cms. we'll talk about cms in the presentations. there is funding that comes in from cms to support medicare retirees in the advantage plans and then the remaining rate is what cascaded to sfhss and guides contribution splits between employers and members. so last year, the reconciliation worked quite favorably for us at hss. and that's what produced a double-digit decrease in the rate. so what is happening, we're reversing out that very favorable funding that occurred last year relative to the actual funding. and then there is an increase amount to reflect the funding difference that is expected this year going into 2020. now the other element that does not impact kaiser medicare, but did impact as we talked about, the kaiser non-medicare and we'll talk about it does impact uhc, is the affordable care act health insurance tax. so we've been on this every other year cycle for a few years. it first started with the passage of the affordable care act. the federal government waived this tax in 2017. it came back for 2018. the federal g

next, another former cms administrator. tom scully served as the administrator of cms for three years under president bush and currently is a general partner at welsh carson, anderson, and stow. he previously served as president and ceo of the federation of american hospitals for several years, and we're privileged to have tom serve as vice chair of our board. had is an attorney, received his degree from kaplan university. and last but not least, mark miller, executive vice president of health care at arnold ventures, where he leads the organization's work to lower the cost and improve the value of health care. mark has more than 30 years experience in implementing health policy. he was previously the executive director of the medicare payment advisory commission and held leadership positions at the congressional budget office, cms, and the office of management and budget. he holds a ph.d. in public analysis. so thank you again to all of you. with that, i'm going to go ahead and turn it over to karen pollitz to get us start

cms continues to be worse --. the uk government must -- non- payments of maintenance to children. but the deck take a full root and branch review of cms, to ensure a new strategy that maintenance payments are properly enforced. and these children, who in many cases are in poverty because of lack of maintenance payments. >> the honorable lady is right. but we want to ensure that both maintenance payments are indeed made to those children. that people, normally it's fathers. buddy cameron some cases be mothers. that they would take the responsibility seriously and recognize the responsibilities. this is a difficult area for many years. efforts are being made by different governments to ensure that we get this right, and that we ensure that those maintenance payments on may. every member of this house has constituency cases in relation to this issue. -- that were brought in recent years has been working better than previous system. but -- that the relevant departments at the case. >> >> thank you mr. speaker. in harlem, my constituency, many -- are tied up and tethered by the roadsid

around cms now allowing for medicare plans to allow enhanced benefits. you see the list of programs that were implemented for 2019 into the uhg ma ppo plan from transition support with transportation services and meal delivery post discharge, routine transportation services and nutrition counseling benefits. what we're recommending with the 14 meal delivery which is the same organization that provides the post hospital discharge delivery service today. and more information on the moms and meals program, we list out on slide 11. so this is a one-time shipment of 14 meals, home delivered, freshly made, annually per member. these are regardless of medical requirements. so there is no particular diagnosis, no medical reason to then qualify for these. these are available to all members who participate in the uhg ma ppo program. they would call the service, mom's meals nourish care to access the benefit. you can see an array of meal options to tailor to a particular individual's needs. breakfast, lunch and dinner options are available and a wide array of cultu

kavanaugh being at cms, you seen healthcare in a broad sense. this legislation basically seems to do three things. it's a price billing, a whole series of provisions aimed at transparency, increasing transparency, so, you can't reduce the cost until you know the cost. the third thing is, and you mentioned this yourself as a former regulator, we have nine provisions to try to increase competition for generic and similar drugs, which are 90% of all the drugs prescribed. if you look at the three areas of surprise billing, transparency, increasing competition, do you see those as meaningful steps and which one would have the most impact on reducing the cost of what people pay out of their own pocket for healthcare? >> sure, i don't see them is that different. i feel like surprise billing is addressing a failure of the market, where the consumer is not in a position to be in a consumer making choices position. they are going through transparency and that makes markets work and people know what they are doing. this is procompetitive policies and that'

. >> contestanos cm;compaÑeroa . >> en san jose tenemos 577 grads en el termometro, prove aprove p paraydsm tenctivi m tenemos san jose con el mecan mecanismo de r las nubs, es, del resto vemos s condiciones secas snotamos cd condiciones de actividad de ll v lluvia se nmamabntienntienen s precipitaciones severas, tenemos granizos durante las proximas o horas tenenonemos el fin de semd durante la inestabilidad, vere veremos precipitacion lÑigera en regfioniones . >> y maÑana el termometro marca los 89 grados , en 77 en santa r rosa, no me extraÑa que estas temperaturas continuen aument d aumentando la proaxima semana ,y nbote otye l que vemos en est s momentos en las montaÑas, ten o tenemos inestabvilida precipitaciones en el este de a san jose lo notamos para el dia dopmingomingo todo depende de o tormentas, el domingo eeverem n incremento en la nubosidad y i e inestabilidad en la atmosfera , en la roprioxaocxima tendremos t te temperaturas en santa cruz con 68 , aqui tendremos temperaturas mas frexscasscas tenenos mejor n y calor el fin de semana, le e echanmosmops un vuiistazo al p n

cms said that.hat are your thoughts on the rebate rule and is it as beneficial as some might believe? sen. stabenow: i'm a skeptic. folks have been able to game it. i think there are people sincerely trying to work within the current system, but i also just know in the end it's about the bottom line. do we pay more, do we pay less? highest in the world, lowest in the world, somewhere in between? we have the highest prices in the world. just my cost-benefit standpoint, a value standpoint, you have to step back and go with does not matter how we change the chairs on the titanic. the ship is going down. we need to be focusing on the big picture, which is why i go back to medicare negotiation. you can cut out a lot of the stuff if you have -- if we believe in competition, we are a ,ountry based on competition the negotiating power of medicare should be brought to bear. just like any other large business. general motors, ford negotiates. a lot of companies use collective purchasing power. medicare is res

i worked at cms. i published regulations all year long, centrally administering prices, in a previous career worked at the maryland rate setting system, i set all rates in maryland, and whenever possible, rely on competition, not regulation. i applaud the approach the committee is taking to try to ensure competition works wherever possible. we believe maintaining a robust physician sector is essential to supporting competition and high value care. unfortunately this approach is at risk as hospitals have been purchasing physician practices and hospital consolidation is a growing impediment to competition and high value care. over half the markets in the country are considered highly consolidated by objective standards of hospital consolidation. we know when hospitals merge, prices includes, quality stagnates. hospitals argue it will lead to greater efficiency and more coordinated care but the evidence doesn't bear it out. gag clauses, anti-tearing and all or nothing clauses are prime examples of excess

cms.are your thoughts on the rebate rule and whether it's as beneficial as some my belief it is? >> well, i'm a skeptic. because every time we've tried to do something, folks have been able to game it. and so i think there are people sincerely in there trying to work within the current system. but i also just know in the end -- to me, it's all about -- bottom line, in the end, do we pay more? do we pay less? are we the highest in the world, lowest in the world, somewhere in between? we are the highest prices in the world. so, you know, just from a cost benefit standpoint, value standpoint, you've got to step back and go, doesn't matter how we change the chairs on the titanic. the ship is going down. and so we need to be focussing on the big picture, which is why i go back to medicare negotiation. you can cut out a lot of this stuff if you have -- if we believe in competition, we are a country based on competition, private sector markets competition, you know, the negotiating power of medic

anand althgh t the w in sysyriis not t over yet, a measurof c cm now prevaiails in the nortrthe. sheikh humumaydi hopes he e canp shape postst-war politicics. sheikh humaydi: if you want to solve problelems, the tribes ae important. 90% of people here belong to a tribe, whether they're arab, kurdish, or christian. we all share the same culture, because these local tribes all have the same traditions and customs. reporter: humaydi's palace is in tell alo, a small village in northern syria. this is where the shammar leader meets petitioners,s, allies,ndd otheher shkhs. together witith his advisosorse decides onon issues affefectine shammar'r's future. he alslso mediates i in dispus between members of the tribe d didistrites aiaid the needy. tell alo i is a long wayay from damascus. that'slwlways affordeded the shammar a a certain autotonomn their dedecision-makining. the tribal leaders even acasas a susubstite foror ctral governmement. the sheikh's's revenues cocomem the region's oil fields an lls s levi on trtravers. they payay for his mililitia d support t for tribal m members. h

we filed, swift hhs and cms as a look into things like for lillard design in part be that they can takeis. the rebate role will go in part towards addressing that but what we have to make sure of is if the discounts in the marketplace go from sort of backend rebates to find in discounts that the same type of what's called rebate trap doesn't apply to the front in which is out due to higher discount on the front in project promise me a follow-on competition isn't going to get access to your formulary. there's litigation on this not between one of our members but between two branded company sponsor issue anything that's going to be seminal to see how that plays out. >> when he generic comes out, when several generics, , out there, especially with molecules the price drops precipitously. i'm skeptical that the same old trooper biosimilars. if you have bio summer comes out it will be cheaper, less prices such as it will be cheaper but this is not the drop off you see with generics, multiple generic. do you foresee the biosimilars industry creating the same kind of savings that you see an sm

i would much prefer to have a top rated, aaa rated clo or cm bs, rather than taking idiosyncratic creditsks later in the cycle and being more exposed to the economic cycle. that is something you need to dampen. what you see time and again in cycles is that people reach for the yield. they need the yield. they play the role and carry, and then it ends badly. i don't want to be in a position where it ends badly. i want to be front footed. i think a way to do that is to insulate yourself through some of the structured product trades. jonathan: andy? andy: i would agree with you. i think the challenge with high-yield is the entry point in terms of price. it is not just pimco and jpmorgan feeding the rally, it is the 16 issuers you referenced on the tape. i think the real challenge there is we are not in a situation where i feel the economy is about to roll over, certainly the interview with richard clarida this morning, he didn't seem nervous in any way, even at 6:30 in the morning. jonathan: i would agree. andy: structured products, securitized products, that is the one area we quite like.

i was there at the time working at cms.figured that medicare would be at a price for these drugs in perpetuity. we never envisioned to be such robust competition. we figured there would be one inhibitor or two. a couple on the marketplace. we never thought there would be a dozen different competitors for inhibitors and interchangeable products you can use in lieu. we never ever thought to be that much competition. we thought these would be natural monopolies. they are not. there is robust competition, but we are still not taking advantage of that because we are stuck in a system that was conceived in a time where we didn't think there would be any competition. bob: a theme of today's event is thinking about drugs being affordable in the future and we cannot ignore a recent gene to -- therapy that was approved recently from novartis, treats a rare spinal disorder in infants and children. it came out with a list price of $2.1 million or so, the most expensive drug now on the market. when we are thinking about the future, and

when you get into pricing and other aspects of that, for example negotiation with the companies by cmshalf of medicare and medicaid, that seems to be running into roadblocks. the house has been very active, but the senate does not seem to want to take that up. and that is unfortunate. that is something that would help the american people tremendously. does that seem like a nonstarter at this point with republicans? >> with their record today of significant legislation passed by the house and no real consideration, frankly, we have been doing nominations now for the last several months. we hope we can get onto the national defense authorization act, which is another rare, bipartisan effort. but there is a lot of legislation piling up that we should be pie -- voting on in the senate and we are not. is all the time we have. i would like to thank senator ray for joining us. us -nator reid for joining senator reed for joining us. >> thank you. >> john adams was not a democrat. in the spectrum of the founders, really those who believed what they said, that all men are created equal. and jeff

platform, carved out, put it into a new company, and are building a company that will be a leading cmsou don't see private equity traditionally do that, but we have those capabilities. carol: you have that depth of knowledge. >> and scale of capital. capability to understand, to build companies, and to deploy large-scale capital. jason: what are you avoiding right now? >> anything high-priced. carol: where are you finding things most high-priced? >> we have been of the view that ever since recovery, where a lot of money has gone into stability kind of deals, deals that are low growth, that do not have continuity, they are stable. a lot of of people are going into those safe haven and paying for that stability, leveraging it to higher and higher levels every year. in that perspective, we think there is a risk for stable assets that have been overpriced because of the liquidity and credit support it got from central banks. carol: what are other areas you find interesting? >> we have a thesis on disruptive consumer brands. canada goose is the most famous, but we have done several stories

. >> the cm a. >> that would be more fun. >> wow! >> donna called in. are you there? >> i am here.ank you for taking that day off. >> [laughing]. >> i provided the food and the groove. [muffled audio]. i was dana's background. we were like the supremes with 2 temptatio temptations. it was fun. oh my god, i had a great time. i downloaded it and my family did. that's why it's number 1. i can't wait to do another song with y'all. greg, if you go to the grammys without me. >> i will make sure you get to the after-party. >> please. >> donna brazil, you are a big reason it went to number 1. >> i was embarrassed. someone i know in the country music industry. i got a text saying congratulations on your number 1 song on the country charts and they have worked their entire career to get number 1. >> taylor. >> yes, taylor. she called me. she was upset when we broke up in 2010. this is salt in the wound. >> blake shelton, has to wonder where did this come from? >> watch your back. >> this is grassroots. we have a treat because our producer together a music video, the first "the five" music vi

neither the fda or cms has anybody for making the determination that the artifact and monopoly. then doing something about that original determination once it has been made. this seems to me like the basic economic question. we have tried to keep control over monopoly pricing. we offer exemption for monopoly under the patent law to encourage some type of investment. the idea that a speculator should be able to take advantage of the monopoly. have to rely on the fda coming in. now you cannot charge anything you will please. quizzically we know that your company was charging a lot less than it doing fine. the fact we will not address that problem suggest to me the complete political dysfunction around this issue. why they should be allowed to export monopoly prices with no response. that is not the free market working. anyways, my time is up. if anybody has any comments on that questions for the record, i would appreciate it not just on the patent but to gain the extension of the lessons monopoly. how we can do better with that. >>> thank you for holding a hearing on this issue. d

platform, carved out, put it into a new company, and are building a company that will be a leading cms you don't see private equity traditionally do that, but we have those capabilities. carol: you have that depth of knowledge. >> and scale of capital. capability to understand, to build companies, and to deploy large-scale capital. jason: what are you avoiding right now? >> anything high-priced. carol: where are you finding things most high-priced? >> we have been of the view that ever since recovery, where a lot of money has gone into stability kind of deals, deals that are low growth, that do not have continuity, they are stable. a lot of of people are going into those safe haven and paying for that stability, leveraging it to higher and higher levels every year. in that perspective, we think there is a risk for stable assets that have been overpriced because of the liquidity and credit support it got from central banks. carol: what are other areas you find interesting? >> we have a thesis on disruptive consumer brands. canada goose is the most famous, but we have done several storie

the national institute of justice found that having a cm record reduces a person's chances of getting a job offer by 50%. 75% of people living in paper prisoners say it prevents them from getting a job. under the clearance system, each record system cost the state over $3,500 to process but with this automated system, the cost plummets to just $.04 per record. as a city, we said to the world, we must do better in instituting restorative justice. folks who have paid their debts to society or who never owed a debt must be able to access jobs, housing and other opportunities without encountering roadblocks that would be removed if they had the means to do so. i want to thank you for the time to speak on this and i hope you will move this forward with a positive recommendation. >> thank you. doesn't look like we have questions for you so i will open this up to public comments. >> this is a good law and it's a derivative of the infractions of jaywalking tickets, open container, infraction laws, tickets are generated for infractions, not a misdemeanor, but infraction. i believe his name is

. >> if it may, please the court it did not require cms to go through notice and comment rulemaking before it could furnish its calculation of one component of a hospital's reimbursement to the contractors that performed the initial reimbursement for the agency it was not binding on the agency or the courts and it could be challenged on administrative appeal as the respondents did here. >> i have a problem with this. i know that you say that, but i don't know how you take this outside of being a policy that it applies to every single provider uniformly. i don't know the basis that you have an individual adjudication and what would happen if they say we will not listen if we are -- even though we are required to listen to the agency's position. if one case tells you it is wrong then is that the new policy? i'm a little lost as to how this isn't an agency policy. >> several points, the first is that we are relying on the operative language whether the issuance is called a policy or a requirement it only triggers notice and comment rulemaking if it is changed from the subsequent legal standar

and we're also engaged, we're monitoring, we're monitoring prices, there's a cms survey, of the prices that pharmacies pay. and so we're monitoring that to see if prices, if there are any price spikes in which case we look to investigate what those are and see if there is an enforcement action what is appropriate. >> thank you. thank you for your testimony. and look forward to working with both of you in the year ahead. thank you, chairman. >> senator moran. >> chairman, thank you. chairman simon, i've heard from kansas companies about criminals who are buying words on search engines that make their fake tech support web sites show up at the top of the list when someone searches for a tech product support. these criminals run i assume complex organizations and are able to trick someone into thinking they are talking to the tech companies product support and then convince the consumer to provide remote access to their computers. they infect their computers with virus, and charge them hundreds of dollars to remove the virus, sometimes accessing their bank accounts as well. do you have an

we will be right back. 4 in 1 cm to kill 99.99% of odor causing bacteria. polident. clean. fresh. and confident. of odor causing bacteria. what do all these people have in common, limu?oug [ paper rustling ] exactly, nothing. they're completely different people, that's why they need customized car insurance from liberty mutual. they'll only pay for what they need! [ gargling ] [ coins hitting the desk ] yes, and they could save a ton. you've done it again, limu. only pay for what you need. ♪ liberty. liberty. liberty. liberty. ♪ if you have moderate to little things can be a big deal. that's why there's otezla. otezla is not a cream. it's a pill that treats plaque psoriasis differently. with otezla, 75% clearer skin is achievable. don't use if you're allergic to otezla. it may cause severe diarrhea, nausea, or vomiting. otezla is associated with an increased risk of depression. tell your doctor if you have a history of depression or suicidal thoughts or if these feelings develop. some people taking otezla reported weight loss. your doctor should monitor your weight and may stop tr

worries at this hour, now china figures into this scene, jamil, foreign senate committee adviser and from cm ira epstein, china is getting involved, president xi of china is having conversations with iran and not the likes of what we saw with shinzo abe of japan who is trying to play peace maker, do we have a new access of evil that involves iran, china and i will throw in north korea? >> look, liz, we saw last week vladimir putin defending china in trade conflict that we had, the u.s. with china, china supporting iran, north korea has always been bad actor supported by china, there's definitely a theme going on here where the people who are not supportive of u.s. policies are coming together in various combinations, whether we have real acts of evil or not, certainly a collaborative interest that they have against us and to push back on u.s. influence and frankly they've been pretty successful and that's a real problem for us as nation and national security. liz: iara, access of evil by president george herbert walker bush back in the day, iraq was in there but no longer an issue for the mo

we had a discussion of the cms based three regulatory requirements. and at that time the committee discussed how these changes in the requirements will impact the quality work and the hospital overall star ratings. they're based on this requirement and there is change in the ranking, so it has some impact, so we want to follow up on that. the presentation on the changes to the star ratings is on your desk, commissioners. the committee also recommended that the full health commission approve the laguna honda medical staff by-laws and rules and regulations which were presented and approved by the j.c.c. and also approved the hospital-wide policies and procedures. in closed session, the committee approved the credential report. thank you, that's the entered of my report. >> thank you. is there comments or questions from the commission? great. commissioners, i didn't pick up that report. i left it in the copier. i apologize for that. item 11, closed session. >> so moved. >> second. i'm not receiving a public comment on this item. >> all those in favor of

veterans and wives and widows in front of the home, one of the couples i want to tell you about is cm strauss. charles maxwell strauss was 17 years old when he joined the fourth battalion louisiana infantry in 1863. as soon as he was old enough to serve, he did. he served in the war, he was never winded. he was involved in several significant campaigns including the atlantic campaign. he was involved in the defenses around jackson. he did suffer from illness frequently during his service. furloughe on a sick when the war and. .- ends/ i want to share their story because they are probably in that photograph. i have no idea what they look like. we don't tend to have their letters or connections to them. strauss, when he came to the home, he never started -- stopped being involved in the community. he had a regular column in the newspaper. the local paper started a section for the home. he would report on everything. sometimes it was competitor it veterans. sometimes they were bible lessons. so-and-so just came to the home. constantly engaging the community with the home. news, weddingsr

idea that over the past three or four days, they have been laying the table and also the east get 46 cmecific slot that each person has and that has been measured out by members of the royal household staff. in the attention to detail is incredible, it is exquisite when you see it and that is what the state banquet is all about. the former communications expert that the queen told me earlier, she goes around the critical eye for anything that is out of place, everything has to be just right. this is 113 state visit she is quite accustomed to it. she knows what she is looking for. so, she has definitely been in command of are she has definitely been in command ofarea she has definitely been in command of are a lot of details and it is something she has had to do. a lot of this has been passed down through history, queen victoria, she started the tradition of the pipers piping in the ballroom itself, this magnificent room which is been around since 1914, do you think there of ever seen a guest like this? this is a different kind of president. is clearly, there's been some very difficult g

before my class, i cm the affirmative action.bies of 1972 women basic fundamentally covered, uh, what we call the soft i hues. we coverlth recovered first ladies, we covered parties, but after action we were covering the pentagon, we we covering politics. we were covering the white house. r everything just washed o.no >> woodruff: pnal journalist and pioneering lesley stahl. yo u can find all episodes of our program on facebook watch at that moment when show. d that's the newshour fo tonight. i'm judy woodruff. join us online and again here tomorrow evening. for all of us at the pbs newshour, thank you and see you soon. >> text night and day. >> catch it on replay. >> burning some fat. >> sharing the latest viral cat! >> you can do the things you like to do with a wireless plan designed for you. with talk, text and data. consumer cellula learn more at consumercellular.tv >> babbel. a lang real-life conversations in a new language, like spanish, french, german, italian, and more. >> and with the ongoing support of these institutio

office issued a weather warning late on sunday and into monday, thunderstorms can bring risk of 20 to 40 cm o'clock. the final two, boris johnson will face jeremy hunt eight o'clock. the final two, boris johnson will facejeremy hunt in the race to be the next prime minister after michael gove was eliminated in the latest tory leadership ballot. the conservative parties 160,000 members will now choose the winner and will be announced towards the end ofjuly. chancellor philip hammond said that a no deal breaks it would harm the british economy and it does vying to be the next prime minister need to come up with a plan b. drip's leaders held talks in brussels for deciding who will get the eu's top

cms is violating the parity law, violating federal law, the largest payer in this country. every major insurer has been found to be in violation of this law, which basically means it's been okay in general public for us to go along as if nothing's happening. and that's the big denial that as a nation we really need to confront. i just want to thank bob gebbia and american foundation for suicide prevention because they are ramping up the political efforts necessary on both sides of the aisle to actually tackle this from a policy standpoint. >> what is mental health for us? >> mental health for us is an opportunity for us to play a role in this 2020 cycle to get both parties to understand that in their platforms, we expect these things to be covered. now, we have voluminous reports on what to do to help stem this crisis. i mean we know what to do. what we're missing is the political will to do it. what we hope to do is join in a coalition of mental health groups, mental heal for us.net, and go around the country and both educate advocates, educate candidates, and educate thos

i took one of the cms classes two decades ago and were talking about postcard campaigns a set of email campaigns. the conversation was i have a limited number of staff that could be making a real difference for constituents. they could make a real difference for public policy but they are bogged down in what is not in engagement but response. what is quality constituent engagement? >> i'm so glad you asked that. that is the direction that the cmf is going. we want to look at constituent engagement holistically. right now it is pretty much siloed. your district offices of townhall meetings. but if you looked at the relationship, the entire interaction, the connection that constituents have with you and looked at it as a relationship which will scare your staffers to death. the idea you want to build relationships. but you do if you want that constituent to have a positive user experience and looking at it holistically and not through the silo. yes yourself, what is a high- quality interaction? did they ask a question? what is a form? is it online or more restrictive that doesn't allow t

i've got to be honest with you i met within a few weeks ago and the secretary and the head of cms allseparately and have been so impressed with the responsiveness to some of the new ideas we've put out there. the pharmacy rebates, it's not a rebate, it's a kickback to the middleman. they call it a rebate like it's a nice thing. it's a kickback to the middleman. we explained it, they got it and they were on top of it and announced no more kickbacks they want 100% of those so-called rebates to go directly to the patients who exhibit the middleman taking money out of the system. system. we'll see if it passes the rules and legal challenges that they are listening and they are doing some good stuff so there is good and bad and when we see some of the good announcements i know too many healthcare journalists that are saying basically this makes him look good as we are not going to cover it. i see the bias. "the wall street journal" just this week said the administration is going to push for total transparency of the negotiated prices that are paid at that amount from insurance companies an

right now specific to cms vendors, our constituent management service vendors, there are five approved vendors but 90% of the market is given to two. i don't think that is right for innovation on how to make our underlying technological backbone be able to better communicate with our constituents, which is the goal of this whole hearing today. and thank you, all, for your testimony. i've learned a lot. i appreciate that. we need to have more competition. i believe that. and i believe the technology or lack thereof in many cases of the house and within the cao is limiting what we could do to talk to our folks. we still have to balance things like speech and debate clause within that operation. so doctor, you spent an enormous time researching and writing about connecting people and their representatives. what are some states or countries that do a better job in this institution -- than this institution with regards to connecting citizens to elected officials? we don't have to reinvent the wheel. what else is out there? >> thank you for the question. so as i briefly mentioned before, ire

the blue ridge mountainsjust to the west of sydney had five cm of snow.g off to new zealand, and the strong southerly winds, we still keep the southerly winds, so temperatures on the chilly side here. at high pressure in control, a good deal of dry weather is expected, at the same time, that stormy weather is heading toward the north island of new zealand, with further wet weather to come as well. into the south island later. over to europe now, as we‘ve got rain pushing into western france, some of that torrential. we have seen significant thunderstorms so far this week in central europe. we‘ve also got some sharp thundry downpours continuing through the balkans, bulgaria, and into romania, but much of the mediterranean is fine, settled and sunny, and some of that heat is still pushing its way further north and east, nearly 30 degrees in moscow, 32 degrees expected in to berlin. more details on the uk‘s weather, where it‘s going to say pretty stormy and unsettled coming up shortly, but as we can see the best of the sunshine, madrid and rome. take care. h

and she hasom cms brought medicaid managed care to our state. what an opportunity for the medicaid providers, organizations, entities. they are talking to us about tonging family kenexa medicaid families as a way to reduce their costs because if they are responsible for health and they have limited dollars. >> let me stop you. toyou have the opportunity show the program -- to show the state that your program will save dollars. dr. dodge: the easy answer is that we will save so many dollars that it will be obvious. that is the easy answer. it is a tough one. i think we have to seize upon creative opportunities. in north carolina, there are six regions in the state and six medicaid entities have been given contracts. why not randomly assigned some. or do the best you can. i think we have to with every community go into it and assess what is in the community and ask what is our best chance of evaluation here and then apply those. l.a.ey are doing tests in now to show that we can save dollars. and also thinking about the fourth trimester for women a

. >> i saw t cm aple years ago down in miami. heck of a show. top five. could. >> no no. thank you so much. >> coming up can you feel the love this morning? anirst liste to beyonce in the new "lion king" remake. >> also, an epic scavenger huntr osal goes viral. was the couple behind it just huntingor clicks? we'll have that story after your local news and weather. "ahh" [water sfx] [bottle opens] [horse sfx] "ahh" [ocean sfx] [bottle opens] "ahh" yoaw! who used expedia to book the vacation rental which led to the discovery that sometimes a little down time can lift you right up. expedia. everything you need to go. expedia. ♪ protect your pet with the #1 name inlea and tick protection. frontline plus. trusted by vets for nearly 20 years. everybody has a great story to tell, and our job as producers is to help pull that story out. my name is taylor, and i am a producer for tv and podcasts. the whole rfoduction is on my suace laptop. it's very powerful, and just speeds up your whole day. i always have at least 4 or 5 programs open on my computer. i do need y

tiene que ver con 30 cm alejado de nosotros. creo que estamos como quitando se declara admiraciÓn por parte de esta diputada. se ve que despuÉs de que la separan existe una atenciÓn. asÍ vemos que lavÓ __la bolso a la pone como cierta manera. me gustarÍa darle seguimiento de los prÓximos encuentros que tienen estos personajes para ver quÉ ocurre. pero serÍa muy arriesgado decir que hay un interÉs . sÓlo se ve una clara admiraciÓn y sobre todo un deseo de estar muy cerca del mandatario. karla: el presidente de estados unidos estÁ de visita en reino unido, probemos caminando junto a la reina. >> tratando de imponerse al menos con la reina. hay otro vÍdeo que fue muy interesante de analizar. lobo que valdrÍa la pena rescatar es que despuÉs de su discurso, parte del protocolo es poder tocarla reina y Él hizo la ruptura de protocolo, donde a la reina, y que buscaba generar un poco de conexiÓn. en los vicios donde vemos estos personajes, por primera vez trump se muestra con cierto respeto y cierta posibilidad de no ser tanagresivo com

, aoc is going to have an argument if those go terribly wrong, and you do see kids in cages, you do cmslicy has to be laid out, and it has to run like clockwork. that is where the president is going to have to go in whatever he does going forward. that is a big thing. he hasn't done that yet. >> it is part of a broader trend that we have seen, going more liberal on abortion, immigration, marijuana. red states going more red. >> bill: that's the clear choice. >> going back to ron desantis and most controversial sanctuary cities ban, the aclu of florida responded, they put out a tweet that it is unconstitutional, inhumane. he says this is about public safety. of this is not about politics. the president applauded him and this measure. >> i think if you also look at polling, the majority of americans don't believe in sanctuary cities. giving refuge to people who want to do harm here in the country. a lot of these individuals are doing so in sanctuary cities. i think there is a national security conversation, as ron desantis pointed out. if you look at polling numbers, he had highest marks

now many of the doctors are afraid of the d.e.a., the drug enforcement agency and also cms sometimesis still a lot of misconceptions and, yes, we had to cut back on prescribing. there is no question that too many doctors were a little too liberal. they had a low threshold for prescribing for acute pain, especially. this is pain, you know, if you break your ankle or something. they give too much at a time. it weensd up in medicine chests and then flow out. all that needed correction. but we have gone too far. steve: yeah, there was no balance. so have you heard from patients who needed the stronger drugs and now they are getting them again after this correction? we have owned heard from the people who didn't succeed unfortunately with their doctors. it's desperate. my colleagues and i get at least 10 letters between us a day heart wrenching and one of our group is keeping a registry of people who killed themselves. brian: lapsely, real quick, do you believe the pharmaceutical companies actually got us started on this mess and the addiction morass we are in right now? >> they are part

the medicare rates are set, physician rates are set by cms largely with consultation of something called the rock. the ama's advisory committee on what physicians get paid. there are $140 billion we're going to assign a primary care physicians, a surgeon gets 1 150,000. they do similar thing for hospitals. every hospital with lots and lots of adjusters gets paid the same thing. medicare sets those prices. medicare advantage takes all of the costs together and puts it in a pot over the years there has been a difference. it's generally become pretty close. the payment largely flex the payment of medicare fee for service is. >> i think the last map i saw was 103%. there may be something more. >> but it's very close. >> last time it was 112%. >> it's actually right at 100% now. there was a drafting issue in 2003 bill which i was involved with. both pots theoretically going up and down depending on the results. better results from private care company and better results from medicare fixing prices. lot of debate either way. >> so, two points to add to this, first of all the medicare cost stru