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Millions of diabetes patients are missing out on Medicare’s nutrition help

LOUISIANA WEEKLY — The estimated 15 million Medicare enrollees with diabetes or chronic kidney disease are eligible for the benefit, but the federal health insurance program for people 65 and older and some people with disabilities paid for only about 100,000 recipients to get the counseling in 2017, the latest year billing data is available. The data does not include the 20 million enrollees in private Medicare Advantage plans.

Published

5 years ago

September 24, 2019

Oakland Post

Glucose meter with result sugar level, healthy food, dumbbells and centimeter, diabetes (Photo by: Ratmaner)

By Phil Galewitz

(Special from khn.org) — Louis Rocco has lived with diabetes for decades but, until he met with a registered dietitian in August, he didn’t know eating too much bread was dangerous for him.

“I’m Italian, and I always eat a lot of bread,” he said. After two hour-long visits with a dietitian — including a session at his local grocery store in Philadelphia — Rocco, 90, has noticed a difference in his health.

“It’s helped bring down my sugar readings,” he said of changes in his diet including eating less bread. “I wish I knew I could have had this help years ago.”

After getting a referral this summer from his doctor, Rocco learned that Medicare covers personal nutritional counseling for people with diabetes or kidney disease.

The estimated 15 million Medicare enrollees with diabetes or chronic kidney disease are eligible for the benefit, but the federal health insurance program for people 65 and older and some people with disabilities paid for only about 100,000 recipients to get the counseling in 2017, the latest year billing data is available. The data does not include the 20 million enrollees in private Medicare Advantage plans.

Health experts say the little-used benefit represents a lost opportunity for beneficiaries to improve their health — and for the program to save money by preventing costly complications from the diseases.

An estimated one in four people 65 and older have diabetes and one in three have chronic kidney disease. Kidney disease is often a complication of diabetes.

The prevalence of diabetes has risen markedly in the past 20 years and the condition is more common as people age.

Nationwide, there are 100,000 registered dietitians — more than enough to meet demand, said Krista Yoder Latortue, executive director of Family Food in Philadelphia, which employs about 50 dietitians including the one who visited Rocco. Medicare data showed about 3,500 dietitians billed the program for nutritional counseling in 2017.

The problem may be that not enough physicians know about the Medicare benefit. Doctors have to refer patients to a dietitian.

Congress approved the benefit, which began in 2002, after studies found medical nutrition counseling leads to improved health outcomes and fewer complications for older patients. Under the preventive health provisions of the Affordable Care Act, the counseling has been available without out-of-pocket costs to Medicare beneficiaries since 2011.

Medicare pays for three hours of dietary counseling during the first year the benefit is used and two hours in subsequent years. A doctor can appeal to Medicare for additional nutritional therapy if the physician believes it is medically necessary.

Larry Lipman, 70, of Falls Church, Va., said he was shocked to learn he had diabetes earlier this year because he’s relatively thin and is an avid cyclist.

When his doctor recommended meeting with a dietitian, he not only said yes but also brought along his wife, who does most of the cooking.

“It was great because I could ask specific questions and get into the nitty-gritty about how I eat, what I eat and when I eat,” said Lipman, a retired journalist.

“I’ve learned I needed to cut down on portion sizes of rice and other things to keep my carbohydrates down,” he said. “I’m thinking more about what I eat every time and staying away from Doritos and ice cream.”

Doctors shoulder some of the blame for patients not getting dietary counseling by failing to refer them to dietitians.

“It’s a lot easier to prescribe a medication than it is to discuss the importance of nutrition and get patients to meet with a registered dietitian,” said Dr. Holly Kramer, a Chicago nephrologist and president of the National Kidney Foundation.

“I don’t understand how we have this burgeoning obesity and diabetes epidemic and we are not using dietitians in our clinics for all these patients, yet we are paying for all these things that mediate from the disease process such as arthritis, dialysis and amputations,” she said.

Jennifer Weis, a registered dietitian in Philadelphia, said the limited hours Medicare covers is frustrating given how difficult it is to change behaviors in older adults.

“It’s better than nothing, but in my mind is not sufficient,” she said.

Doctors might not be aware of the Medicare option since “it’s a challenge to keep up with what is a covered benefit and what is not,” said Dr. Michael Munger, chairman of the American Academy of Family Physicians who practices in Overland Park, Kan. He said that many doctors who don’t practice with a large health system may not be familiar with dietitians in their community.

For convenience, Munger said, he refers his diabetes patients to a nurse practitioner in his office for nutritional counseling. But only registered dietitians are covered under the Medicare benefit, so his Medicare patients face a copayment for that service.

Nutritional counseling is not the only underused Medicare benefit that can prevent health complications.

Fewer than five percent of Medicare beneficiaries use their 10 to 12 hours of diabetes self-management training benefit, which can cover individual and group sessions providing tips for eating healthily, being active, monitoring blood sugar, taking drugs and reducing risks.

Part of the problem, said Yoder Latortue in Philadelphia, is there is a lot of misinformation about whom the public can trust on nutrition advice.

“Everyone eats and everyone has an opinion,” Yoder Latortue said.

Lauri Wright, a Jacksonville, Fla., registered dietitian and spokeswoman for the Academy of Nutrition and Dietetics, said the federal Centers for Medicare & Medicaid Services sends out notices to health providers once a year but more information is needed.

About 10,600 registered dietitians have enrolled to treat Medicare patients, a CMS spokeswoman said. She said the agency has been advising health providers about the benefit and promoting it to enrollees on its website and its annual handbook that it sends to beneficiaries.

Still, “I think because only two diseases are covered by Medicare and the rest aren’t, it falls off everybody’s radar,” Wright said.

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

This article originally published in the September 16, 2019 print edition of The Louisiana Weekly newspaper.

This article originally appeared in The Louisiana Weekly.

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Beloved Actor and Activist Louis Cameron Gossett Jr. Dies at 87

NNPA NEWSWIRE — Louis Gossett Jr., the groundbreaking actor whose career spanned over five decades and who became the first Black actor to win an Academy Award as Best Supporting Actor for his memorable role in “An Officer and a Gentleman,” has died. Gossett, who was born on May 27, 1936, in Brooklyn, N.Y., was 87. Recognized early on for his resilience and nearly unmatched determination, Gossett arrived in Los Angeles in 1967 after a stint on Broadway.
The post Beloved Actor and Activist Louis Cameron Gossett Jr. Dies at 87 first appeared on BlackPressUSA.

Published

4 weeks ago

March 29, 2024

Oakland Post

By Stacy M. Brown
NNPA Newswire Senior National Correspondent
@StacyBrownMedia

Louis Gossett Jr., the groundbreaking actor whose career spanned over five decades and who became the first Black actor to win an Academy Award as Best Supporting Actor for his memorable role in “An Officer and a Gentleman,” has died. Gossett, who was born on May 27, 1936, in Brooklyn, N.Y., was 87. Recognized early on for his resilience and nearly unmatched determination, Gossett arrived in Los Angeles in 1967 after a stint on Broadway.

He sometimes spoke of being pulled over by law enforcement en route to Beverly Hills, once being handcuffed to a tree, which he remembered as a jarring introduction to the racial tensions of Hollywood. In his memoir “An Actor and a Gentleman,” Gossett recounted the ordeal, noting the challenges faced by Black artists in the industry. Despite the hurdles, Gossett’s talent shone brightly, earning him acclaim in groundbreaking productions such as “A Raisin in the Sun” alongside Sidney Poitier. His Emmy-winning portrayal of Fiddler in “Roots” solidified his status as a trailblazer, navigating a landscape fraught with racial prejudice.

According to the HistoryMakers, which interviewed him in 2005, Gossett’s journey into the limelight began during his formative years at PS 135 and Mark Twain Junior High School, where he demonstrated early leadership as the student body president. His passion for the arts blossomed when he starred in a “You Can’t Take It With You” production at Abraham Lincoln High School, catching the attention of talent scouts who propelled him onto Broadway’s stage in “Take A Giant Step.” His stellar performance earned him the prestigious Donaldson Award for Best Newcomer to Theatre in 1952. Though initially drawn to sports, Gossett’s towering 6’4” frame and athletic prowess led him to receive a basketball scholarship at New York University. Despite being drafted by the New York Knicks in 1958, Gossett pursued his love for acting, honing his craft at The Actors Studio under the tutelage of luminaries like John Sticks and Peggy Fury.

In 1961, Gossett’s talent caught the eye of Broadway directors, leading to roles in acclaimed productions such as “Raisin in the Sun” and “The Blacks,” alongside legends like James Earl Jones, Cicely Tyson, Roscoe Lee Brown, and Maya Angelou. Transitioning seamlessly to television, Gossett graced small screens with appearances in notable shows like “The Bush Baby” and “Companions in Nightmare.” Gossett’s silver screen breakthrough came with his role in “The Landlord,” paving the way for a prolific filmography that spanned over 50 movies and hundreds of television shows. From “Skin Game” to “Lackawanna Blues,” Gossett captivated audiences with his commanding presence and versatile performances.

However, his portrayal of “Fiddler” in Alex Haley’s groundbreaking miniseries “Roots” earned Gossett critical acclaim, including an Emmy Award. The HistoryMakers noted that his golden touch extended to the big screen, where his role as Sergeant Emil Foley in “An Officer and a Gentleman” earned him an Academy Award for Best Supporting Actor, making him a trailblazer in Hollywood history.

Beyond the glitz and glamour of Hollywood, Gossett was deeply committed to community activism. In 1964, he co-founded a theater group for troubled youth alongside James Earl Jones and Paul Sorvino, setting the stage for his lifelong dedication to mentoring and inspiring the next generation. Gossett’s tireless advocacy for racial equality culminated in the establishment of Eracism, a nonprofit organization dedicated to combating racism both domestically and abroad. Throughout his illustrious career, Gossett remained a beacon of strength and resilience, using his platform to uplift marginalized voices and champion social change. Gossett is survived by his children, Satie and Sharron.

The post Beloved Actor and Activist Louis Cameron Gossett Jr. Dies at 87 first appeared on BlackPressUSA.

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COMMENTARY: D.C. Crime Bill Fails to Address Root Causes of Violence and Incarceration

WASHINGTON INFORMER — The D.C. crime bill and so many others like it are reminiscent of the ‘94 crime bill, which produced new and harsher criminal sentences, helped deploy thousands of police and surveilling methods in Black and brown communities, and incentivized more states to build prisons through a massive infusion of federal funding. While it is not at the root of mass incarceration, it significantly accelerated it, forcing a generation of Black and brown families into a never-ending cycle of state-sanctioned violence and incarceration.
The post COMMENTARY: D.C. Crime Bill Fails to Address Root Causes of Violence and Incarceration first appeared on BlackPressUSA.

Published

4 weeks ago

March 27, 2024

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By Kaili Moss and Jillian Burford | Washington Informer

Mayor Bowser has signed the “Secure DC” omnibus bill passed by the D.C. Council last month. But we already know that this bill will be disastrous for all of D.C., especially for Black and brown residents.

While proponents claim that this legislation “will make D.C. residents safer and more secure,” it actually does nothing to address the root of the harm in the first place and instead maintains a cycle of violence, poverty, and broken community ties. The omnibus bill calls for increased surveillance, drug-free zones, and will expand pre-trial detention that will incarcerate people at a significantly higher rate and for an indeterminate amount of time before they are even tried. This bill will roll back decades of nationwide policy reform efforts and initiatives to keep our communities safe and whole, which is completely contradictory to what the “Secure” D.C. bill claims it will do.

What is unfolding in Washington, D.C., is part of a dangerous national trend. We have seen a resurrection of bad crime bills in several jurisdictions across the country — a phenomenon policy experts have named “zombie laws,” which are ineffective, costly, dangerous for communities of color and, most importantly, will not create public safety. Throwing more money into policing while failing to fund preventative measures does not keep us safe.

The D.C. crime bill and so many others like it are reminiscent of the ‘94 crime bill, which produced new and harsher criminal sentences, helped deploy thousands of police and surveilling methods in Black and brown communities, and incentivized more states to build prisons through a massive infusion of federal funding. While it is not at the root of mass incarceration, it significantly accelerated it, forcing a generation of Black and brown families into a never-ending cycle of state-sanctioned violence and incarceration. Thirty years later, despite spending billions each year to enforce these policies with many of these provisions remaining in effect, it has done very little to create long-term preventative solutions. Instead, it placed a permanent moving target on the backs of Black people, and the D.C. crime bill will do the same.

The bill calls for more pretrial detention. When our loved ones are held on pretrial detention, they are held on the presumption of guilt for an indeterminate amount of time before ever seeing a judge, which can destabilize people and their families. According to experts at the Malcolm Weimer Center for Social Policy at Harvard University, just one day in jail can have “devastating consequences.” On any given day, approximately 750,000 people are held in jails across the nation — a number that beats our nation’s capital population by about 100,000. Once detained, people run the risk of losing wages, jobs, housing, mental and health treatments, and time with their families. Studies show that pretrial detention of even a couple of days makes it more likely for that person to be rearrested.

The bill also endangers people by continuing a misguided and dangerous War on Drugs, which will not get drugs off the street, nor will it deter drug use and subsequent substance use disorders (SUDs). Drug policies are a matter of public health and should be treated as such. Many states such as Alabama, Iowa and Wisconsin are treating the current fentanyl crisis as “Crack 2.0,” reintroducing a litany of failed policies that have sent millions to jails and prisons instead of prioritizing harm reduction. Instead, we propose a simple solution: listen to members of the affected communities. Through the Decrim Poverty D.C. Coalition, community members, policy experts and other stakeholders formed a campaign to decriminalize drugs and propose comprehensive legislation to do so.

While there are many concerning provisions within the omnibus bill, car chases pose a direct physical threat to our community members. In July 2023, NBC4 reported that the D.C. Council approved emergency legislation that gave MPD officers the ability to engage in vehicular pursuits with so-called “limited circumstances.” Sgt. Val Barnes, the head of MPD’s carjacking task force, even expressed concern months before the decision, saying, “The department has a pretty strict no-chase policy, and obviously for an urban setting and a major metropolitan city, that’s understandable.” If our law enforcement officers themselves are operating with more concern than our elected officials, what does it say about the omnibus bill’s purported intention to keep us safe?

And what does it mean when the risk of bodily harm is posed by the pursuit itself? On Saturday, Feb. 10, an Eckington resident had a near-miss as a stolen car barreled towards her and her dog on the sidewalk with an MPD officer in pursuit. What responsibility does the city hold if this bystander was hit? What does restitution look like? Why are our elected officials pushing for MPD officers to contradict their own policies?

Just a few summers ago during the uprisings of 2020, we saw a shift in public perspectives on policing and led to legislation aimed at limiting police power after the highly-publicized murders of loved ones Breonna Taylor and George Floyd — both victims of War on Drugs policing and the powers gained from the ’94 crime bill. And yet here we are. These measures do not keep us safe and further endanger the health of our communities. Studies show that communities that focus on harm reduction and improving material conditions have a greater impact on public safety and community health. What’s missing in mainstream conversations about violent crime is the violence that stems from state institutions and structures that perpetuate racial and class inequality. The people of D.C. deserve to feel safe, and that includes feeling safe from the harms enacted by the police.

Kaili Moss is a staff attorney at Advancement Project, a national racial justice and legal organization, and Jillian Burford is a policy organizer at Harriet’s Wildest Dreams.

The post COMMENTARY: D.C. Crime Bill Fails to Address Root Causes of Violence and Incarceration first appeared on BlackPressUSA.

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Mayor, City Council President React to May 31 Closing of Birmingham-Southern College

THE BIRMINGHAM TIMES — “This is a tragic day for the college, our students, our employees, and our alumni, and an outcome so many have worked tirelessly to prevent,” Rev. Keith Thompson, chairman of the BSC Board of Trustees said in an announcement to alumni. “We understand the devastating impact this has on each of you, and we will now direct our efforts toward ensuring the smoothest possible transition for everyone involved.”
The post Mayor, City Council President React to May 31 Closing of Birmingham-Southern College first appeared on BlackPressUSA.

Published

4 weeks ago

March 27, 2024

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By Barnett Wright | The Birmingham Times

Birmingham-Southern College will close on May 31, after more than a century as one of the city’s most respected institutions.

“This is a tragic day for the college, our students, our employees, and our alumni, and an outcome so many have worked tirelessly to prevent,” Rev. Keith Thompson, chairman of the BSC Board of Trustees said in an announcement to alumni. “We understand the devastating impact this has on each of you, and we will now direct our efforts toward ensuring the smoothest possible transition for everyone involved.”

There are approximately 700 students enrolled at BSC this semester.

“Word of the decision to close Birmingham Southern College is disappointing and heartbreaking to all of us who recognize it as a stalwart of our community,” Birmingham Mayor Randall Woodfin said in a statement. “I’ve stood alongside members of our City Council to protect this institution and its proud legacy of shaping leaders. It’s frustrating that those values were not shared by lawmakers in Montgomery.”

Birmingham City Council President Darrell O’Quinn said news of the closing was “devastating” on multiple levels.

“This is devastating for the students, faculty members, families and everyone affiliated with this historic institution of higher learning,” he said. “It’s also profoundly distressing for the surrounding community, who will now be living in close proximity to an empty college campus. As we’ve seen with other institutions that have shuttered their doors, we will be entering a difficult chapter following this unfortunate development … We’re approaching this with resilience and a sense of hope that something positive can eventually come from this troubling chapter.”

The school first started as the merger of Southern University and Birmingham College in 1918.

The announcement comes over a year after BSC officials admitted the institution was $38 million in debt. Looking to the Alabama Legislature for help, BSC did not receive any assistance.

This past legislative session, Sen. Jabo Waggoner sponsored a bill to extend a loan to BSC. However, the bill subsequently died on the floor.

Notable BSC alumni include former New York Times editor-in-chief Howell Raines, former U.S. Sen. Howell Heflin and former Alabama Supreme Court Chief Justice Perry O. Hooper Sr.

This story will be updated.

The post Mayor, City Council President React to May 31 Closing of Birmingham-Southern College first appeared on BlackPressUSA.