The number of Medicare enrollees is projected to rise over the next few years as the baby boomer population ages. More than 2 million Illinoisans are currently enrolled in the federal health care program, according to Healthinsurance.org,

The Office-Based Facility Association, a coalition of practitioners, is calling for a change in what they view as an ineffective and unfair pricing structure of the Medicare Physician Fee schedule.

Jason McKitrick, executive director of the association, said other payers linking themselves to Medicare is one of the issues.

"When you've got ongoing cuts to Medicare, that means you've likely got ancillary cuts going on with the private side, with the Medicaid side, etc.," McKitrick explained. "It's the Centers for Medicare and Medicaid Services, CMS, ultimately, that's the agency and the federal government that sets the rates for the Medicare Physician Fee Schedule."

The association pointed out the current fee schedule addresses doctor's fees only, not the costly and necessary supplies and equipment needed for their practices. According to the Centers for Medicare and Medicaid Services data, there are 300 office-based services under the fee schedule for which Medicare reimbursement is less than the direct costs, before even considering other costs like overhead and physician work.

Dr. Sreenivas Reddy, a vascular interventional radiologist in Hinsdale, said in addition to seeing patients, he has to monitor overhead expenses such as office space and employee salaries, both affected by inflation. Not having the proper medical equipment and supplies, he added, limits his ability to perform specialized procedures and forces patients to seek care elsewhere.

"That makes these patients go to the hospital-based facilities," Reddy noted. "We have to close our offices and try to join these hospital-based models. They would love to come to the office, get the procedure done in one or two hours, versus it takes like a whole day in the hospital setting."

Reddy emphasized physicians' reimbursement, based on the current physician pay schedule, has been on the downtrend for the last five years. The group has further concerns about a decrease in the number of private practices causing more medical deserts for interventional radiology, cardiology, vascular surgery, radiation and oncology care.

The Environmental Protection Agency this week banned a toxic chemical commonly used in dry cleaning and other consumer products.

Trichloroethylene and perchloroethylene have been used for decades and are known to affect the liver, brain, kidney and immune and nervous systems. Research shows dry-cleaning and laundry workers are at increased risk of dying from cancer.

Jennifer Orme-Zavaleta, former principal deputy assistant administrator for science at the EPA Office of Research and Development, said businesses will be required to use alternatives and employees will be safer at work, adding the changes also affect surrounding communities.

"If you happen to live near a dry-cleaning facility, you know there would be the potential for the ground to be contaminated and for these chemicals to get into the water supply," Orme-Zavaleta pointed out.

California has been ahead of the curve. In 2007, the state banned installations of new perchloroethylene dry-cleaning machines, required existing ones be shut down by 2010, and required a complete ban of use of the chemical by 2023.

Orme-Zavaleta noted many environmental statutes are aimed at cleaning up hazardous chemicals. While recent legislation has enabled the EPA to more effectively reduce exposures or prevent them from happening in the first place, she stressed the effort takes time and resources.

"The agency's been playing a lot of catch up," Orme-Zavaleta acknowledged. "They need to keep going, but they also need to be looking to the future, especially looking at some of the new chemicals coming into commerce."

According to the advocacy group Heal the Planet, the dry-cleaning industry uses hundreds of millions of gallons of solvents such as perchloroethylene every year, the chemical's airborne particles are difficult to detect in the air and can linger for weeks.


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Kentucky residents are being notified about their lead water pipes that could be posing a health danger. According to an EPA report, around 40,000 service lines in the Commonwealth contain lead, and earlier this year the agency announced a new rule requiring drinking water utilities in all states to identify and replace lead pipes within ten years.

Dr. Leah Werner, family physician and assistant professor at Oregon Health and Science University, said the federal change increases water sampling and transparency about lead between communities and local governments, and added that there are actions residents can take, too.

"People can also test their own water, and really the best way to do that is to look at your either your city government website, and beyond that, the government is mandated to help you with testing kits, but Home Depot and places like that also sell lead testing kits," she explained.

The mailed notices from utilities will confirm whether or not a home relies on lead water lines, or if the piping materials is unknown, and if any pipes need to be replaced.

Werner added that if a family is concerned that they and their children may be exposed to lead, it's important to visit a primary-care physician as soon as possible, who can also be a guide through the process of testing and treatment for lead exposure.

"Lead crosses the placenta, so that is really dooming a fetus before even being born, to the same sort of cognitive impairments and behavioral issues that children who are exposed to lead suffer," Werner continued.

According to the CDC, exposure to lead can reduce IQ in children and be a primary driver to learning disabilities and Attention Deficit/Hyperactivity Disorder, permanently damage the brain and nervous system, and cause speech and hearing problems.


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If your holiday shopping list is far from complete, consumer advocates in Nebraska hope you don't ignore warning signs of scams in the rush to buy gifts.

In a digital world, there are always new things to pay attention to.

Over the past few years, shoppers have been warned about avoiding gift card scams, or not falling prey to phony texts about a shipment delay.

Jina Ragland - associate state director of advocacy and outreach for AARP Nebraska - said the emergence of cryptocurrency in the online trading world presents another challenge, including during the holiday shopping crunch.

"Scammers and fraudsters are using the same types of scams that they've used in the past," said Ragland, "but they're now soliciting people to pay them through the cryptocurrency ATMs, using things such as bitcoins and that."

AARP says if you're directed to send someone money by converting cash to cryptocurrency at a convenience store kiosk, it's a scam.

As for other tips, experts note scammers can tamper with gift cards on store racks and steal the funds when the card is activated.

They say it's best to ask for a gift card sold behind the counter. They also advise regularly updating software on your electronic devices for additional fraud protection.

Ragland said if you get a call from someone initiating a scam about a purchase you never made, asking for a call-back number will quickly get their attention.

"Typically, you will find if you do ask for a call-back number, they're going to hang up on you immediately," said Ragland, "because they've not gotten what they need and they want it, and they know you're on to them. "

Overall, Ragland said a key thing to remember is, if you see an online ad for something that appears too good to be true in terms of price, it's usually a fishy deal.

Shoppers are also encouraged to take advantage of tracking information and other shipping supplier services, and to schedule deliveries for when you or someone you trust is present to receive them.