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slot games tricks 'I Never Liked Him': Zachary Levi Receives Harsh Criticism From 1 Former Co-Star - CBRSWEET treat fanatics are flocking to three discount stores to get their hands on a new selection of Baileys deserts. Both Baileys Eclairs and Baileys Indulgent Biscuits have been spotted on the shelves this Christmas. Aldi and Home Bargains have stocked up the creamy confectionaries and eagle-eyed shoppers were delighted to find them in Iceland as well. A lot of people adored the creamy-flavoured find, and were gushing in the comment section of the Iceland website. One wrote: "Wow absolutely delicious. "You can taste the Baileys in the very generous cream, will definitely buy again." Another added: "Very nice, lots of Baileys in a small eclair." A third user commented: "Delicious, just the right amount of Baileys cream." However not everyone was impressed. One user posted: "Pleased I didn't pay full price for them. "I wont be buying any for myself for Christmas and will have to decide whether I still give them as gifts or give them to the local church for Christmas raffle - maybe with a very sweet warning attached." Another complained: "Smaller than expected, and with a weird aftertaste. "They don't taste like proper Baileys, more like a cheap imitation." Despite the mixed reviews, shoppers are still keen to give the new Baileys collection a try. The Baileys Indulgent Biscuits are described as buttery but still with a hint of liqueur, and not too overpowering. As the the Baileys Milk Chocolate Creams, they consist a balance of a creamy whisky filling covered in milk chocolate. The mini eclairs have a creamy Baileys flavoured filling in a light pastry, covered with a smooth chocolate coating. These are frozen in a pack of 12 and instructions suggest defrosting them for 30 minutes before tucking in. If you're a sucker for that creamy Irish whiskey liqueur, then there are some sneaky hacks that can save you on splashing out on Baileys this festive season. If you want to save your money for presents, you can always go for a Baileys dupe, which have been described as "almost perfect." If you're prepared to let go of the litre bottle you can purchase the 70cl Ballycastle cream liqueur for £5.79 - just 82p per 100ml. Shoppers have described the product as "lush" and "gorgeous" on Facebook. The Ballycastle product also comes in various flavours, such as the newest addition, which is a luscious Milk Chocolate Clementine version for £7.49. If you fancy giving something new a try, this could save you up to a whopping £16.21 on one bottle of Baileys. For the price of one Baileys bottle from Morrisons or Asda, £22.00, you could nearly buy four bottles of the Ballycastle. However, keep in mind that the ABV of Bailey's is 16 per cent, the Ballycastle booze is 12 per cent. Other supermarkets which offer up their own Baileys dupes include Sainsbury's, Tesco, Morrison's, Asda, Lidl and M&S. Consumer reporter Sam Walker reveals how you can save money on your Christmas shopping Limit the amount of presents - buying presents for all your family and friends can cost a bomb. Instead, why not organise a Secret Santa between your inner circles so you're not having to buy multiple presents. Plan ahead - if you've got the stamina and budget, it's worth buying your Christmas presents for the following year in the January sales. Make sure you shop around for the best deals by using price comparison sites so you're not forking out more than you should though. Buy in Boxing Day sales - some retailers start their main Christmas sales early so you can actually snap up a bargain before December 25. Delivery may cost you a bit more, but it can be worth it if the savings are decent. Shop via outlet stores - you can save loads of money shopping via outlet stores like Amazon Warehouse or Office Offcuts. They work by selling returned or slightly damaged products at a discounted rate, but usually any wear and tear is minor

Science and Technology Daily: Promoting AI Governance JointlyCDWP approves 15 projects worth Rs422.704bn Meeting chaired by Minister PDSI & Deputy Chairman Planning Commission Ahsan Iqbal Federal Minister for Planning Development & Special Initiatives Ahsan Iqbal chairs a meeting to review the progress of Public Sector Development Programme (PSDP) projects in Balochistan on September 2, 2024. — APP ISLAMABAD: The Central Development Working Party (CDWP) has approved 15 development projects worth Rs422.704 billion during its meeting chaired by Minister PDSI & Deputy Chairman Planning Commission Ahsan Iqbal. googletag.cmd.push(function() { googletag.display('div-gpt-ad-1700472799616-0'); }); Out of these, 6 projects worth Rs17.95 billion have been approved by the CDWP forum, while the forum has recommended 9 projects worth Rs404.754 billion to the Executive Committee of the National Economic Council (ECNEC) for its consideration. The meeting was attended by Secretary Planning Awais Manzur Sumra, Joint Chief Economist (Ops), Members of the Planning Commission, as well as respective federal secretaries, heads of provincial and representatives from federal ministries and provincial governments. The agenda included discussion on projects of health, agriculture, environment, manpower, governance, water resources, transport & communication and science & technology.

A weapons call sparked a big police response to Burnaby's Metrotown mall Thursday evening. Burnaby RCMP got a report at about 6:45 p.m. about a person with a weapon, possibly a knife, according to an emailed Burnaby RCMP statement. When police arrived, they located a 37-year-old man being held by security guards near Lids in the northwest area of the mall. Police took the man into custody after he was linked to an alleged robbery at a jewelry store in the mall, according to police. The suspect used a metal tool to break display cases inside the store, police said. After his arrest, the man was taken to hospital to be treated for minor injuries. Burnaby RCMP said 10 police vehicles responded to the mall for the incident. The large police presence raised concerns among mall goers, some of whom took to social media. Metrotown Mall Attack by u /Ahootchie in burnaby A.H., who didn't want her full name published because of safety concerns, told the Burnaby NOW she posted on Reddit to find out what happened after she ran away from the area where the suspect was arrested. She said she saw a group of about four youths all clad in black puffy jackets and wearing balaclavas attack a man who had bumped into them. "They were all dressed the same," A.H. said of the youths. "Eventually, I saw one of the dudes making this stabbing motion, and I saw he had a knife, so after that I just left, and I saw two security guards running towards the scene." The investigation is ongoing, according to police. Follow Cornelia Naylor on X/Twitter @CorNaylor Email [email protected]

The emergence of generative AI has reshaped the face of the corporate landscape. Its integration with most global technology has brought about equal risk and opportunity that boards can no longer afford to overlook. Unlike traditional technologies, AI has the potential to be embedded deeply in corporate practice in a manner that provides access and use to all employees, regardless of their technical expertise; this exposure enhances the probability of misuse, unintended consequences, and exposure to increased risks regarding reputations, financials, operations, and inducts legal. Board of directors are now saddled with the responsibility of proactively monitoring how their organizations deploy AI. While a useful tool for managing efficiency in the workplace, the use of AI can, at times, lead to more problems than solutions. Michael Portegello , a former executive at a Big Four professional services firm and seasoned business advisor with over 37 years of experience, offers some perspective on this delicate task of balancing power. The Heavy Responsibility of AI Use Institutional investors, regulators, and other stakeholders have begun paying more attention to how companies govern their AI strategies. There's also a rising call for transparency, as these stakeholders expect companies to disclose AI-related risks and measures taken to mitigate them. Consider this: from 2022 to 2024, it appears from the S&P 500 Form 10-K filings that the number of companies referencing AI as a risk factor has grown from 49 to 281. Such rapid growth in disclosures evidences the growing scrutiny over AI adoption and the fact that boards should be well-prepared to navigate this new regulation landscape. Portegello highlights the weightiness of boards proactively working alongside management to integrate AI in ways that align with corporate values, ethics, and compliance expectations. Equally important, boards are responsible for asking the right questions at the right time to meet head-on with the unique wagers AI presents. Such a hands-on approach powers responsible innovation and lays the foundation of accountability throughout the organization. Portegello points out that the board’s responsibility will extend into legal compliance, ethics, and enterprise risk management. The Harvard Law School Forum on Corporate Governance has stated that boards must exercise fiduciary oversight, ensuring AI strategies are transparent, ethically managed, and supported by strong internal controls. Effective AI governance now requires that boards understand the potential of the technologies involved and their inherent risks, constantly engaging with management to sustain a cohesive sense of broadly informed decision-making. Portegello emphasizes a key question that boards must ask to fulfill fiduciary duties: “How much does each individual director know about AI?” He references a recent Deloitte study that found almost 80% of boards report having little or no knowledge of AI; to bridge this unsettling gap, Portegello recommends companies focus on adding AI expertise through specialized training, consulting from experts, or even new board members dedicated to that area of expertise. With AI moving at this pace, “boards must increase and update their knowledge about AI, receive frequent and systematic updates on strategies and related risks to ensure that they fulfill their fiduciary responsibilities,” says Portegello. Under increasing pressure from regulators, investors, and stakeholders, corporate leaders should create an environment in which AI converges with both long-term strategic goals and the core ethical standards of their organization. This will provide a foundation for boards to lead their companies through AI governance complexities confidently and clearly, setting the stage for further in-depth exploration. Mitigating the Risk in AI Use With the huge role AI plays in the corporate scene, boards are faced with a double-sided challenge: embracing the potential of AI to drive the growth of their company while simultaneously ensuring its use is in compliance with company values and regulatory expectations. Portegello highlights that, in today’s world, boards need to go beyond traditional oversight by understanding both the opportunities and risks AI presents. This journey starts with building a solid foundation of AI knowledge, fostering a culture of ethical AI use, and establishing governance frameworks that support both innovation and responsibility. It is important to examine key areas for boards to focus on as they learn to walk the road between security and innovation. From boosting AI expertise to performing ethical practices, these steps offer practical ideas, user-friendly implementation, and essential questions board members can ask to feel more confident in their understanding of AI. 1. Prioritizing AI oversight AI’s presence in the world is non-negotiable. As such, boards need to ensure their organization’s employees have at least a working knowledge of AI and the dangers it poses to the safety and reputation of the company. Portegello stresses that many boards still have a significant knowledge gap, with nearly 80% of directors lacking in-depth AI understanding . To close this gap, he points out the value in “ensuring the AI governance framework addresses leadership’s challenges related to the potential impact on recruiting and diversity, equity and inclusion among many other related opportunities, risks and compliance issues.” By focusing on these critical areas, boards will be better equipped to guide their organizations by learning to use AI responsibly. Additionally, once they feel they have a stronger grasp on the usage of AI, board members can explore their organization’s strategy from diversified angles. A stream of regular, informed questioning keeps them actively engaged with the company’s values and promotes their ability to stay ahead in the market. 2. Integrating innovation with risk management For corporate leaders, the question is how to strike the right balance between AI-driven growth and risk management. According to Portegello, AI governance guides the efforts of AI-driven innovation in a way that guarantees that core values and regulatory expectations are fully complied with. A strong governance structure coupled with transparent communication between the board and management will help to strike a balance in overseeing the risks that come with AI. To responsibly stimulate innovation, boards should strive to set a pattern of safety-oriented, transparent conversations with management. That kind of engagement assures that AI initiatives not only drive growth but are also supported by solid safeguards to minimize risk. In this way, through the regular review and challenge of decisions, the board can create an environment where growth through AI occurs ethically and effectively, thereby establishing a foundation of confidence among stakeholders and investors. 3. Teaching ethical AI use Ethics is at the core of AI governance; boards have a critical role in promoting such values across the organization. The inclusion of ethics in the AI governance framework ensures that the AI initiatives will meet the company's initial values. Portegello suggests that the board set these ethical principles from the very beginning and embed them in policies, procedures, and controls to ensure accountability. This proactive approach provides a culture in which ethical AI use becomes standard and supports both compliance and integrity. This would again mean consistent monitoring of such ethical standards as AI becomes integrated across various functions. The board should review the policies on AI regularly to ensure they reflect current ethical standards and deal maturely with issues of bias, discrimination, and transparency. Steady oversight of these significant concerns underpins company-wide accountability and ties practices in AI with corporate purpose, setting the standard for the responsible use of AI. By prioritizing ethics, boards will secure their organization’s future in a swiftly changing digital world. Traditional IT vs. Generative AI In learning of the risks associated with AI, it is essential to touch on the challenge of governing AI compared to traditional IT. This new area of digital monitoring presents boards with a highly complex responsibility. “One of the differences between AI and traditional IT development and software deployments is the democratization of AI within organizations, with all functions either becoming automated and/or enhanced by AI,” Portegello points out. As such, this shift in responsibility would involve building a company culture where growth in AI is congruent with maintaining an awareness of its differentiation from IT. Just as a help desk allows employees to have their questions regarding IT answered, there should be a gradual process to establish an AI-centered team of experts within each company. Boards must also ensure that management is proactively preparing employees for the unique compliance challenges created by AI. Data privacy, bias, discrimination, and regulatory compliance are far more complex with AI's self-learning and decision-making capabilities than with traditional IT. As Portegello suggests, strong communication within the company can establish a foundation through which AI can drive growth while respecting corporate values and expectations. Harnessing AI for Corporate Growth With its exponential improvement, artificial intelligence is capable of creating transformational change across various industries. Furthermore, AI's opportunities for unconventional growth and competitive advantage exceed all past limitations, along with the potential for new operational efficiencies and improved decision-making capabilities. With appropriate governance and strategic planning, companies can use AI to build a highly skilled workforce, exploring new frontiers in emerging technologies. "New and exciting ways to leverage AI are being introduced every day," says Portegello, emphasizing the role of boards in supporting responsible AI implementation. Companies should work towards the goal of providing their employees with a tailored set of strategic tools, allowing the organization to thrive under the current wave of AI development. 1. Developing workforce readiness One of the many ways that AI has revolutionized the concept of knowledge is through its infusion into various business functions. Boards are vital in preparing the organization for this transformation by creating a culture of continuous learning and development. Portegello emphasizes the importance of "ensuring employee readiness and the need and costs for re-training and skill development." The boards should ensure that the necessary training programs for leadership and employees to bridge the skills gaps exist, creating a diverse and inclusive AI talent pool. Such an approach sets an organization up for profitable success by making room for sustainable growth. 2. Strategic capital investment in AI infrastructure AI’s transformative potential requires heavy investment in infrastructure, data management, and compliance measures. Boards must take on a long-term perspective when overseeing these capital expenditures, connecting AI investments with the organization’s strategic goals to maximize return on investment (ROI). Portegello encourages boards to take an active role in this process; if the board sets frequent updates on ROI and tracking management accountability, then such investments will be channeled toward growing the company. 3. Keep an eye on emerging AI trends “Future applications will have a truly transformational impact as AI merges with other transformational technologies such as robotics, biotechnology, quantum among others,” Portegello claims. This development requires advanced governance models in the convergence of ethical, moral, and operational risks. Additionally, regulatory demands are going to increase, with stakeholders such as institutional investors desiring a great level of transparency and accountability. In preparation, boards should frequently update their knowledge of emerging AI trends and establish sound governance practices to ensure compliance with evolving regulations. This will be the best position from which organizations can responsibly take advantage of AI growth to meet their audience's heightened expectations. Striking a Balance in AI Regulation As AI continues to rebuild the internal lining of the corporate landscape, boards must adopt proactive governance to balance the potential of AI for growth with the associated risks. Michael Portegello's contributions bring forth the importance of continuing learning and watchful oversight in guiding responsible AI use. Boards can prepare their organizations for the transformative power of AI by encouraging a culture of innovation and accountability, as well as support for workforce readiness and readiness for emerging trends. This balanced approach allows boards to fulfill their fiduciary duties in a manner that ensures sustainable growth, full regulatory compliance, and alignment with corporate values in an increasingly AI-driven world.Barilla and Meals on Wheels America Unite for Connection Kitchen Food Truck to Help End the Wait TM for Seniors Hoping to Receive Nutritious Meals and Meaningful Connection NORTHBROOK, Ill. , Nov. 26, 2024 /PRNewswire/ -- Barilla, the world's leading pasta maker, believes in the joy of food for a better life and knows that the most joyful meals aren't enjoyed alone. That's why this holiday season, the pasta company is on a mission to spread joy and combat loneliness through its first signature giving event, the Barilla Connection Kitchen food truck. This year Barilla America, which is headquartered in Northbrook Illinois , is partnering with Meals on Wheels America to help End the Wait TM for seniors who struggle with hunger and isolation. Across the country, local Meals on Wheels programs serve nutritious meals and meaningful connections to seniors in their communities, but limited funding and volunteers force one in three programs to keep a waitlist. Through the Connection Kitchen program, Barilla is helping bring to life a new plan to End the Wait TM for millions of seniors who need Meals on Wheels. In addition to helping to inspire and recruit volunteers for Meals on Wheels Chicago and programs across the country, Barilla is supporting national efforts to End the Wait by donating $250,000 to Meals on Wheels America. Launching during the holiday giving season, the Connection Kitchen pop-up food truck will take to the streets of Chicago to serve delectable pasta dishes, spreading warmth and joy, with a suggestion to sign up to volunteer with Meals on Wheels Chicago while enjoying their pasta. The food truck will be stationed at the Merchandise Mart in downtown Chicago on Friday, December 6 th from 12pm-3pm CT and at Oakbrook Center on Saturday, December 7 th from 11am-5pm CT . All pasta will be served free of charge to the public with the centralized mission to spread awareness of important connections and joy this holiday season. "At Barilla, we know the most joyful meals are meant to be shared," said Laura Birk , Vice President of Human Resources, Barilla America. "In fact, research we recently conducted in collaboration with the University of Minnesota showed that 60% of individuals acknowledged eating alone more often over the past two years. That said, people who embraced sharing meals with others on a weekly basis experienced notable improvement in their mental well-being. What better way to spread this joy of food than by helping Meals on Wheels Chicago connect people within the local community?" Barilla's head Chef Lorenzo Boni curated the Connection Kitchen menu to ignite the holiday spirit. At the Connection Kitchen, Chicagoans can choose from the following classic Italian recipes: "At Meals on Wheels America, we're thankful for Barilla's partnership helping us End the Wait, which is to ultimately ensure that every senior who needs Meals on Wheels, gets it," said Ellie Hollander , President and Chief Executive Officer at Meals on Wheels America. "As Barilla encourages those in their own backyard to support the local Meals on Wheels Chicago program, we hope this inspires others around the country to do the same by donating to and volunteering with the Meals on Wheels program in their own community." "This partnership encourages the local Chicago community to get involved and help the Meals on Wheels network End the Wait TM for the thousands of seniors in our community who face hunger and isolation each year," said Cory Morris , Director of Community Impact, Meals on Wheels Chicago. "In Chicago, 8 out of 10 seniors served by Meals on Wheels report that their delivery driver is their primary social contact, on any given day. With Barilla's help, we're raising awareness of this need for more volunteer resources in order to build more of these moments of connection." Over the years, Barilla has made significant contributions to a variety of nonprofits. Since 2010, the global Barilla Group has donated 50,000 tons of product and over 60 million euros to support communities worldwide. In the US, Barilla also works closely with organizations like the Greater Chicago Food Depository, Feeding America, and Food Bank for New York City – to name just a few – to feed people across the United States . This partnership is yet another step in Barilla's mission of the joy of food for a better life. To join Barilla and Meals on Wheels America in bringing meaningful connections to those who need it most through the mobile Connection Kitchen truck, visit BarillaConnectionKitchen.com . To learn more about Meals on Wheels volunteer opportunities visit www.mealsonwheelsamerica.org/endthewait . About Barilla Group: Barilla is a family business, not listed on the Stock Exchange, chaired by the brothers Guido, Luca and Paolo Barilla. It was founded by their great-grandfather Pietro Barilla, who opened a bakery in Parma in 1877. Today, Barilla is renowned in Italy and around the world for the quality of its food products. With its brands – Barilla, Mulino Bianco, Pan di Stelle, Gran Cereale, Harrys, Pavesi, Wasa, Filiz, Yemina, Misko, Voiello, Academia Barilla, First, Catelli, Lancia, Splendor, Back To Nature and Pasta Evangelists – it advocates tasty, hearty and wholesome nutrition, inspired by the Mediterranean Diet and the Italian lifestyle. When Pietro opened his shop over 145 years ago, the main aim was to make good food. That principle has now become the Barilla way of doing business, with almost 9,000 people working for the company and a supply chain that shares its values and passion for quality. The Group's commitment is to offer people the joy that good, well-made food can bring them, produced with selected ingredients favouring those from responsible supply chains, to contribute to a better present and future. Since 1987, a historical archive has been collecting and preserving the company's over 145-year history, now a resource open to all via the portal-museum www.archiviostoricobarilla.com . For further information, visit: www.barillagroup.com ; Twitter: @barillagroup; LinkedIn: Barilla Group; Instagram: @barillapeople. About Barilla Group's Corporate Giving: Over the years, with the aim of supporting local communities, Barilla has supported and participated in numerous initiatives and projects that promote access to food for disadvantaged communities or those affected by natural disasters. At the same time, guided by its purpose "The joy of food for a better life," Barilla has established and strengthened relationships with charities, businesses, and nonprofit organizations, working alongside local authorities through partnerships, financial contributions, and product donations. About Meals on Wheels America: Meals on Wheels America is the leadership organization supporting the more than 5,000 community-based programs across the country that are dedicated to addressing senior hunger and isolation. Powered by a trusted volunteer workforce, this network delivers a comprehensive solution that begins with a meal and is proven to enable independence and well-being through the additional benefits of tailored nutrition, social connection, safety and much more. By providing funding, programming, education, research and advocacy, Meals on Wheels America empowers its local member programs to strengthen their communities, one senior at a time. For more information, or to find a Meals on Wheels provider near you, visit www.mealsonwheelsamerica.org . For further information contact: Media Contacts: Brook Kovanda Davis brooke.kovanda@barilla.com Kyle Sharick kyle.sharick@edelman.com View original content to download multimedia: https://www.prnewswire.com/news-releases/eating-pasta-to-spread-joy-barilla-is-giving-back-by-bringing-connection-to-those-who-need-it-most-302316841.html SOURCE Barilla America, Inc.Global Pharmaceutical Cartridges Market Set For 9.9% Growth, Reaching $3.29 Billion By 2028

Renuka Rayasam | (TNS) KFF Health News In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online baby message boards and other social media forums , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the Patient Advocate Foundation . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the American College of Obstetricians and Gynecologists . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to spread out one-time payments over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the Peterson-KFF Health System Tracker . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the 100 million U.S. people with health care debt, 12% attribute at least some of it to maternity care, according to a 2022 KFF poll . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said Joy Burkhard , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the timing of the pregnancy , plan benefits, and health complications, said Erin Duffy , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said Sabrina Corlette , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, Lacy Marshall , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Related Articles Health | Which health insurance plan may be right for you? Health | California case is the first confirmed bird flu infection in a US child Health | UC campus and hospital worker strike continues across university system Health | Phillips 66 indicted on charges it dumped tainted water from Carson refinery into sewer system Health | US towns plunge into debates about fluoride in water Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

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