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In Tennessee, a Medicaid mix-up would possibly land you on a ‘most wished’ checklist – Live Healthy and Well



Life was upended for LaShonia Ingram over the earlier yr, and a shadow nonetheless follows her spherical.

Search her title on-line, and the first consequence consists of the phrases “fraud” and “most wished.”

“It was horrible. I couldn’t get a job,” acknowledged the 42-year-old mother from Memphis, Tennessee. “All doorways had been being closed in my face.”

Ingram resorted to selling purses out of her trunk to assist her family. She acknowledged even DoorDash and Uber wouldn’t allow her to work with a felony price. Her alleged crime? Fraud.

The state of Tennessee accused Ingram of residing in shut by Horn Lake, Mississippi, whereas nonetheless enrolled throughout the state’s Medicaid program, commonly known as TennCare. All of it turned out to be a mix-up, nonetheless the harm to her reputation and funds was carried out.

Each state has an office to research Medicaid fraud devoted by medical docs and totally different effectively being care suppliers, since that’s usually the place basically probably the most money could also be recovered. Few states crack down on victims as Tennessee does. Tennessee posts the names and photos of people arrested for alleged fraud on a authorities web page and social media. Some even wind up on a “most wished” checklist.

The checklist is maintained by Tennessee’s Workplace of Inspector Normal. The office was launched in 2005 when most of the situations involved drug diversion: Folks had been accused of using TennCare benefits to build up massive parts of narcotics to advertise on the highway. However as federal pointers have slowed the illegal prescription drug market, arrests related to Medicaid are in its place sweeping up people accused of shifting out of state — often inside the same neighborhood — with out canceling their benefits.

Ingram was one amongst 28 Medicaid beneficiaries in Tennessee charged in 2022, in accordance with the Tennessee OIG; higher than a 3rd of them had been accused of not being a Tennessee resident, with many situations originating throughout the Memphis house, the place suburbs delay into Mississippi.

In Ingram’s case, Tennessee launched her arrest in a press launch, which acknowledged she eluded authorities for nearly a yr. Ingram acknowledged she didn’t have a clue regarding the charges until she obtained a ticket for not carrying her seat belt.

“They pulled me over, and they also acknowledged, ‘You could have a felony warrant.’ And I acknowledged, ‘Stop lying,’” she recalled. “I’ve not at all been in trouble a day in my life.”

It took $2,000 to bond out of jail and rather more to hire an authorized skilled. Not until higher than six months later did prosecutors current her the proof so she might refute the charges and clear her title.

The clarification ended up being pretty easy. Through the time she was on Tennessee’s Medicaid program and residing in Memphis, she filed for divorce from her husband who lived shut by in Mississippi. Ingram acknowledged they’d been separated for years, nonetheless her driver’s license nonetheless had the outdated Mississippi deal with.

After her arrest, Ingram confirmed her Tennessee lease and electrical funds, and the Shelby County district authorized skilled dropped the felony charges.

“We try to use the laws compassionately,” Chad Holman, who leads the TennCare OIG, instructed KHN.

Different states have fraud investigation gadgets centered on victims, nonetheless they don’t basically title the accused publicly, which happens in Tennessee. For example, South Carolina retains the accused anonymous even after they’ve agreed to reimburse the state.

Holman defends Tennessee’s observe of posting a “most wished” checklist for its Medicaid program. He acknowledged it’s presupposed to be a deterrent: “It’s to not blast anyone or defame anyone. It’s to simply deal with the enterprise that’s at hand, keep people accountable, and do what we’re proper right here to do,” he acknowledged.

As drug-related situations have diminished, enforcement has an increasing number of centered on guaranteeing that people enrolled in TennCare keep throughout the state. In Memphis, 20 of the 27 Medicaid fraud situations since 2019 involved questions of state residency, in accordance with the Shelby County district authorized skilled. And prosecutors have dropped on the very least a half-dozen of those situations because of the proof was so weak.

Holman acknowledged his office acquired’t overlook low-level offenses.

“This won’t be murder,” he acknowledged. “However the legislature categorized it as a felony, and that’s the laws that I’m proper right here to implement.”

Holman acknowledged it costs far more to run the TennCare fraud unit than the office will ever recoup from people on Medicaid, who’re usually low-income. Even when the state recovered every buck from charges launched in opposition to beneficiaries in 2022, the whole would amount to decrease than $900,000. The office has a value vary of $6.4 million a yr. Since its creation in 2005, the OIG has launched in decrease than $10 million and charged virtually 3,200 people with fraud, in accordance with its press releases.

The payment of arrests has slowed dramatically. It now arrests fewer people in a yr than it beforehand did in a single month.

About 1 in 4 Individuals are on Medicaid or CHIP — the Kids’s Well being Insurance Program. The number of people enrolled elevated by higher than 20 million since early 2020. And for the first time given that start of the pandemic, states will resume verifying income and addresses over the next yr. Thousands and thousands of Individuals might lose their Medicaid safety as a consequence. It’s as a lot as each state to search out out who’s eligible and one of the best ways to deal with potential fraud on this system.

Michele Johnson, govt director of the Tennessee Justice Heart, acknowledged policing fraud amongst TennCare beneficiaries takes time and money that in another case may be spent on one factor additional helpful.

“It’d be good if our leaders would get out of the ‘gotcha recreation’ and get into the ‘getting people healthful recreation,’” she acknowledged.

As Medicaid packages restart checks on eligibility, Johnson acknowledged, recipients shouldn’t have to stress {that a} mistake might lastly get them arrested.

Regardless of her ordeal, Ingram is bouncing once more. Nonetheless, she has approved funds to pay and has grown additional pissed off at being ensnared by the state’s Medicaid dragnet.

“They made a large mistake,” she acknowledged.

This story is part of a partnership that options WPLN, NPR, and KHN.

This text was reprinted from with permission from the Henry J. Kaiser Household Basis. Kaiser Well being Information, an editorially neutral info service, is a program of the Kaiser Household Basis, a nonpartisan effectively being care protection evaluation group unaffiliated with Kaiser Permanente.

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Unraveling the affect of mom’s milk on toddler development and well being – Live Healthy and Well




In a contemporary analysis printed within the journal Frontiers in Pediatrics, researchers described the protocol of a possible medical analysis known as NUTRISHIELD, being carried out within the Spanish-Mediterranean space, which involved mother-infant starting cohorts and in distinction the share weight gained month-to-month in preterm and time interval infants that had been utterly fed their very personal mom’s milk (OMM) or pasteurized milk from a human donor (DHM).

Examine: Truth-based food regimen for infants and lactating mothers—The NUTRISHIELD analysis. Picture Credit score: HTeam / Shutterstock


The World Well being Group (WHO) recommends that mothers breastfeed their time interval or preterm infants until the age of six months for the reason that bioactive compounds, microbiota, and nutritional vitamins in human milk are essential for the toddler’s development and immunity. Developments in medical science have moreover elevated the survival prospects of infants born early all through the gestation interval or with low-birth weight. Moreover, the amount of preterm deliveries (earlier than 37 weeks) has moreover elevated within the closing decade. This has resulted in an elevated curiosity in early toddler food regimen since points associated to preterm starting are one of many prevalent causes of mortality amongst kids beneath the age of 5 years.

Pasteurized DHM is advisable instead of formulation in situations the place the mother produces insufficient portions of milk to breastfeed the toddler partially or utterly. Nonetheless, the provision of DHM is proscribed, and quite a few analysis have reported that no matter providing bioactive compounds, infants ate up DHM have slower development fees than these ate up OMM. Since DHM is generally equipped by girls plenty of months after a time interval provide and within the later phases of lactation, DHM is assumed to have a lower content material materials of fat, proteins, and totally different nutritional vitamins as as compared with OMM. Whereas there could also be proof to help some great benefits of using DHM over formulation for preterm infants, analysis evaluating some great benefits of DHM and OMM are few.

Examine protocol

The present analysis is a non-randomized, parallel-group, observational medical analysis known as NUTRISHIELD, which examines preterm and time interval infants, their mothers for the interval spanning the primary two years of the toddler’s life, along with mothers who had donated human milk. The analysis accommodates three groups of mother-infant dyads — preterm infants fed with OMM and their mothers, preterm infants fed with DHM and their mothers, and time interval infants fed with OMM and their mothers. Human milk donors had been recruited all through their visits to the human milk monetary establishment on the hospital.

The inclusion requirements encompass a gestational age of decrease than 32 weeks for preterm infants and higher than 37 weeks for time interval infants and the distinctive consumption (bigger than 80% of full milk consumption) being each DHM or OMM on the time of full enteral food regimen stage for preterm infants. Participant pairs had been excluded in the event that they didn’t modify to the inclusion requirements, the mother was required to devour probiotics or a specialised consuming routine, or the toddler had chromosomopathies, congenital malformations, or required intestinal surgical process.

Organic samples akin to twine blood, urine, buccal swabs, and fecal samples are collected from the mother and infants at starting and at quite a few time elements until six months from provide. Human milk samples are moreover collected from lactating mothers and human milk banks sooner than and after pasteurization. These natural samples are used for genome sequencing, microbiome analysis, untargeted metabolomic fingerprinting, and analyses of microbiome train markers, nutrient biomarkers, macronutrients, oligosaccharides, steroids, dietary nutritional vitamins, and fatty acid profiles. Moreover, human milk and urine samples are moreover used to quantify proteins, creatinine, phosphate, fatty acids, and pH.

Information comprising anthropometric measurements, dietary composition, sociodemographic information, psychosocial standing, and lifestyle are collected using questionnaires. Moreover, the neurodevelopment of the toddler was moreover assessed on the ages of six and 24 months. The questionnaire moreover registers the attitudes and problems with the mothers about breastfeeding.


The analysis is ongoing in quite a few collaborating institutions, and the knowledge analyses are in progress. The outcomes will in all probability be used to understand the affect of maternal food regimen, gestational age, physique mass index, psychosocial standing, and form of provide on elements akin to protein fat, macronutrient content material materials, and the microbiome of human milk. As well as, the analysis targets to utilize quite a few natural matrices to supply a longitudinal understanding of the mother-infant-microbiome triad, which might then be used to teach machine-learning algorithms to supply dietary suggestion to lactating mothers by the use of a user-friendly platform.

The findings will current readability on the interplay between human milk composition and microbiome and the expansion and physiology of infants, significantly these born preterm and with low starting weight. This knowledge would possibly help improve weak preterm infants’ survival prospects and outcomes.

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How the meals service trade battles salt to make America more healthy – Live Healthy and Well




In a present analysis revealed within the journal Advances in Vitamin, researchers in the USA explored the challenges and methods going by means of the meals service trade in reducing sodium content material materials.

Most Americans eat far more sodium than is healthful, rising their risk of hypertension and coronary coronary heart sickness. About 55% of the meals funds is spent on meals prepared and consumed away from home (FAFH). Eating places, locations of labor, school campuses, military bases, and senior services are only a few places the place these meals are served. Makes an attempt to lower sodium ranges in prepared and acquired meals have met a lot of challenges. Regardless of these obstacles, many environment friendly methods have been used to chop again sodium content material materials in FAFH.

Perspective: Challenges and Methods to Cut back the Sodium Content material of Meals by the Meals Service Business. Picture Credit score: Evan Lorne / Shutterstock

Challenges in sodium low cost in meals

A survey of nearly 6,122 US adults found that whereas 52% of respondents most popular low sodium/salt menu decisions when consuming out, solely 6% actually requested for them. Clients choose a restaurant most steadily for the deliciousness of the delicacies, whereas merely 29% select a restaurant for its healthfulness. Because it has the reverse affect of accelerating consumer demand, meals service corporations rarely promote “healthful” or “lowered sodium” choices. Due to this, corporations usually lower the sodium stage of their merchandise with out consumer consciousness. As a end result, workers within the meals service trade are beneath pressure to place collectively and serve objects with a lot much less sodium.

Giant meals service operations may have hassle discovering enough low-sodium meals to fulfill demand. Bread and bread merchandise are a regular FAFH because of people eat them with all objects ranging from burgers and hen sandwiches to pizza and breakfast sandwiches, and they also’re moreover delicious when eaten alone. The outcomes of fairly a couple of analysis reveal {{that a}} low cost within the sodium content material materials could very effectively be as much as with out considerably affecting consumer acceptability. Subsequently, this potential adjustment would significantly contribute to decreasing sodium consumption. Producers is also persuaded to chop again sodium in bread objects in response to such data and requests from meals service operators for such objects.

Strategies for decreasing sodium content material materials in meals

Alternative with alternate choices

Meals service corporations may additionally assist lower the amount of sodium of their purchasers’ diets by modifying and creating new dishes that incorporate style enhancers. Sodium-replacement ingredient testing has been the subject of intensive analysis. One approach for rising a sodium substitute entails altering the crystal development of the sodium molecule to supply a salt crystal that’s every greater and coarser.

Some examples of favor enhancers are glutamates, herbs and spices, amino acids/peptides, and umami substances. Bread, sauces, condiments, meats, savory snacks, and mixed dishes can all potential have their salt content material materials lowered with the help of style enhancers.

Instruct kitchen employees on find out how to make low-sodium dishes

One tactic for making lower-sodium menus is to coach and educate the culinary employees utilized by meals service establishments to create such dishes. The low cost of salt in meals has been aided by collaborations between meals service corporations and culinary schools. Inside 4 years of the start of this partnership, a whole of 12% of sodium had been far from the menus of the US member companies. Salt low cost instruction for cooks has moreover been confirmed to be environment friendly in nations exterior the USA.

Promotion and present of low-sodium meals

Altering the constructed environment to increased facilitate the purchase of lower sodium meals by bettering their availability, location, promoting and advertising, and promotion may enhance product sales. It has been found that 48% of consumers substitute snacks for meals in any case three to 4 situations per week, with effectively being points having fun with a activity within the decision-making course of for 50% of those occasions. Mini-meals based on nutrient-dense, low-sodium snacks are an incredible selection for lots of non-retail situations.


The analysis findings confirmed that sodium low cost and the availability of lower-sodium decisions may be troublesome for meals service suppliers as a consequence of restrictions and real-world factors. Sustaining product sales and enhancing inhabitants effectively being must be complementary goals. It’s important to consider the next components when working with meals service suppliers to lower sodium ranges: ingredient availability; expert culinary teaching; consumer selection; style; meals safety; and primary points about costs.

The restaurant and catering sectors have made strides in decreasing the sodium stage of their decisions. The choices offered have the talent to impact the FAFH salt focus all through meals service venues and, by extension, the American consuming routine and cardiovascular risk, although there could also be nonetheless quite a bit space for enchancment.

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Athletes redefining protein and masculinity – Live Healthy and Well




In a present analysis printed throughout the Urge for food journal, researchers talked about the viewpoints of male athletes regarding plant-based and mixed diets.

In 2018, the documentary ‘The Recreation Changers’ was launched, showcasing distinguished athletes who argue {{that a}} plant-based weight reduction program can enhance their effectivity and current a aggressive edge with out animal protein. The documentary is about in the direction of the backdrop of adjusting societal discussions surrounding meat consumption. World meat manufacturing and consumption have raised issues about their hostile outcomes on the environment along with people’s effectively being in present a very long time. But, the angle of non-featured athletes on meals on this topic stays largely unknown.

Research: Recreation changers for meat and masculinity? Male athletes’ views on mixed and plant-based diets. Picture Credit score: The Picture Get together / Shutterstock

Concerning the analysis

Within the present analysis, researchers explored athletes’ views on mixed and plant-based diets.

The authors utilized a qualitative methodology known as the big Q technique, as described by Braun and Clarke. The present methodology was moreover influenced by Braun and Clarke’s technique in the direction of reflexive thematic analysis. The analysis methodology was based on theoretical assumptions which have methodological implications. Semi-structured interviews had been utilized as a method of data assortment.    

An entire of 13 expert and semi-professional athletes had been interviewed. Amongst these, seven athletes participated in nationwide competitions, whereas six competed internationally. Three retired athletes keep involved of their sports activities actions by the use of educating or as leisure athletes. The analysis included members of assorted European nationalities and residences, with a majority being Dutch or Finnish.

The authors carried out interviews in a semi-structured technique between March and April 2021. The interviews aimed to gather particulars about members’ current weight reduction program and meals habits, causes and beliefs behind their meals choices, their information, and sources of particulars about their diets, parts that alter their beliefs and views, the historic previous of their weight reduction program, their views concerning others, and the operate of their meals habits of their sport. The interviewees had been requested to provide full explanations of their day by day dietary and life-style habits. Questions had been requested in an open technique, with none steering.


The interviews highlighted the significance of explicit meals and nutritional vitamins. Athletes talked about their meals choices with regards to food plan and practicality, indicating that they view dietary information as clear and acceptable for his or her needs. The interviewees extensively talked about the dietary benefits of plant- and animal-based diets, along with their have an effect on on bodily effectivity, restoration, and complete effectively being, notably in relation to mixed and plant-based diets. Athletes’ discussions on dietary information had been biased within the path of explicit subjects, indicating an ordinary dialogue on healthful consuming. Notably, athletes prioritize protein over totally different micronutrients, resembling fiber.

Meat is taken into consideration by many mixed eaters as an important provide of nutritional vitamins for athletic effectivity. The affiliation between protein and animal merchandise is extensively accepted, as meat is normally seen as a significant provide of protein in typical diets. Combined eaters prioritize animal-based meals as vital for his or her athletic effectivity. The plant-based eaters (PBEs) challenged the idea meat is important for protein consumption. They acknowledged that there are totally different sources of protein furthermore animal merchandise nevertheless nonetheless emphasised the importance of protein of their discourse.

Plant-based diets (PBDs) had been perceived as extraordinarily restrictive by mixed eaters, who felt that PBD conflicted with their need for a constructive relationship with meals. Members who seen PBD as restrictive adopted a strict consuming routine themselves, with actual measurements and restricted meals choices.

Some athletes had been devoted to creating prepared meat dishes nevertheless found cooking plant-based meals to be an extreme quantity of labor. The analysis revealed that athletes’ want for model was intently linked to the consolation problem of their day by day routine. Meat dishes had been found to be further helpful and flavorful as compared with plant-based meals, requiring a lot much less effort and time to rearrange. Athletes have reported that they think about the extra effort and time required for plant-based meals may make them a lot much less pleasing.  


The analysis findings confirmed that male athletes’ views on weight reduction program are influenced by diversified parts previous dietary discussions and justifications. These parts embrace practicalities of their day by day lives and moral beliefs. The buyer’s perspective on PBDs varies from curiosity to admiration and, in positive circumstances, even enthusiastic endorsement. PBDs are seen positively and with curiosity, whereas typical meat-eating males are seen negatively. The findings suggest changes throughout the relationship between hegemonic masculinity and the affiliation with meat.

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