The Inflation Reduction Act of 2022 (IRA), signed into law by President Biden on August 16, 2023, is already providing cost savings for Medicare beneficiaries in 2023, including a monthly cap of $35 for covered insulin and free vaccines for certain conditions.  In January 2024, even more beneficial changes are starting.  As noted on the www.medicare.gov website:
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• If you have drug costs high enough to reach the catastrophic coverage phase in your Medicare drug coverage, you won’t have to pay a copayment or coinsurance, starting in 2024.  (Note that according to KFF, this provision will effectively cap out-of-pocket costs at approximately $3,250 in 2024)
• Extra Help affording prescription drug coverage (the Part D Low-Income Subsidy (LIS) program) will expand to cover more drug costs for people with limited resources who earn less than 150% of the federal poverty level, starting in 2024. People who qualify for Extra Help generally will pay no more than $4.50 for each generic drug and $11.20 for each brand-name drug.

     In addition, the drug price negotiation program created by the IRA allows Medicare to use its bargaining power to negotiate the prices of prescription drugs for the first time.  

     The pattern of lowered cost continues in 2025, when the annual Part D out-of-pocket cap will be decreased to $2,000.  Individuals will also have the option to pay out-of-pocket costs in monthly amounts over the plan year, instead of when they happen.
 

SOURCE/MORE: CENTER FOR MEDICARE ADVOCACY>>

During the Jim Crow era, Black Americans traveling the country through segregated America consulted a guidebook - colloquially known as the "Green Book" - to determine which restaurants, hotels and other amenities they could safely visit.
 
This year, legislation to recognize sites included in the guide with historical markers has been making its way through the General Assembly.  Specifically, this legislation is known as House Bill 1968 and directs the Virginia Department of Historic Resources "to designate or approve supplementary signs for historic site signs” identifying locations from the Green Book.  The signs would be affixed to the bottom of preexisting silver and black historical markers, similar to signs marking Virginia's historic trails.
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The bill's patron, Del. Mike Mullin, D-Newport News, told the Senate Committee on Agriculture, Conservation and Natural Resources on Feb. 14, 2023, that the bill would "preserve the memory of those businesses and those sites that served to Black customers throughout the commonwealth and their contributions to African American history."
 
The Green Book, whose full name is "The Negro Motorist Green Book," was published by New York City mailman Victor Hugo Green from the 1930s to the 1960s and provided a list of hotels, restaurants, service stations and other places that were safe for Black people to go to while traveling. In recent years, the guidebook served as inspiration for a 2018 award-winning movie of the same name that helped grow public interest in the book.
 
Mullin, who is also an attorney at Randall, Page & Bruch in Courtland, told the Senate committee that "approximately 315 sites" are listed in the Green Book in "about 56 cities and towns" in Virginia. Mullin added that, of those, there are about 60 that could have markers under HB 1968.  "These sites are hugely important to our history and I hope that they get the recognition and protection that they duly deserve," Mullin told the committee.
 
The bill faced no opposition in the committee, with audible laughs from those in the room when committee chair Del. R. Lee Ware, R-Powhatan, asked if anyone was at the meeting to speak against the bill. The committee voted to report the bill unanimously.  HB 1968 passed the House of Delegates unanimously in a bloc vote on Jan. 24 before being sent to the Senate, where the Senate Committee on Agriculture, Conservation and Natural Resources reviewed the bill on Feb. 14, 2023.
 
Among those who spoke in favor of the bill before the Senate committee was Elizabeth Kostelny, chief executive officer of Preserving Virginia. The organization, a privately funded non-profit historic preservation organization, previously listed Green Book sites among its compilation of "Most Endangered Historic Places" in 2021.
 
"We named Green Book sites to our 2021 Most Endangered Historic Places in order to raise awareness of this important history. We thank Delegate Mullin for this legislation, and we support it," Kostelny said.
 
Like in the House of Delegates, the Senate committee voted to advance the bill unanimously.  HB 1968 was passed unanimously by the full Senate in a bloc vote on Feb. 17, 2023.
 
This amendment provides $50,000 in fiscal year 2024 for the Virginia Tourism Authority and Department of Historic Resources to effectuate the provisions of House Bill 1968 of the 2023 General Assembly to designate or approve signs for historic Green Book locations. 

The Nursing Home Improvement and Accountability Act is a bill that was introduced in August which addresses common issues that nursing home staff and residents face, especially in the wake of COVID. Nearly 1 in 3 COVID-related deaths were connected to nursing homes, and more than 184,000 nursing home and long-term care residents and staff have died from the virus. The NHIAA is designed to improve staffing issues, quality, oversight of nursing home and long-term care facilities, require an infection preventionist to be working full-time, and improve transparency for residents and their families. Keep reading to learn about what the bill intends to do for seniors and staff:


1. Resolve Staffing Issues

The NHIAA will require all nursing homes to employ an “infection prevention and control specialist”—someone who controls and prevents the spread of diseases—and ensure that nurses are available 24 hours a day (currently nurses must be present only 8 hours a day). It also gives power to the Department of Health and Human Services (HHS) to study how many nurses and nursing assistants are needed in nursing homes to be able to provide quality care to residents. Then the HHS can also use that information to ensure that facilities are never understaffed.

2. Protect Seniors’ Legal Rights

Many nursing homes require applicants to sign an arbitration agreement before being admitted into the facility, which requires the residents and the facilities to resolve issues together instead of suing each other in court. The bill will protect seniors so that they won’t have to choose between long-term care and their right to sue their nursing home if they suffer during their car.

3. Ensure that Nursing Homes are Financially Stable

To ensure that nursing and long-term care facilities are financially secure, the bill requires that the post a bond of $500,000 to the HHS as an emergency fund. This bond ensures that there will always be money available in case of emergencies or unexpected circumstances, for example, if the facility must suddenly close or if it faces financial hardships. The HHS will also provide additional oversight to low-performing nursing homes to help improve their quality of care, infection control, and emergency preparedness.

4. Modernize the Physical Environments

​Facilities will receive help to upgrade their physical space for residents and staff. The NHIAA proposes to “enhance staff experience” and “promote evidence-based, patient-centered care for residents” to make nursing homes better places to live and work. There will also be a demonstration program which provides money to nursing homes so that they can invest in improving the facilities and raise workforce standards.


You can read more about the Nursing Home Improvement and Accountability Act here and read it in its entirety here.

The internet is a wellspring of free information.  But should it be?  Writers and artists work hard to earn a living.  Is the age of online information a threat to their livelihood, or can it instead be a useful tool to help their craft reach millions around the world?  This is perhaps the question at the heart of the case that examined the legality of Google’s digital library, Google Books.

Google Books strives to provide people all over the world with an online, searchable catalog of books in all languages.  This could mean much more than saving a college student a trip to the campus library.  It could mean, in theory, that even a poor farmer’s daughter in rural Thailand could have access to information and education so long as she has access to the internet.

But what does this mean for the authors of these works?  Does this online catalog infringe on their copyrights?  The US Court of Appeals for the Second Circuit ruled last Friday that it does not.

The reproduction of the work must fall under the category of “fair use.”  Fair use is determined by four factors that include the purpose of use, the nature of the work, the amount of the work that’s reproduced and the effect of its reproduction on the potential market (simply put, will the writer lose money because of it?).

Google claims their efforts actually benefit copyright holders.  Google Books only reveals portions of certain pages until a customer decides to purchase access to the entire book online.  The company claims this gives potential buyers an easy way to access and purchase the works, without revealing too much information in advance that could threaten their copyright.

The digital age is saturated with an ongoing struggle to find the balance between the public’s access to information and digital media and the writer or artist or musician’s right to claim ownership over their intellectual property and use it to make a living.  This recent decision by the Federal appeals court takes another step toward finding that balance.