapeutic effect and cognitive improvements in the mice model.
irrespective of the accuracy of their answers.”
Moreover, they found a specific signal – neural oscillations in the beta frequency range – originating from the anterior cingulate cortex (ACC) in the frontal lobe of the brain, showed a consistently strong and positive correlation with the reward bias behavior and tracked closely with the receipt of rewards and their value. Further, they found that this specific brain region was engaged in evaluating both reward stimuli and outcomes, potentially acting as a critical node with a common mechanism for reward assessment.
“Our study has addressed a longstanding fundamental question in neuroscience – which specific brain region and signal regulates the classic reward bias response, a famous example of which is the Pavlovian conditioning where dogs learned to associate the sound of a ringing bell to food,” said co-senior author Dr. Benjamin Hayden, professor of neurosurgery at Baylor.
there is great potential for enabling cross-disciplinary collaboration to develop new technologies and approaches for detecting, monitoring and treating cancer,” said Molldrem, chair of Hematopoietic Biology & Malignancy at MD Anderson. “Our goal is to bridge the gap between bioengineering and cancer research to create transformative solutions that significantly improve patient outcomes.”
Reward bias response is altered in patients with treatment-resistant depression
Next, Sheth and his team conducted the PRT in four individuals with severe treatment-resistant depression. They found that reward processing in the ACC was altered in this group. These individuals did not exhibit the typical behavioral response of favoring choices that are more frequently rewarded. This observation suggests a lack of reward-oriented anticipation and that their choices were less driven by reward feedback. Consistent with this change in reward bias behavior, beta activity in the ACC region was reduced and delayed in these individuals.
“In this study, we identified beta activity in the ACC as a potential biomarker for anhedonia,” said Sheth, also a McNair Scholar and Cullen Foundation Endowed Chair at Baylor. “Such a biomarker could have many potential benefits, including improving diagnosis and monitoring symptoms
Rice is home to a top-ranking bioengineering department whose faculty stand at the forefront of research in biomaterials, nanotechnology, genome engineering, synthetic biology, neuro-engineering and computational modeling. MD Anderson ranks as one of the world’s most respected centers focused on cancer patient care, research, education and prevention. By expanding prior and existing collaborations between the two
of patients with severe depression and other anhedonia-related psychiatric conditions. Moreover, our findings present an exciting possibility that modulation of the ACC beta activity might be effective treatment anhedonia, a hypothesis we plan to test in future clinical trials.”
The neurotechnology advancements of this research have advanced at a pace not previously possible due in part to funding by the National Institutes of Health Brain Research Through Advancing Innovative Neurotechnologies Initiative, or the BRAIN Initiative.
“This study exemplifies how BRAIN-funded research is already having an impact in the clinic today,” said Dr. John Ngai, director of the NIH BRAIN Initiative. “The innovations in data collection and individualized deep brain stimulation demonstrated in this study may enable a new generation of precision treatments.”
institutions, the Cancer Bioengineering Collaborative will work to accelerate innovative solutions to address unmet medical needs in cancer prevention, detection and treatment
Continued from page 12
due to power outages.
Preparing for Future Storms
“This advancement could significantly impact the treatment strategies for Alzheimer’s and related tauopathies, offering new hope for millions of patients suffering from these debilitating conditions,” said Sagar Gaikwad, first author of the study and postdoctoral fellow at UTMB. This study highlights the potential impact on future treatments for neurodegenerative diseases. Researchers at UTMB plan to advance this research by conducting further preclinical trials and exploring the potential of TTCM2-ms in human clinical trials. The goal is to translate these promising results into a viable treatment option for patients suffering from Alzheimer’s disease and other tau-related disorders.
Even without a storm on the horizon, preparing ahead of time is wise. Essential items to have on hand include:
• Generator: Permanent or portable generators can keep critical appliances running.
• Gas stove or grill: If you have an electric stove, you will not be able to boil water or cook.
• Flashlights: Ensure you have plenty of batteries.
• Water and Non-Perishable Food: Stock enough for at least a few days.
• Portable Batteries: For charging phones and other devices.
Physical and Financial Protection
Beyond immediate preparations, ensure you are financially prepared. Establish an emergency fund and review your insurance coverage regularly. A CERTIFIED FINANCIAL PLANNER™ practitioner can help you set up an emergency fund and choose the right insurance policies for your needs.
Final Thoughts
Preparation is key to minimizing the impact of storms. By taking proactive steps, you can protect your home, belongings, and finances. Stay informed, stay prepared, and ensure you have the necessary resources to weather any storm.
Disputes
Continued from page 1
this authority – Section 1128J(d) of the Social Security Act – is silent on the circumstances under which an overpayment becomes identified, while CMS purports to supplement the statute with its own interpretations for what the identification of an overpayment entails. Under Loper Bright, providers have more leeway to challenge the reasonableness of CMS’ independent requirements not found under the statute.
4. Overpayment appeals. Many CMS overpayment demands are founded upon alleged noncompliance with subregulatory guidance, which does not undergo the formal rulemaking process under the APA. Therefore, courts were not required to defer to CMS when adjudicating the validity of these overpayments. Notwithstanding, providers often have colorable arguments they have complied with
Oncology
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women diagnosed aged 63 years or older. Regular pelvic exams and awareness of family history or high risk hereditary conditions such as a BRCA mutation can help identify women at higher risk, prompting more specific diagnostic tests like transvaginal ultrasounds (TVUS) or CA-125 blood tests.
• Uterine (Endometrial) Cancer:
The most common gynecologic cancer in the U.S., with about 67,880 new cases estimated to be diagnosed in 2024, uterine (or endometrial) cancer primarily affects postmenopausal women. However, it can also occur in younger women, particularly those with risk factors such as obesity or a family history of the disease. Currently, there are no screening tests or exams to find endometrial cancer early in women who are at average risk and have no symptoms. Regular well-woman visits can help monitor symptoms such as abnormal bleeding and
the medical necessity requirements for the services under the statute(s) notwithstanding compliance with subregulatory guidance expanding upon the same. Loper Bright provides a stronger basis for providers to push back on these overpayments through the Medicare overpayment appeal process, and Administrative Law Judges (“ALJs”), the Medicare Appeals Council, and the district courts reviewing such agency actions and appeals should be even less inclined to defer to CMS’ overpayment determinations when they are founded on alleged noncompliance with subregulatory guidance standing alone, and providers may expect greater success with their appeals. While it remains to be seen to what extent Loper Bright ultimately affects provider reimbursement day-to-day and long-term, providers
should consult with their outside legal counsel to address past, present, and potential reimbursement issues to determine how Loper Bright presents them with new opportunities and tools to challenge contractor overpayments, conduct self-audits, determine whether voluntary overpayment refunds are warranted, and more – including challenging CMS’ regulations under the APA.
prompt timely intervention.
Screening and preventive care
Well-woman visits include important screenings based on age and risk factors. Regular check-ups during these formative years help to establish healthy habits and open lines of communication about sexual health.
For teenagers and young women, these appointments may include administration of the HPV vaccine, which is recommended to start at ages 11-12, but can be given up to age 26 (and in some cases, older).
For adult women, these visits become even more vital. Annual screenings ensure that any changes in health or risk factors are promptly addressed. For example, cervical cancer screenings should begin at age 25, and women aged 21-65 should have a Pap smear every three years, or a combined Pap smear and HPV test every five years if previous results have been normal. Starting the school year healthy
For girls, tweens, teens, and young adults, scheduling an annual physical exam with a primary care
provider before the school year begins is a proactive step toward maintaining health. These appointments can address issues related to puberty, menstrual health, and sexual education, providing a solid foundation for lifelong well-being. It is also an ideal opportunity for education and counseling. Physicians can provide guidance on diet, exercise, and other lifestyle factors that reduce the risk of gynecologic and other types of cancer.
Don’t let a busy schedule or lack of symptoms be the reason to skip annual well-woman visits. From comprehensive health assessments and vital screenings to preventive care that prevents gynecologic cancer, regular well-woman visits should be a non-negotiable part of every woman’s healthcare routine.
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