Archive for April, 2022

As Healthcare Officials Watch, Ban on NPI Funding Continues for Another Year – RACmonitor

After nearly two decades, passage of a National Provider Identifier remains elusive.

Since the Health Insurance Portability and Accountability Act (HIPAA) was passed and signed in 1996, a National Provider Identifier and many of the laws transactions and code set standards have been successfully implemented, and now have been in use for years. However, efforts to implement another type of identifier found in the act, a National Patient Identifier, have continued to be frustrated by Congress blocking any funding from being put towards it.

For the last two and half decades, Section 510 of the Department of Labor/U.S. Department of Health and Human Services (HHS) appropriations bill has constituted a longstanding ban prohibiting the use of federal funds in developing this patient identifier. However, for the better half of a year now, it was looking like the ban might finally be over, as the Houses version and Senates draft version of this years bill saw the section removed. Additionally, removal saw support from both sides of the aisle in Congress.

In spite of this, when Congress passed the final version of the Labor/HHS bill, Section 510 remained fully intact, ensuring that the debate will continue between those who believe the ban is outdated and those who think it is needed to protect patient privacy.

Section 510 was initially introduced in 1998 by former Congressman Ron Paul. Continuing the family tradition, his son, Senator and Doctor Rand Paul, remains passionate about prohibiting the development of any National Patient Identifier.

Citing doctor-patient trust and privacy, Sen. Paul worries both about security breaches and having intimate personal information centralized by the government. In a 2021 letter to the Senate Committee on Appropriations, Sen. Paul expressed his worry about a cradle-to-grave tracking system for private medical history of Americans, and recent attacks by hackers and cyber-terrorists.

Although Paul has not yet again filed his National Patient Identifier Repeal Act after it failed to move forward in 2019, his continued advocacy has proved to be an effective factor in the repeated renewal of Section 510.

In contrast, many healthcare and health IT groups believe that developing a National Patient Identifier is a keyway to innovate the healthcare industry and prevent potentially deadly misidentification and medical errors. While many among these groups acknowledge that Section 510 perhaps made sense back in the day of paper medical records, they believe that in the digital era, the only purpose it serves is to hinder both patient safety and progress in the healthcare industry.

Advocates say that the need for a national strategy on identifying patients has never been stronger than in times of COVID. They spoke to issues reported during the pandemic with COVID test results and vaccine records being matched to the wrong patient, hindering both public health efforts to combat the pandemic, as well as individual health outcomes for the patients involved, who might not have fully accurate medical records going forward.

Outside of the pandemic, a previous Office of the National Coordinator for Health Information Technology (ONC) study found that seven out of every 100 patient records are mismatched, and within healthcare entities, the error rate is typically close to 20 percent. That number dramatically increases when looking at healthcare entities that exchange information with each other.

Advocates believe that this disproportionately affects underserved and minority populations, as they are more likely to suffer from chronic illnesses that can lead to delayed treatment if their information is matched to the wrong patient. Advocates also suggest that this decreases potential innovation in healthcare by increasing administrative burdens and costs to the system.

Despite several signs seen in the last few months that it might finally be the patient identifiers time to shine, the Section 510 ban remains in place for now. There is little indication, however, that either side intends to give up the fight, so expect to see the debate continue into the foreseeable future.

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As Healthcare Officials Watch, Ban on NPI Funding Continues for Another Year - RACmonitor

Top Women in Business Spotlight: Aubrey Vaughan Travis of Rubicon – The Lane Report

By Lorie Hailey

(Editors note: The March issue ofThe Lane Report features our semi-annual list of the Top Women in Business. At lanereport.com, were shining the spotlight on one of the honorees each day. Day 9: Aubrey Vaughan Travis, executive director of the Rubicon Institute.)

Our occasional feature, Top Women in Business, highlights some of the women in and around Kentucky who are making an impact in business, the professions, politics and economic development. The feature recognizes women in key roles whose work ethic and body of work are making important contributions to commerceand lifein Kentucky.

Top Women in Business has grown to become one of The Lane Reports most popular features. Over the years, weve profiled nearly 115 women who shatter stereotypes, encourage other businesswomen and help their Kentucky companies reach new heights. The women featured in this issue are no exception. From president of the Kentucky Hospital Association to executive director of the Rubicon Institute, and the founder of Jeptha Creed Distillery to regional president of PNC bank and others, these women are forging their own paths, proving that hard work, perseverance and creativity pay off.

Aubrey Vaughan Travis is executive director of the Rubicon Institute, which pursues policy reforms to end waste on behalf of Rubicon, a digital marketplace for waste and recycling and provider of innovative software-based sustainability solutions to businesses and governments.

Title/company: Executive director of the Rubicon Institute. Rubicon is a software company that provides smart waste and recycling solutions for businesses and governments worldwide. Rubicon Institute is a brand-new project of the company dedicated to advancing innovative policy solutions that support ending waste. Rubicons global operations are based in Lexington, the home of its founder and CEO, Nate Morris.

Previous jobs/positions: General counsel for U.S. Senator Rand Paul; executive advisor for Gov. Matt Bevin in the Public Protection Cabinet; Kentucky state director for Right on Crime; finance committee manager for Rand Paul for President.

Education: B.A. in political science with a minor in studio art from Wake Forest University (2012) and juris doctor from University of Kentucky College of Law (2015).

Top accomplishment: My proudest accomplishment is the president signing into law two pieces of legislation I drafted in Sen. Pauls office.

Volunteer work: I love to volunteer with my church, Christ the King. One of my favorite events is their annual Oktoberfest celebration.

The person(s) who most influenced or mentored me: My parents, so many wonderful teachers and professors, great mentors in all of my jobsgenerally, people who pushed me outside my comfort zone to always be creative and curious, and to learn and grow.

My advice to younger women in business: I am a big advocate of the one-page resume and saving the details for your interview or LinkedIn. Also, apply to jobs that you want even if you dont meet all of the qualifications. You can miss out on so much if you dont put yourself out there.

Something I learned during the pandemic: Life skillI became a mom in 2020. New hobbyI learned how to brew kombucha.

Something I love doing: I love doing ink and watercolor art, especially for my friends weddingstheir signature drink signs, wedding maps, and envelope calligraphy. I also love trying new restaurants and exploring the outdoors in Kentucky.

When I was a child, I wanted to be: I have always wanted to be involved in politics, and I am so grateful to have worked in campaigns, the federal government, state government and think tanks throughout my career.

Im inspired/driven by: Always trying to leave the world better than I found it, even if it just means a small compliment or word of thanks to someone.

Where I do my best thinking: I have always loved working out of coffee shops, especially local onesthe caffeine and constant background noise help keep me going.

In the next five to 10 years, I hope to accomplish: Our goal with the Rubicon Institute is to make Rubicon the premier thought leader in waste policy, beginning with four main issue areas: space waste, waste as a national security issue, rural waste, and urban waste. Each area presents unique challenges in waste reduction, but our objective is to implement innovative policy and thinking to improve sustainable outcomes over the coming years.

Day 1: Kay Geiger of PNC

Day 2: Nancy Galvagni of the Kentucky Hospital Association

Day 3: Jeanne Schroer of Catalytic Development Funding Corp.

Day 4: Joyce Nethery of Jeptha Creed

Day 5: Carri Chandler of St. Elizabeth Foundation

Day 6: Nicole Yates of Passport Health Plan

Day 7: Meredith Moody of Buffalo Trace

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Top Women in Business Spotlight: Aubrey Vaughan Travis of Rubicon - The Lane Report

Republicans discuss impact of rising inflation, NATO weaknesses at American security conference – Fox News

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FIRST ON FOX: Republican Reps. Thomas Massie of Kentucky and Dan Bishop of North Carolina, as well as Ohio Senate candidate J.D. Vance, spoke about the consequences of record-high inflation and NATO weaknesses during the "Up from Chaos" conference hosted by American Moment, a conservative nonprofit, and The American Conservative magazine.

The Republicans expressed their constituents' concerns about paying higher prices in the grocery store and in the gas pump, as well as President Biden's response to Russia's invasion of Ukraine and NATO's purpose three decades after the end of the Cold War.

"My constituents are feeling the maleffects of inflation. The price of food and the price of fuel is going up. Its permanent. Its not going to go back down, and Im worried that its going to get worse," Massie told Fox News Digital in an interview at the conference Thursday.

"Im worried that Joe Biden may try to push through this Democratic congress another stimulus package or COVID packages, and Americans cant afford another one of those COVID packages."

Rep. Thomas Massie, R-Ky., at the "Up from Chaos" conference hosted by the American Moment nonprofit and The American Conservative magazine. (Fox News Digital)

Vance, the Senate candidate from Ohio and author of "Hillbilly Elegy," similarly told Fox News Digital that inflation is one issue he hears "most about on the campaign trail."

RUSSIA INVADES UKRAINE: LIVE UPDATES

"Inflation is very bad. Its one of the things I hear most about on the campaign trail. The way that I think about it is: youve got a lot of grandparents in Ohio, who, like my grandparents, took care of me. Theyre taking care of grandkids they werent expecting to take care of because the opioid problem is raging in Ohio, theyre living on a fixed income, and now, inflation is making it harder for them to put food on the table for their grandkids," he said.

"And that, at the end of the day middle-class people in Ohio are finding it harder to pay for basic things, and that is a huge, huge tragedy. And unfortunately, its one of those things thats forced by very bad policy from the Biden administration."

Vance also suggested that President Biden's $5.8 trillion budget proposal for fiscal year 2023 which would raise taxes by $2.5 trillion, largely be borne by Wall Street and the top sliver of U.S. households would make inflation worse.

Republican Ohio Senate candidate J.D. Vance at the "Up from Chaos" conference hosted by the American Moment nonprofit and The American Conservative magazine. (Fox News Digital)

"One of the reasons we have an inflation problem is because were spending money that we dont have," he said. "And so, if you say were not going to tax middle-class people, but then you propose a budget that causes inflation to go up by 10%, well, you are taxing middle-class people. Youre just doing it through inflation."

Rep. Dan Bishop, R-N.C., said that while the "American people are greatly sympathetic to the people of Ukraine," their "lives are being turned upside-down by crisis after crisis," including the border crisis and inflation.

WHITE HOUSE ECONOMIC ADVISER PRESSED ON BUDGET PLEDGE: IS INFLATION NOT A TAX ON FAMILIES?

"[G]as prices are $4 or $5 in some places and likely to get up into $6, $7, $8. We are crippling American energy production. Just terrible decisions on every front, and the American people are ready to make a change," he said.

Wednesday's conference featured speeches from several Republican members of Congress, including Sen. Rand Paul, R-Ky., as well as panelists from various Washington, D.C., publications and think tanks, centered around American security as it relates to Russia's invasion of Ukraine.

Speakers and panelists discussed a wide range of subjects from U.S. sanctions against Russia; the mainstream media's reaction to Russia's invasion; U.S. border security; and the purpose of NATO after the Cold War.

Sen. Rand Paul, R-Ky., speaks at the "Up from Chaos" conference hosted by the American Moment nonprofit and The American Conservative magazine. (Fox News)

The North Atlantic Treaty Organization (NATO) is an intergovernmental, military-political alliance between the United States, Canada and a number of European countries. NATO was founded after World War II in 1949 in an effort to protect NATO countries against threats from Russia then the Soviet Union.

Ukraine is not part of NATO, which plays no formal role in Russia's war with Ukraine, but Ukrainian President Volodymyr Zelenksyy has called on NATO officials to enact a no-fly zone over his country to stop Russian missile attacks. Most NATO officials have thus far denied those requests, citing concerns of a third world war against Russia.

END UKRAINE SLAUGHTER AND STAND UP TO RUSSIA, AMERICANS TELL BIDEN IN NEW POLL

Some panelists argued that NATO is not serving its purpose to defend the West from Russian aggression and has instead provoked Russia as NATO allies expand further East.

"I dont want to suggest that NATO is weak or should be weak or that we should abandon it in any way. But the way for it to be strengthened is for Europe to know that defending the integrity of Europe is primarily a European responsibility," Bishop told Fox News Digital.

Rep. Dan Bishop, R-N.C., at the "Up from Chaos" conference hosted by the American Moment nonprofit and The American Conservative magazine. (Fox News Digital)

Bishop and Vance pointed to former President Trump's demands that NATO countries commit to putting 2% of their gross domestic product (GDP) toward NATO defense.

"One way in which [Trump] really affected American thinking was about the NATO alliance and what should happen to it. The NATO alliance is very important to Western security, but Europe needs to be responsible financially for itself and, frankly, ought to be a very leading force in NATO rather than be dependent upon the United States," Bishop said.

Vance said that while the United States is "still a global power," but that could change if the government keeps "making very bad decisions, especially here at home."

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"Part of being a global power is having a safe and strong country at home. Right now, we dont have either, and so, eventually that global power starts to fade," he said. "I think about Donald Trump, who went to NATO and said, If you guys want to have an effective alliance, you need to keep your end of the bargain, versus Bidensometimes is babying NATO into weakness. If its going to be an alliance, the allies have to keep their end of the bargain."

Massie argued that the United States "should immediately reverse our policy of expanding NATO to every country that we can."

"Even if NATO were relevant and had a place in a post-Cold War era, it wouldnt make sense to include smaller countries that really dont benefit us in a mutual defense agreement," he said.

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Republicans discuss impact of rising inflation, NATO weaknesses at American security conference - Fox News

Ukraine In The Predicament Of Information Warfare OpEd – Eurasia Review

By Chan Kung*

Politicians in Europe are now waiting for Ukraines popularity to wane, so that they can get back to how things were in the past. Their current reluctant support for Ukraine is after all, a result of mass pressure. In the United States, Senator Ron Wyden, chairman of the Senate Committee on Finance, expressed concern that the bill to halt normal trade relations with Russia and Belarus has not been introduced. Although President Joe Biden has just visited new European countries, it remains to be seen how much role can the enthusiasm for Ukraine play in American politics and in the Democratic Partys election.

For this reason, Senator Mike Crapo, the ranking Republican on the panel, said to CNN that, I wish we had been able to move last week. But as you know, in the Senate, we have to get unanimous consent or spend a week or more on a filibuster battle. Weve been working really hard to get it put together and weve been making some progress. And my hope is that well be able to move soon.

What he was saying was that President Biden has previously proposed suspending normal trade relations with Russia and banning imports of seafood, vodka and diamonds from Russia to increase economic pressure on it for invading Ukraine. The move however, requires approval from Congress. The House passed the bill on March 17, a day after Ukrainian President Volodymyr Zelenskyy made an emotional appeal in a virtual address to Congress. Now the legislation has moved to the Senate, which requires consent of all 100 senators. If there is any objection, Senate Majority Leader Chuck Schumer might take time consuming procedural steps to overcome it, assuming he gets 60 votes. Kentucky Republican Senator Rand Paul objected to a quick vote, and demanded changes to the bills sanctions language, worrying that it would be too broad and could be potentially abused by the U.S. government. Nonetheless, Schumer refused to take more time to overcome this objection.

In political language, these twists and turns are attempted negotiations to reach consensus, but as for now nothing has been produced.

The problems in the U.S. may be a little more complicated than this, but in any case its enthusiasm in Ukraine is cooling down, and people are increasingly considering about real issues. With more considerations, there is less room for real actions. In the end, the support for Ukraine will become perfunctory, and any act taken would be constrained by the bureaucracy. The zeal for Ukraine cannot be underestimated, as it is related to a series of adjustments such as political bottom line, principles, and resources. How Ukraine responds to this is related to information warfare. Time factor is crucial in any form of passion; the longer the time, the lower the enthusiasm will become.

I think Ukraine now needs more new materials to sustain such enthusiasm. Unless Zelenskyy and his team can do this, the zeal of various countries for Ukraine will gradually dwindle. We will hear more impatient voices from the governments, the Congress, the refugees and from elsewhere. Such is the reality for information warfare. Ukraine can choose to wait for everything to pass, but of course the condition for this would be that it could still hold on. Russia too, may opt for this strategy to deal with information warfare.

The test for Zelenskyy and his PR team has come.

*Chan Kung, Founder of ANBOUND Think Tank (established in 1993), Mr. Chan Kung is one of Chinas renowned experts in information analysis. Most of Chan Kungs outstanding academic research activities are in economic information analysis, particularly in the area of public policy.

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Ukraine In The Predicament Of Information Warfare OpEd - Eurasia Review

The far-right’s vision of environmentalism has long roots in the US – NPR

The modern environmental movement and the far-right movement might appear to be on opposing sides of the political ideology spectrum. But overlap does exist and researchers say it's growing. Christian Aslund/EyeEm/Getty Images hide caption

The modern environmental movement and the far-right movement might appear to be on opposing sides of the political ideology spectrum. But overlap does exist and researchers say it's growing.

At first glance, the modern environmental movement and the far-right movement including anti-immigrant and white supremacist groups might appear to be on opposing sides of the political ideology spectrum. But overlap does exist.

Researchers say this intersection between the far-right and environmentalism is bigger than many people realize and it's growing.

"As climate change kind of turns up the heat, there's going to be all sorts of new kinds of political contestations around these issues," Alex Amend said.

Amend used to track hate groups at the Southern Poverty Law Center. These days he researches eco-fascism. He says once you start to look at this overlap, you find two big misconceptions.

"One that the right is always a climate denialist movement. And two that environmental politics are always going to be left-leaning," Amend said.

Conservative leaders from Rush Limbaugh to former President Donald Trump have certainly denied climate change in the past.

But today, a different argument is becoming more common on the conservative political fringe.

On the podcast "The People's Square," a musician who goes by Stormking described his vision for a far-right reclamation of environmentalism.

"Right-wing environmentalism in this country is mostly especially in more modern times an untried attack vector," Stormking said. "And it has legs, in my opinion."

"Attack vector" is an apt choice of words because this ideology has been used in literal attacks.

In El Paso, Texas, in 2019, a mass shooter killed more than 20 people and wounded more than 20 others. He told authorities he was targeting Mexicans. He also left behind a manifesto.

"The decimation of the environment is creating a massive burden for future generations," the shooter wrote. "If we can get rid of enough people, then our way of life can be more sustainable."

Abel Valenzuela, local of El Paso, meditates in front of the makeshift memorial for shooting victims at the Cielo Vista Mall Walmart in El Paso, Texas, on August 8, 2019. Paul Ratje/AFP/Getty Images hide caption

He titled that manifesto, "An Inconvenient Truth," which was also the name of Al Gore's Oscar-winning 2006 documentary about climate change.

Anti-immigrant environmental arguments pop up in more official places too like court filings.

Last July, Arizona Attorney General Mark Brnovich filed a lawsuit against the federal government. He claimed that the Biden administration's decision to stop building the border wall was a violation of the National Environmental Policy Act.

"I wish people like, you know, the environmentalists cared half as much about human beings and what's going on in Arizona as they do, or they supposedly do, about plant and wildlife, Brnovich said in an interview with KTAR News.

Brnovich argued that because migrants leave trash in the desert, a border wall is needed to protect the environment.

"We know that there's information out there that says that every time someone crosses the border, they're leaving between six and eight pounds of trash in the desert," he said. "That trash is a threat to wildlife. It's a threat to natural habitats."

Mainstream environmental organizations take the opposite view that a wall will harm ecosystems on the border. A federal judge ultimately tossed out Brnovich's case.

Workers reinforce a section of the U.S.-Mexico border fence, as seen from eastern Tijuana, Mexico, on January 18, 2019. Guillermo Arias/AFP/Getty Images hide caption

This strain of anti-immigrant environmentalism may be growing today but it isn't new. And that brings up another misconception that environmental politics are always left-leaning.

The truth is, eco-fascism has a long history, both in the U.S. and in Europe. Blair Taylor is a researcher at the Institute for Social Ecology. He said even the Nazis saw themselves as environmentalists.

"The idea that natural purity translates into racial or national purity that was one that was very central to the Nazis' environmental discourse of blood and soil," Taylor said.

In the 90s when Taylor started reading books about the environmental movement, he stumbled upon some ideas that seemed very wrong.

"There is this earlier very nativist, exclusionary and racist history of environmental thought," Taylor said. "It was very much based on this idea of nature as a violent competitive and ultimately very hierarchical domain where, you know, white Europeans were at the top. So that's been rediscovered, I think, by the alt-right."

Taylor was kind of horrified to learn that in some ways, the environmental movement was founded on ideas of white supremacy.

The word "ecology" was even coined by a German scientist, Ernst Haeckel, who also contributed to the Nazis' ideas about a hierarchy of races. This history applies to the United States, too.

A view of the Lower Falls at the Grand Canyon of the Yellowstone National Park on May 11, 2016. Mladen Antonov/AFP/Getty Images hide caption

Dorceta Taylor is a professor at Yale University and author of The Rise of the American Conservation Movement: Power, Privilege, and Environmental Protection.

Taylor's research helped reveal parts of American environmental history that had not been widely known.

"We see a taking of Native American lands to turn into park spaces that are described as empty, untouched by human hands, pristine, to be protected," Taylor said.

"Environmental leaders are very, very at fault for setting up this narrative around, you know, untouched spaces. And to preserve them, Native people must be removed, the lands taken from them and put under federal or state protection ... so this is where the language of preservation really crosses over into this narrative of exclusion."

Taylor read the notes and diaries of early American environmentalists and learned that the movement to preserve natural spaces in the U.S. was partly motivated by a backlash against the racial mixing of American cities.

"White elites, especially white male elites, wanted to leave the spaces where there was racial mixing," she said. "And this discomfort around racially mixed neighborhoods infuses the discourse of those early conservation leaders."

John Muir was a Scottish-born American naturalist, engineer, writer and pioneer of conservation. He campaigned for preservation of U.S. wilderness including Yosemite Valley and Sequoia National Park, and founded The Sierra Club. Universal History Archive/Getty Images hide caption

The connections between environmentalism and xenophobia in the U.S. are long and deep. In recent years, some prominent groups, including the Sierra Club, have begun to publicly confront their own exclusionary history.

"We're not just going to pretend that the problem's not happening. We're actively going to do the responsible thing and begin to address it," said Hop Hopkins, the Sierra Club's director of organizational transformation.

The organization went through its own transformation. In the 20th century, the group embraced racist ideas that overpopulation was the root of environmental harm.

In fact, in 1998 and again in 2004, anti-immigrant factions tried to stage a hostile takeover of the Sierra Club's national board. They failed, but the organization learned a lesson from those experiences you can't just ignore these ideas or wish them away.

"We need to be educating our base about these dystopian ideas and the scapegoating that's being put upon Black, indigenous and people of color and working-class communities, such that they're able to identify these messages that may sound like they're environmental, but we need to be able to discern that they're actually very racist," Hopkins said.

It's common to come across people who say they believe in the environmental movement and the racial justice movement, but don't believe the movements have anything to do with each other. That disbelief is why Hopkins said he does the work he does.

That work goes beyond identifying the racism and bigotry in the environmental movement. It also means articulating a vision that can compete with eco-fascism. Because as climate change increases, more people will go looking for some narrative to address their fears of collapse, says Professor Emerita Betsy Hartmann of Hampshire College.

"If you have this apocalyptic doomsday view of climate change, the far-right can use that doomsday view to its own strategic advantage," Hartmann said.

In that way, the threat of eco-fascism has something in common with climate change itself.

The problem is visible now and there is time to address it, but the longer people wait, the harder it's going to be.

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The far-right's vision of environmentalism has long roots in the US - NPR