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By 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 | Norovirus is rampant. Blame oysters, cruise ships and holiday travel 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.jili slot free bonus

NoneA man who was arrested in Broward County in August has pleaded guilty to kidnapping a Lyft driver in Texas and forcing her to drive to South Florida, where he said he intended to kidnap a social media influencer in order to demand a multi-million dollar ransom. Miguel Alejandro Pastran Hernandez, 24, pleaded guilty in federal court Tuesday to kidnapping, carjacking and possessing a firearm in furtherance of a violent crime. He faces up to life in prison, federal prosecutors said in a news release Thursday afternoon. It was shortly before 10:30 p.m. Aug. 16 when the victim, a woman working as a Lyft driver, picked up Pastran Hernandez in the Arlington, Texas, area, according to a factual proffer, the facts of the case agreed on by the defense and prosecutors. Pastran Hernandez had entered his drop-off location as a gas station that looked closed when they arrived. Soon afterward, the woman said she heard a click and saw Pastran Hernandez holding what she thought was a gun. Investigators later determined it was an airsoft or BB gun, the factual proffer said. She offered up her belongings, but Pastran Hernandez told her he would tie her up and put her in the back of her Honda. He told her to start driving to Florida and allowed her to drive as long as she went the speed limit and followed his orders, the factual proffer said. During the trip to Florida, Pastran Hernandez found that the woman had an unloaded gun in her car. He found her ammunition, which she kept separately, loaded it and kept the gun on him throughout the kidnapping, the factual proffer said. They stopped at multiple gas stations, and he would take the car keys to prevent her from escaping. Rideshare driver kidnapped at gunpoint in Texas and forced to drive to South Florida He forced the woman to call her family about 11 a.m. the next day to tell them she was taking “a long work trip” so they would not question why she was gone. Pastran Hernandez himself drove the car sometimes, keeping the woman’s gun on him while she rested, the factual proffer said. Pastran Hernandez and the woman arrived in Miami Beach on Aug. 18, where he “surveilled” the home of a social media influencer, who he told the woman he planned to also kidnap, or a relative of the influencer, for a $3 million ransom, according to the factual proffer. On Aug. 19, Pastran Hernandez forced the Lyft driver to go to a dollar store in Hialeah in Miami-Dade County to buy supplies, the factual proffer said. The woman was in the bathroom when police officers arrived and Pastran Hernandez ran. Officers found him a few hours later at a park in Hollywood with the woman’s loaded handgun in his bag, the factual proffer said. He had a backpack inside the victim’s car that had airsoft or BB guns, knives and kidnapping supplies. Pastran Hernandez will be sentenced on Feb. 20, court records show.

MAPUTO, Mozambique. (AP) — At least 6,000 inmates escaped from a high-security prison in Mozambique’s capital on Christmas Day after a rebellion, the country's police chief said, as widespread post-election riots and violence are roiling the country. Police chief Bernardino Rafael said 33 prisoners died and 15 others were injured during a confrontation with the security forces. The prisoners fled during violent protests that have seen police cars, stations and infrastructure destroyed after the country’s Constitutional Council confirmed the ruling Frelimo party as the winner of the Oct. 9 elections. The escape from the Maputo Central Prison, located 14 kilometers (9 miles) southwest of the capital, started around midday on Wednesday after “agitation” by a “group of subversive protesters” nearby, Rafael said. Some of the prisoners at the facility snatched weapons from the guards and started freeing other detainees. “A curious fact is that in that prison we had 29 convicted terrorists, who they released. We are worried, as a country, as Mozambicans, as members of the defense and security forces,” said Rafael. “They (protesters) were making noise, demanding that they be able to remove the prisoners who are there serving their sentences”, said Rafael, adding that the protests led to the collapse of a wall, allowing the prisoners to flee. He called on the escaped prisoners to surrender to authorities and for the population to be informed about the fugitives. Videos circulating on social media show the moment inmates left the prison, while other recordings reveal captures made by military personnel and prison guards. Many prisoners tried to hide in homes, but some were unsuccessful and ended up being detained again. In one video, a prisoner still with handcuffs on his right wrist says he was held n the disciplinary section of the prison and was released by other inmates.

AP News Summary at 1:37 p.m. EST

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It’s hard to think of a time when the Democratic Party was more bereft of real leaders. As the losing presidential candidate, Kamala Harris is not held in warm regard, and her continuing fundraising efforts have added to the irritation. Joe Biden, who accomplished more than his critics give him credit for, is going out on a low note. Usually, the chair of the Democratic National Committee is a technocrat and not the face of the party. But this time could be different. A number of names have been mentioned in the press coverage and in self-promotion, but it’s clear that the two finalists will be Ken Martin, 51, Minnesota party chair, and his neighbor, Ben Wikler, 43, who chairs the Wisconsin state party. Both are excellent party-builders, both are substantive progressives, and both have earned wide respect. The election is set for February 1. Martin, the chair of the Minnesota Democratic-Farmer-Labor Party, began as a campaign worker for Paul Wellstone. Under Martin’s leadership, Minnesota Democrats won 22 statewide elections in a row, flipping Minnesota from a state that often elected Republican governors and all-Republican legislatures to a normally blue one. Gov. Tim Walz’s were built on a strong grassroots state party. Martin is also a first-rate fundraiser. Under his leadership, the state party has a budget for county parties and pays half the cost of local organizers. “We need to contest every race,” he told me, “even races that we know we are not going to win.” In a recently circulated memo to members of the DNC, he called for party-building in every state, rejected the model of the DNC as an adjunct of the White House, and declared bluntly, “The majority of Americans now believe the Republican Party best represents the interests of the working class and the poor, and the Democratic Party is the party of the wealthy and the elites. It’s a damning indictment on our party brand.” Ben Wikler has a similar philosophy and can claim parallel achievements in Wisconsin. In 2022, Gov. Tony Evers won a second term, the first time a Democratic governor was re-elected since the JFK era. Voters flipped the state Supreme Court to majority-Democratic, setting up gerrymandering reform and the , Scott Walker’s anti-union law. Harris actually got 37,000 more votes in Wisconsin than Biden did in 2020. Turnout rose 1.3 percent, highest in the nation. Tammy Baldwin was re-elected in a state carried by Trump. And Democrats broke the Republican legislative supermajority, flipping ten State Assembly seats, and four Senate seats. This was built both on grassroots party-building at the county level, and on prodigious (and somewhat controversial) fundraising, of which more in a moment. What’s the difference between the two men? Both are great party-builders. Martin, because of his long years of work with other state parties, has closer relationships with the membership of the DNC. Wikler has more of a public persona. And each has taken pains not to bad-mouth the other. As president of the Association of State Democratic Committees, Martin has already lined up endorsements of at least 100 voting members of the DNC out of about 450. Because of this head start, Martin has been considered the front-runner. But since declaring his candidacy last Sunday, Wikler has sought to create a bandwagon psychology, by lining up endorsements by prominent Democrats. So far, these include a spate of flattering press mentions and explicit endorsements by Rahna Epting of MoveOn, Adam Green of the Progressive Change Campaign Committee, our colleague Robert Reich, as well as Jonathan Cowan of Third Way. Third Way, heavily financed by Wall Street, calls itself center-left, but because of its past policy positions ( ) and efforts at a feeble bipartisanship, it is better described as center-right. Third Way has no real base in the Democratic Party. to write an effusive piece that begins, “At Third Way, we represent the center-left of the party. But we agree with former Progressive Caucus Co-Chair Mark Pocan and others on the far left [ ] that the person best equipped to lead the Democratic National Committee in this uncertain and high-stakes moment is Wisconsin Democratic Party Chair Ben Wikler.” Far left? What’s Cowan up to? Perhaps he wants to back a possible winner, but this is also about money, of which Third Way can channel plenty. Wikler has been criticized in some quarters for taking dark money from the likes of Reid Hoffman, . Hoffman was also a big backer of Kamala Harris, whom he urged to fire FTC Chair Lina Khan. Such are the perils of taking money from corporate Democrats. A source close to Wikler defends the coziness with Third Way, which doesn’t represent Wikler’s own politics, as showing that he’s seeking to build a “big tent” party. But even critics, who wish Wikler were more circumspect about whom he raises money from, respect him as a great state party chair. And in fairness, money remains an ongoing dilemma for Democrats. Quite apart from who ends up being elected the next party chair at February’s meeting, there will be a vote on a resolution proposed by Larry Cohen, Bernie Sanders’s top lieutenant on the DNC, calling for a ban on corporate dark money in party primaries. Others who have been either self-promoting, or who have been mentioned in the press as possible candidates for DNC chair, have little chance against Martin and Wikler. Former Maryland Gov. Martin O’Malley, a declared candidate, has little if any base in the broader DNC. Rahm Emanuel, also mentioned in press accounts, is an even more far-fetched possibilty. Happily, there is no way for Wikler and Martin, as two progressives, to crowd each other out, as happened with Bernie Sanders and Elizabeth Warren in the 2020 presidential priimaries, since the DNC rules provide for a runoff between the top two. One other party leadership post is open, and here the news is terrible. Michigan Sen. Gary Peters is stepping down as chair of the Democratic Senatorial Campaign Committee (DSCC), the fundraising arm of the Senate Democratic caucus. The only declared candidate for the job is New York Sen. Kirsten Gillibrand. Gillibrand, in contrast to Martin and Wikler, represents all that is corrupt and opportunistic in the Democratic Party. She is very close to the crypto industry, which dumped scads of dark money into late campaign ads to defeat progressives such as Sen. Sherrod Brown of Ohio. Gillibrand also is widely loathed for leading the campaign to hound Sen. Al Franken out of office on charges of sexual harassment. Gillibrand will get the job mainly because nobody else wants it. Since the DNC and the DSCC work in close concert, expects sparks to fly whether the new DNC chair is Martin or Wikler. One possibility, still premature, is that one could be chair and the other executive director. If ever there were a moment for both a strong Democratic Party and a compelling face of the party, it’s now.

A UK ticket-holder has won £177 million in Tuesday’s EuroMillions draw. But it is not the largest prize a person has won in this country. Here are the 10 biggest UK lottery winners – all from EuroMillions draws – and what some of them did with their fortunes. – Anonymous, £195,707,000 A UK ticket-holder scooped the record EuroMillions jackpot of £195 million on July 19 2022 – the biggest National Lottery win of all time. – Joe and Jess Thwaite, £184,262,899.10 Joe and Jess Thwaite, from Gloucester, scooped a then record-breaking £184,262,899 with a Lucky Dip ticket for the draw on May 10 2022. At the time, Joe was a communications sales engineer, and Jess ran a hairdressing salon with her sister. – Unclaimed ticket holder, £177 million Tuesday’s winner is wealthier than former One Direction member Harry Styles and heavyweight boxer Anthony Joshua, who are both worth £175 million, according to the latest Sunday Times Rich List. Players have been urged to check their tickets to see if they can claim the prize. – Anonymous, £170,221,000 The fourth biggest winner of the National Lottery to date scooped £170 million in October 2019, after matching all the numbers in a Must Be Won draw. – Colin and Chris Weir, £161,653,000 Colin and Chris Weir, from Largs, North Ayrshire, bagged their historic winnings in July 2011, making them the biggest UK winners at the time. Colin used £2.5 million of his fortune to invest in his beloved Partick Thistle Football Club, which led to one of the stands at the stadium being named after him. He later acquired a 55% shareholding in the club, which was to be passed into the hands of the local community upon his death. He died in December 2019, aged 71. The couple also set up the Weir Charitable Trust in 2013 and donated £1 million to the Scottish independence referendum in 2014. They divorced in the same year as Colin’s death. – Adrian and Gillian Bayford, £148,656,000 Adrian and Gillian won 190 million euros in a EuroMillions draw in August 2012, which came to just over £148 million. The couple bought a Grade II listed estate in Cambridgeshire, complete with cinema and billiards room, but it was sold in 2021, some years after the pair divorced, as reported by The Mirror. – Anonymous, £123,458,008 The seventh biggest National Lottery winner won a Superdraw rollover jackpot in June 2019, and decided not to go public with their success. – Anonymous, £122,550,350 After nine rollovers, one lucky anonymous ticket-holder bagged more than £122 million in April 2021. – Anonymous, £121,328,187 Another of the UK’s top 10 lottery winners found their fortune through a Superdraw jackpot rollover, this time in April 2018. – Frances and Patrick Connolly, £114,969,775 Former social worker and teacher Frances set up two charitable foundations after she and her husband won almost £115 million on New Year’s Day 2019. She estimates that she has already given away £60 million to charitable causes, as well as friends and family. She considers helping others to be an addiction, saying: “It gives you a buzz and it’s addictive. I’m addicted to it now.”

AP News Summary at 1:45 p.m. EST

Three priests suspended over report that felled Justin WelbyAtletico Madrid and Atalanta scored six apiece and Bayer Leverkusen five while Robert Lewandowski reached 100 Champions League goals. Manchester City’s crisis deepened as they surrendered a three-goal lead late in the game to draw 3-3 against Feyenoord in the Champions League. Pep Guardiola’s side avoided the indignity of a sixth successive defeat in all competitions and looked on course for a welcome victory thanks to a double from Erling Haaland – the first from the penalty spot – and a deflected effort from Ilkay Gundogan. Yet Guardiola was left with his head in hands as Feyenoord roared back in the last 15 minutes with goals from Anis Hadj Moussa, Sergio Gimenez and David Hancko, two of them after Josko Gvardiol errors. Arsenal delivered the statement Champions League win Mikel Arteta had demanded as they swept aside Sporting Lisbon 5-1. Arteta wanted his team to prove their European credentials, and goals from Gabriel Martinelli, Kai Havertz, Gabriel, Bukayo Saka and Leandro Trossard got their continental campaign back on track in style following the 1-0 defeat at Inter Milan last time out. A memorable victory also ended Sporting’s unbeaten start to the season, a streak of 17 wins and one draw, the vast majority of which prompted Manchester United to prise away head coach Ruben Amorim. Paris St Germain were left in serious of danger of failing to progress in the Champions League as they fell to a 1-0 defeat to Bayern Munich at the Allianz Arena. Kim Min-jae’s header late in the first half was enough to send PSG to a third defeat in the competition this season, leaving them six points off the automatic qualification places for the last 16 with three games to play. Luis Enrique’s side, who had Ousmane Dembele sent off, were deservedly beaten by Bayern who dominated chances and possession. Elsewhere, Atletico Madrid were 6-0 winners away to Sparta Prague, Julian Alvarez and Angel Correa each scoring twice whilst there were also goals from Marcos Llorente and Antoine Griezmann. Barcelona ended tournament debutants Brest’s unbeaten start with a 3-0 victory courtesy of two goals from Robert Lewandowski – one a penalty – and Dani Olmo. Lewandowski’s first was his 100th Champions League goal, only the third man to reach the mark after Cristiano Ronaldo and Lionel Messi. A Castello Lukeba own goal saw Inter Milan go top of the standings with a narrow 1-0 win over RB Leipzig at San Siro, whilst Bayer Leverkusen were emphatic victors against Red Bull Salzburg, Florian Wirtz scoring twice to move Xabi Alonso’s side into the automatic qualification places. Atalanta continued their strong start, albeit whilst conceding a first goal in Europe this season in a 6-1 win away to Young Boys, whilst Tammy Abraham scored the decisive goal as AC Milan beat Slovan Bratislava 3-2.More loans, more pains and the season of discontent

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