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Mikel Arteta has called on Arsenal to make a Champions League statement with a win at Sporting. The Gunners have failed to win – or score – in their last four European matches on the road. Advertisement A narrow 1-0 defeat at Inter Milan last time out has left Arteta’s side down in 12th place in the new-look Champions League table. London to Lisbon. ✈️ Champions League football returns tomorrow ⭐️ pic.twitter.com/oOhGLN9WSA — Arsenal (@Arsenal) November 25, 2024 Advertisement And the Spaniard believes a victory in the Portuguese capital, against a Sporting side who, when still managed by Ruben Amorim, thumped Manchester City 4-1 earlier this month, will prove they belong in elite company. “It’s certainly something we have to improve,” said Arteta. Advertisement “I think we have made the right steps and, looking back with the way we played against Inter, which is a team that has been so dominant in their league, reached the final of the Champions League which they should have won, to play and dominate that game. “But the reality is that you have to make it happen and we didn’t. “Making those steps is what we have to do next. Be ruthless, be efficient in the opposition box and do what we have to do to take the three points away from here.” Sporting are now managed by Joao Pereira, who has been promoted seamlessly from the reserve team in the wake of Amorim’s switch to Manchester United. Advertisement “The run they are on is incredible,” added Arteta. “That tells you that it is not only the quality, the set-up, the ambition, it is something about the team energy that they have. Advertisement “That is a great challenge that we have tomorrow, to come here and make a statement and show we are capable against this kind of opponent. Be ourselves and win the game.” Kieran Tierney was a surprise addition to the travelling squad. The Scotland full-back has been sidelined since June after suffering a hamstring injury at Euro 2024. If called upon, Tierney would make his first Arsenal appearance since the 2023 Community Shield. “Everybody in the squad is fully fit and available to start the game,” said Arteta. “We have Kieran Tierney after a long injury, it’s great news that he’s back, he’s been training with the team and he’s at the level to participate.”NoneKGYY-15 is under clinical development by Op-T-Mune and currently in Phase I for Type 1 Diabetes (Juvenile Diabetes). According to GlobalData, Phase I drugs for Type 1 Diabetes (Juvenile Diabetes) have a 69% phase transition success rate (PTSR) indication benchmark for progressing into Phase II. GlobalData tracks drug-specific phase transition and likelihood of approval scores, in addition to indication benchmarks based off 18 years of historical drug development data. Attributes of the drug, company and its clinical trials play a fundamental role in drug-specific PTSR and likelihood of approval. KGYY-15 overview KGYY-15 is under development for the treatment of multiple sclerosis, type 1 diabetes and community acquired pneumonia (CAP) with sepsis. KGYY-15 is peptide which targets CD40, CD154 interaction. CD40 is a member of the tumour necrosis factor (TNF) receptor superfamily. It is administered through intravenous route. Op-T-Mune overview Op-T-Mune is developing drugs for the treatment of autoimmune diseases and inflammation. The company is headquartered in Aurora, Colorado, the US. For a complete picture of KGYY-15’s drug-specific PTSR and LoA scores, This content was updated on 12 April 2024 From Blending expert knowledge with cutting-edge technology, GlobalData’s unrivalled proprietary data will enable you to decode what’s happening in your market. You can make better informed decisions and gain a future-proof advantage over your competitors. , the leading provider of industry intelligence, provided the underlying data, research, and analysis used to produce this article. GlobalData’s Likelihood of Approval analytics tool dynamically assesses and predicts how likely a drug will move to the next stage in clinical development (PTSR), as well as how likely the drug will be approved (LoA). This is based on a combination of machine learning and a proprietary algorithm to process data points from various databases found on GlobalData’s .
6,000 inmates escape from a high-security prison as post-election violence roils MozambiqueThere’s precious little agreement between congressional Republicans and Democrats these days. So it’s unusual that the president this week vetoed a bill that garnered bipartisan support in both houses. The explanation, not surprisingly, rests in pure partisanship and the progressive thirst for political power. On Monday, President Joe Biden vetoed the JUDGES Act, which would have added 66 new judges to the federal courts. The move was an effort to speed up justice by addressing backlogs in the federal courts. The bill had unanimously sailed through the Senate in August before passing the House 236-173 last week. Supporters of the reform point out that there has been no increase in the number of federal appeals court judgeships in four decades. The federal district courts haven’t added judgeships since 2003. Yet caseloads have increased about 20 percent in both courts over the past two decades. The expansion proposal was embraced by a wide range of judicial organizations, and Mr. Biden’s veto was met with criticism from across the political spectrum. “The communities affected and their current judges deserved this bipartisan solution to the caseload crisis,” noted the Federal Bar Association. “The FBA urges continued work on this issue when the new Congress convenes in January.” Mr. Biden’s veto explanation argued that the bill was too hastily assembled. That’s balderdash. In reality, the president and some House Democrats are unhappy with the November election results and don’t want leave the appointment of additional federal judges to Donald Trump. Yet the legislation was structured to spread the creation of the new seats across the next three administrations, precisely to avoid partisan battles. Clearly Mr. Biden — or whoever is making decisions at the White House these days — isn’t bullish on his party’s chances in the 2028 and 2032 elections. “The president’s veto will contribute to the pattern of growing caseloads and increasing backlogs that hurt litigants and weakens public confidence in our courts,” said a statement from Judge Robert J. Conrad Jr., director of the administrative office of the U.S. courts. Mr. Biden leaves office having made a slew of unfortunate decisions that make clear he places more emphasis on protecting his own family members and kowtowing to the radical left than on ensuring the federal judicial system delivers justice in an efficient and timely manner for all those involved. When Republicans gain control of the Senate in January, they should resuscitate the JUDGES Act and send it to the White House for Mr. Trump’s signature.
NoneSpecial counsel moves to dismiss election interference and classified documents cases against Trump
Manmohan Singh News: Harbhajan Singh, Virender Sehwag Lead Condolences For Former Prime Minister's Demise
Doug Collins named hero of the month 12/24 Veterans for America First announced Lucretia Hughes GA VFAF Comms DirectorFive facts about electric vehicles in 2024Alex Ovechkin is expected to miss 4 to 6 weeks with a broken left legNone
What I learned from the 106 games I played this yearEx-India’s PM Manmohan Singh dies at 92NEW DELHI – Former Indian prime minister Manmohan Singh passed away at the age of 92 on Thursday. According to Indian media reports, Manmohan Singh was rushed to a hospital in Delhi in a semi-conscious state due to deteriorating health, where doctors attempted treatment. However, he passed away during the process. Manmohan Singh served as India’s prime minister for two consecutive terms from 2004 to 2014. The former prime minister also held the position of Finance Minister and had a PhD in Economics before transitioning into politics. Previously, he served as the Governor of the Reserve Bank of India. Since 2005, Singh had expressed a desire for Siachen to be recognised globally as a “Mountain of Peace.”
Put politics aside and act on online harms, mother of sextortion victim tells MPs
Microsoft Flight Simulator (MSFS) 2024 is set to redefine aviation simulation, and at the forefront of this revolution is the introduction of the highly anticipated Airbus A350. This cutting-edge aircraft is renowned for its advanced technology in the real aviation world, and its digital twin promises to bring a new level of realism and innovation to the virtual skies. Unmatched Realism The A350 is a marvel of modern engineering known for its fuel efficiency and impressive range. MSFS 2024 developers have dedicated themselves to authentically replicating its intricate flight systems and aerodynamic performance. This commitment ensures that virtual pilots will experience unprecedented realism, from the handling dynamics to the nuances of its cockpit instrumentation. Advanced Technology Integration MSFS 2024 leverages new technologies to enhance every flight experience. The integration of real-time weather data, groundbreaking AI, and ultra-high-definition graphics allows the A350 to glide through breathtaking skies under realistic weather conditions. With a newly enhanced physics engine, the simulator promises to capture the essence of flying this iconic aircraft with unprecedented fidelity. A Look into the Future The inclusion of the A350 in MSFS 2024 sets the stage for an exciting future in flight simulation. This advancement hints at the potential for even more sophisticated aircraft models and tools, paving the way for a richer, more immersive experience. As technology continues to evolve, MSFS 2024 is poised to remain at the cutting edge, serving as a beacon for enthusiasts who yearn for the closest experience to real-world aviation from the comfort of their homes. Discover the Future of Aviation Simulation with MSFS 2024 Introduction to MSFS 2024 and the Airbus A350 Microsoft Flight Simulator (MSFS) 2024 is shaping up to be a landmark in the evolution of aviation simulation, particularly with the inclusion of the much-awaited Airbus A350. While the original excitement centers around this model’s cutting-edge features, several new elements and insights further enhance what MSFS 2024 has to offer to virtual pilots and aviation enthusiasts. Key Features and Innovations # Enhanced Real-Time Weather Simulation One of the most anticipated features in MSFS 2024 is its enhanced real-time weather simulation. Real-world data integration not only reproduces current weather conditions accurately but also allows for dynamic weather changes mid-flight. This innovation enables pilots to experience the challenges and beauties of flying under varied conditions, from thunderstorms to serene sunsets, giving a true-to-life experience. # Breakthroughs in Artificial Intelligence MSFS 2024 incorporates advanced AI systems to improve both air traffic control and aircraft behavior. The AI is designed to provide realistic interactions not only with live players but also with AI-controlled aircraft, offering a more authentic simulation of real-world aviation dynamics. This feature significantly elevates the learning and engagement aspects for users aiming to enhance their piloting skills beyond basics. # Cutting-Edge Graphics and Visuals With ultra-high-definition graphics, MSFS 2024 stands out for its visually stunning environments. Pilots can fly over impeccably rendered cities, landscapes, and natural wonders seized in breathtaking detail. This visual upgrade enhances the realism and immersion, likely making MSFS 2024 one of the most visually ambitious flight simulators to date. Predictions and Market Insights # Increased Demand for High-Performance Simulation PCs With the advanced graphics and processing requirements of MSFS 2024, there is an expected increase in demand for high-performance PCs and peripherals optimized for gaming and simulation. This trend may also stimulate market growth in the computer hardware industry, particularly for graphics cards, processors, and other gaming-centric components. # Expansion of Aviation Enthusiast Community MSFS 2024 promises to not only retain its current fanbase but also expand it, attracting new users interested in both casual flying experiences and serious flight training simulations. The realism and incredible attention to detail are expected to draw those who may have previously been uninterested in flight simulation. FAQs Q: What systems are required to run MSFS 2024 smoothly? A: While specific system requirements may vary, a high-performance PC with a powerful graphics card and substantial RAM is recommended for the best experience. Q: Can MSFS 2024 be used as an actual flight training tool? A: MSFS 2024 offers highly realistic simulation capabilities that can complement flight training, but it should not be considered a substitute for certified aviation training programs. Sustainability and Future Developments # Commitment to Sustainability In a nod towards environmental consciousness, MSFS 2024 developers have worked on optimizing energy usage within the game’s framework, reducing its overall computational footprint. This step aligns with broader trends in software development that prioritize sustainability. # Ongoing Updates and User Engagement MSFS 2024 plans to release periodic updates to incorporate new aircraft, scenarios, and technological advancements. The community is encouraged to provide feedback, ensuring the simulator evolves in line with user expectations and technological progress. Conclusion Microsoft Flight Simulator 2024 continues to push the boundaries of aviation simulation with the introduction of the Airbus A350 and beyond. As this innovative software rolls out, both existing enthusiasts and newcomers can expect an unprecedented level of engagement, realism, and community interaction. Experience the skies like never before with the unparalleled immersion MSFS 2024 offers. For more information, visit the official website of Microsoft .Interview: Stefanie Powers finds her life’s calling in the William Holden Wildlife FoundationMoney Research Collective’s editorial team solely created this content. Opinions are their own, but compensation and in-depth research determine where and how companies may appear. Many featured companies advertise with us. How we make money . By Kat Tretina MONEY RESEARCH COLLECTIVE December 5, 2024 China is a powerful force to be reckoned with. According to Safeguard Global, the country has the second largest economy based on its gross domestic product, which stands at $14.7 trillion in 2024. China’s role as an economic powerhouse is particularly evident through the lens of the global gold market, in which the nation plays a substantial role. China is the largest producer of gold in the world, and there is also significant demand within the country for gold jewelry and other products, which drives consumption. What’s driving China’s role in the gold market ? There are several factors, including cultural traditions, manufacturing needs and concerns about investments. China’s history with gold China has a long relationship with gold . Its use in the country dates back to the Han dynasty as early as 206 BC, and it’s since been used as currency, for making jewelry and even as part of worship. In 1978, when China re-entered the international economy and resumed trade with other countries, the gold market shifted. China transformed into an industrial powerhouse, and gold played a major role; along with jewelry, gold is frequently used in the creation of electronics, medical devices and in the automotive industry. In 1983, China allowed its citizens to own gold — private gold ownership was previously prohibited — and it created the Shanghai Gold Exchange, major milestones for the gold industry. Those changes began China’s transition to a gold superpower, as the government accumulated its gold reserves and gold mining within the country accelerated. China and gold: its impact today China is a huge presence in the gold market for both production and consumption: China is responsible for about 11% of global gold production, making it the largest producer of gold in the world. In fact, since it overtook South Africa for the lead in 2007, it has dominated the gold production market. According to Mining Technology, there are over 1,300 gold mines in the world, and China operates 117 of them. In 2023, China produced 370 tons of gold. To put that in perspective, that’s more than double the gold production of the U.S. The five largest mines in the country include: Gold is an important part of China’s economy, particularly in the manufacturing industry. China’s chief exports are electronics, machinery and vehicles — all segments that require gold. The Central Bank of China has been buying gold to bolster its reserves, moving its reserves away from traditional assets like U.S. Treasury debt. Its accumulation of gold has helped drive the price of gold . In China, gold was traditionally a common gift, particularly for brides, new parents and for the Lunar New Year, which helped drive its jewelry market. However, as the country has become richer and its citizens more wealthy, purchasing gold for personal use or investments is increasingly common as a status symbol. Right now, China is facing some issues with deflation , meaning prices across the economy have dropped. Combined with a volatile stock market and difficult real estate market, gold can be an appealing alternative for investors . Gold as an investment is particularly popular among young adults interested in alternative assets. Gone are the days when investors needed thousands of dollars or Chinese Yuan to purchase gold; today, Chinese investors can buy “gold beans” — as the name implies, small nuggets of gold — that cost less than $100 per bean. Gold beans have gone viral on Chinese social media platforms like Weibo, and mainstream jewelry stores have addressed the trend by selling gold beans in glass jars in their stores. In fact, Chinese consumers between the ages of 18 and 24 are more likely to purchase pure gold than any other age group, according to a report by the Chow Tai Fook Jewellery Group. The increased demand for gold as an investment — and the availability of smaller, more accessible gold for investing — played a major role in China’s gold rush, with gold premiums reaching a then-all-time high in 2023. Outlook for China’s gold market Although the gold industry in China is still booming, there are some signs it’s cooling down. Record-high gold prices may have affected consumers, as gold jewelry sales dropped significantly in October 2024. China saw a slight decrease in gold production; for the first three quarters of 2024, its total production dropped by -1.17%. If gold prices remain high, that could continue the downward trend of jewelry sales, but it could increase the demand for gold for investments. How China’s gold market can affect you Because of China’s significant presence in the gold industry, many economists believe that gold prices and demand are affected not by the economy, but by Chinese investors themselves. With so many Chinese investors and consumers purchasing gold, it has markedly increased demand for the precious metal, which subsequently drives up prices. If you’re looking to invest in gold , China’s gold industry and its outlook is encouraging. However, it’s always important to diversify your portfolio so your investments aren’t concentrated in a single asset class. If you do invest in precious metals, investing in traditional securities — such as stocks, bonds, mutual funds or ETFs — can give you a well-rounded portfolio.
NASA has announced more delays in sending astronauts back to the moon more than 50 years after the Apollo missions. or signup to continue reading Administrator Bill Nelson on Thursday said the next mission in the Artemis program - sending four astronauts around the moon and back - is now targeted for April 2026. It had been on the books for September 2025, after slipping from this year. The investigation into heat shield damage from the capsule's initial test flight two years ago took time, officials said, and other spacecraft improvements are still needed. This bumps the third Artemis mission - a moon landing by two other astronauts - to at least 2027. NASA had been aiming for 2026. NASA's Artemis program, a follow-up to the Apollo moonshots of the late 1960s and early 1970s, has completed only one mission. An empty Orion capsule circled the moon in 2022 after blasting off on NASA's new Space Launch System rocket. Although the launch and lunar laps went well, the capsule returned with an excessively charred and eroded bottom heat shield, damaged from the heat of re-entry. It took until recently for engineers to pinpoint the cause and come up with a plan. NASA will use the Orion capsule with its original heat shield for the next flight with four astronauts, according to Nelson, but make changes to the reentry path at flight's end. To rip off and replace the heat shield would have meant at least a full year's delay, officials said. During the flight test, the capsule dipped in and out of the atmosphere during re-entry and heat built up in the shield's outer layer, explained Pam Melroy, NASA deputy administrator. That resulted in cracking and uneven shedding of the outer layer. The commander of the lunar fly-around, astronaut Reid Wiseman, took part in Thursday's news conference at NASA headquarters in Washington. His crew includes NASA astronauts Victor Glover and Christina Koch and Canadian astronaut Jeremy Hansen. "Delays are agonising and slowing down is agonising and it's not what we like to do," Wiseman said. But he said he and his crew wanted the heat shield damage from the first flight to be fully understood, regardless of how long it took. Twenty-four astronauts flew to the moon during NASA's vaulted Apollo program, with 12 landing on it. The final bootprints in the lunar dust were made during Apollo 17 in December, 1972. DAILY Today's top stories curated by our news team. WEEKDAYS Grab a quick bite of today's latest news from around the region and the nation. WEEKLY The latest news, results & expert analysis. WEEKDAYS Catch up on the news of the day and unwind with great reading for your evening. WEEKLY Get the editor's insights: what's happening & why it matters. WEEKLY Love footy? We've got all the action covered. WEEKLY Every Saturday and Tuesday, explore destinations deals, tips & travel writing to transport you around the globe. WEEKLY Going out or staying in? Find out what's on. WEEKDAYS Sharp. Close to the ground. Digging deep. Your weekday morning newsletter on national affairs, politics and more. TWICE WEEKLY Your essential national news digest: all the big issues on Wednesday and great reading every Saturday. WEEKLY Get news, reviews and expert insights every Thursday from CarExpert, ACM's exclusive motoring partner. TWICE WEEKLY Get real, Australia! Let the ACM network's editors and journalists bring you news and views from all over. AS IT HAPPENS Be the first to know when news breaks. DAILY Your digital replica of Today's Paper. Ready to read from 5am! DAILY Test your skills with interactive crosswords, sudoku & trivia. Fresh daily! Advertisement AdvertisementMEXICO CITY (Reuters) - Mexican lower house lawmakers on Tuesday overwhelmingly passed a proposal to alter the constitution to include a ban on e-cigarettes and vaping devices as well as a crackdown on synthetic drugs such as fentanyl. WHY IT'S IMPORTANT Former President Andres Manuel Lopez Obrador, who sent the proposal to Congress before leaving office this year, had argued that smoking devices were damaging public health, with children particularly susceptible to getting hooked. ADDITIONAL CONTEXT Lopez Obrador had already banned such devices through a presidential decree, though they remain widely available for purchase. Millions of Mexicans, meanwhile, smoke traditional cigarettes, which remain legal. The reform passed by the legislature on Tuesday also sanctions "production, distribution and sale of toxic substances, chemical precursors, the illicit use of fentanyl and other non-authorized synthetic drugs." Fentanyl, while approved for some use medically, is also by and large banned in Mexico. BY THE NUMBERS The measure passed, in general terms, with 410 votes in favor and 24 against. Less than 1 million people from ages 12 to 65 reported regularly using a vape in 2022, according to federal data cited by lawmakers. Meanwhile, around 500,000 teens and 300,000 adults used e-cigarettes. KEY QUOTES "We value girls', boys', and young people's right to good health above economic and political interests," said Workers' Party lawmaker Mary Carmen Bernal, who belongs to the ruling bloc. Opposition legislator Ector Jaime Ramirez, meanwhile, said banning fentanyl and vaping in the same reform was excessive and "trivializing to the effort being made to combat the most addictive and dangerous drugs." WHAT'S NEXT The reform is now set to head to the senate, where the ruling Morena party and its allies hold a strong majority. (Reporting by Kylie Madry; Editing by David Gregorio) Copyright 2024 Thomson Reuters .
Dates Set for PG&E Quarterly Stock Dividends
A good Samaritan who went outside to grab a delivery found two infant girls dumped in a ditch near his home in the US state of Indiana after the car they were in was stolen. The Indianapolis Metropolitan Police Department on Monday asked for the public’s help in locating a silver Hyundai Sonata that was stolen with a four-month-old girl and a five-month-old girl in the backseat. About 20 minutes after police appealed for information on social media, officials shared an update that the children had been found safe and the vehicle had been located. Know the news with the 7NEWS app: Download today The good Samaritan had gone outside to collect a package when he saw two car seats, NBC affiliate WTHR of Indianapolis reported. The baby girls had been left in the car seats in the cold. The man brought the babies inside and called 911. Police confirmed that the babies were the missing girls from the stolen vehicle, the news station reported. The car was found near where the children were left. William Young, with the Indianapolis police department, told WTHR that he could not thank the good Samaritan enough. “It’s cold out here, who knows what would have happened if this particular individual hadn’t gone outside,” he said. A suspect has not yet been taken into custody.Giannis Antetokounmpo named Eastern Conference Player of the Week for Week 5
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It was not the Wright Brothers but an Indian sage who invented flying, Uttar Pradesh governor Anandiben Patel said on Thursday, igniting a controversy involving facts and history as the former Bharatiya Janata Party (BJP) leader sought new education to students over these aspects. “Students should be told about how Wright Brothers are being wrongly credited for developing an airplane,” Patel declared during her first media interaction after completing five years in office. She asserted that ancient sage Maharishi Bharadwaj developed aviation technology first — a claim that contradicts records of Orville and Wilbur Wright achieved the first sustained, controlled, powered flight in Kitty Hawk, North Carolina, in 1903. The governor ventured further by describing Kumbhakarna, a character from the Hindu epic Ramayana, as “a technocrat who did not sleep for six months and instead worked in laboratories during the period.” This interpretation markedly differs from traditional religious texts, which portray Kumbhakarna as a mythological figure who slept for six-month intervals due to a divine boon or curse. These assertions follow her remarks at Lucknow University’s 66th convocation ceremony on December 6, 2023, where she elaborated on ancient Indian aviation. “Maharishi Bharadwaj’s Ashram, which still exists in Prayagraj, and his Yantra Sarvasva, called the encyclopaedia of machines, of which the Vymaanika Shastra is a part, revealed eight types of airplanes,” Patel, a former Gujarat CM, said. Scholars have noted that the Vymaanika Shastra, frequently cited in discussions of ancient aviation, was actually authored in the early 20th century and published in 1952 by G.R. Josyer. “Shivkar Bapuji Talpade, a resident of Mumbai, developed the first model of airplane eight years ahead of Wright Brothers... Talpade’s flew his airplane at a height of 1,800 feet,” Patel added. Talpade attempted to build an aircraft and fly it, too, is regarded as unverified with no reliable records. Patel, who took oath at Raj Bhavan on July 29, 2019, made these statements during her first comprehensive media interaction after completing five years in office.Victoria’s Secret & Co. Reports Third Quarter 2024 ResultsBy Katheryn Houghton and Arielle Zionts, KFF Health News (TNS) Tescha Hawley learned that hospital bills from her son’s birth had been sent to debt collectors only when she checked her credit score while attending a home-buying class. The new mom’s plans to buy a house stalled. Hawley said she didn’t owe those thousands of dollars in debts. The federal government did. Hawley, a citizen of the Gros Ventre Tribe, lives on the Fort Belknap Indian Reservation in Montana. The Indian Health Service is a federal agency that provides free health care to Native Americans, but its services are limited by a chronic shortage of funding and staff. Hawley’s local Indian Health Service hospital wasn’t equipped to deliver babies. But she said staff there agreed that the agency would pay for her care at a privately owned hospital more than an hour away. That arrangement came through the Purchased/Referred Care program, which pays for services Native Americans can’t get through an agency-funded clinic or hospital. Federal law stresses that patients approved for the program aren’t responsible for any of the costs. But tribal leaders, health officials, and a new federal report say patients are routinely billed anyway as a result of backlogs or mistakes from the Indian Health Service, financial middlemen, hospitals, and clinics. The financial consequences for patients can last years. Those sent to collections can face damaged credit scores, which can prevent them from securing loans or require them to pay higher interest rates. The December report , by the federal Consumer Financial Protection Bureau, found these long-standing problems contribute to people in Native American-majority communities being nearly twice as likely to have medical debt in collections compared with the national average. And their amount of medical debt is significantly higher. The report found the program is often late to pay bills. In some cases, hospitals or collection agencies hound tribal citizens for more money after bills are paid. Hawley’s son was born in 2003. She had to wait another year to buy a home, as she struggled to pay off the debt. It took seven years for it to drop from her credit report. “I don’t think a person ever recovers from debt,” Hawley said. Hawley, a cancer survivor, still must navigate the referral program. In 2024 alone, she received two notices from clinics about overdue bills. Frank White Clay, chairman of the Crow Tribe in Montana, testified about the impact of wrongful billing during a U.S. House committee hearing in April. He shared stories of veterans rejected for home loans, elders whose Social Security benefits were reduced, and students denied college loans and federal aid. “Some of the most vulnerable people are being harassed daily by debt collectors,” White Clay said. No one is immune from the risk. A high-ranking Indian Health Service official learned during her job’s background check that her credit report contained referred-care debt, the federal report found. Native Americans face disproportionately high rates of poverty and disease , which researchers link to limited access to health care and the ongoing impact of racist federal policies . White Clay is among many who say problems with the referred-care program are an example of the U.S. government violating treaties that promised to provide for the health and welfare of tribes in return for their land. The chairman’s testimony came during a hearing on the Purchased and Referred Care Improvement Act, which would require the Indian Health Service to create a reimbursement process for patients who were wrongfully billed. Committee members approved the bill in November and sent it for consideration by the full House. A second federal bill, the Protecting Native Americans’ Credit Act , would prevent debt like Hawley’s from affecting patients’ credit scores. The bipartisan bill hadn’t had a hearing by mid-December. The exact number of people wrongfully billed isn’t clear, but the Indian Health Service has acknowledged it has work to do. The agency is developing a dashboard to help workers track referrals and to speed up bill processing, spokesperson Brendan White said. It’s also trying to hire more referred-care staff, to address vacancy rates of more than 30%. Officials say problems with the program also stem from outside health providers that don’t follow the rules. Melanie Egorin, an assistant secretary at the U.S. Department of Health and Human Services, said at the hearing that the proposed legislation doesn’t include consequences for “bad actors” — health facilities that repeatedly bill patients when they shouldn’t. “The lack of enforcement is definitely a challenge,” she said. But tribal leaders warned that penalties could backfire. Related Articles Health | How America lost control of the bird flu, setting the stage for another pandemic Health | How to kick back, relax and embrace a less-than-perfect holiday Health | New childhood leukemia protocol is ‘tremendous win’ Health | For some FSA dollars, it’s use it or lose it at year’s end Health | Reporting for duty: Monica Martinez, Kim De Serpa sworn in as newest Santa Cruz County supervisors White Clay told lawmakers that some clinics already refuse to see patients if the Indian Health Service hasn’t paid for their previous appointments. He’s worried the threat of penalties would lead to more refusals. If that happens, White Clay said, Crow tribal members who already travel hours to access specialty treatment would have to go even farther. The Consumer Financial Protection Bureau report found clinics are already refusing to see any referred-care patients due to the program’s payment problems. The bureau and the Indian Health Service also recently published a letter urging health care providers and debt collectors not to hold patients accountable for program-approved care. White, the Indian Health Service spokesperson, said the agency recently updated the referred-care forms sent to outside hospitals and clinics to include billing instructions and to stress that patients aren’t liable for any out-of-pocket costs. And he said the staff can help patients get reimbursed if they have already paid for services that were supposed to be covered. Joe Bryant, an Indian Health Service official who oversees efforts to improve the referral program, said patients can ask credit bureaus to remove debt from their reports if the agency should have covered their bills. Leaders with the Confederated Tribes of the Colville Reservation in Washington state helped shape the proposed legislation after their citizens were repeatedly harmed by wrongful billing. Tribal Chairman Jarred-Michael Erickson said problems began in 2017, when a regional Indian Health Service office took over the referred-care program from local staff. It “created a domino effect of negative outcomes,” Erickson wrote in a letter to Congress. He said some tribal members whose finances were damaged stopped using the Indian Health Service. Others avoided health care altogether. Responsibility for the Colville Reservation program transferred back to local staff in 2022. Staffers found the billing process hadn’t been completed for thousands of cases, worth an estimated $24 million in medical care, Erickson told lawmakers . Workers are making progress on the backlog and they have explained the rules to outside hospitals and clinics, Erickson said. But he said there are still cases of wrongful billing, such as a tribal member who was sent to collections after receiving a $17,000 bill for chemotherapy that the agency was supposed to pay for. Erickson said the tribe is in the process of taking over its health care facilities instead of having the Indian Health Service run them. He and others who work in Native American health said tribally managed units — which are still funded by the federal agency — tend to have fewer problems with their referred-care programs. For example, they have more oversight over staff and flexibility to create their own payment tracking systems. But some Native Americans oppose tribal management because they feel it releases the federal government from its obligations. Beyond wrongful billing, access to the referred-care program is limited because of underfunding from Congress. The $1 billion budget this year is $9 billion short of the need, according to a committee report by tribal health and government leaders. Donald Warne, a physician and member of the Oglala Sioux Tribe in South Dakota, called the proposed legislation a “band-aid.” He said the ultimate solution is for Congress to fully fund the Indian Health Service, which would reduce the need for the referred-care program. Back in Montana, Hawley said she braces for a fight each time she gets a bill that the referral program was supposed to cover. “I’ve learned not to trust the process,” Hawley said. ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.
Native American patients are sent to collections for debts the government owes