If you’d like to let your legislator know what you think you can offer testimony virtually. Legislative Services created a platform to submit testimony and receive a Zoom link. All you have to do is navigate to leg.mt.gov and click on the “HAVE YOUR SAY MONTANA” speech bubble icon. Follow the directions provided and make sure you submit everything by noon the day prior to the hearing. When you log onto the Zoom meeting, your camera and audio will be turned off. Once the chair calls for proponent and opponent testimony, you can click the “Raise Hand” button and wait for staff to turn your audio on. At which point you can give your testimony. Be sure to stick around in case members of the committee have questions for you.
Government
City, County Governments May Co-locate in Stillwater Building
Yellowstone County and the City of Billings are exploring in earnest the possibility of consolidating local government offices in the Stillwater Building.
On Monday, County Commissioners asked County Finance Director Kevan Bryan to research the feasibility of the county purchasing a portion of the Stillwater Building, and to present commissioners a report on January 22. His research should also include other options that might serve the county’s future growth and space needs
Kevin Iffland, Assistant City Administrator, who heads a committee to do much the same for the city, said they remain interested in a proposal they received about a year and a half ago from WC Commercial the company that owns the Stillwater Building. The Stillwater Building is a five-story building at 316 N. 26th in downtown Billings, formerly known as the James F. Battin Building. Several departments of county government currently occupy part of the third floor under a lease with the company that owns the building WC Commercial headed by Joe Holden.
A few weeks ago, Holden sent a letter to the city and the county saying he wanted to sell the property and asking for $24 million.
The county and city will initiate the process of getting appraisals on the building. Iffland said that he is sending WC Commercial a letter this week announcing their interest and asking permission to conduct appraisals, which would probably not be completed until near the end of February at the earliest.
Commissioner John Ostlund initiated a conversation about the need to develop a plan for their future needs with other commissioners and department heads during a discussion meeting. He underscored the wisdom of making plans now for the future of what they know will eventually be a need for more space. Both the county attorney’s office and courts are working in crowded spaces, said Ostlund, and both will need more space as “felony cases have went off the charts. “We know at some point we will be booted out of the court house.” Eventually, he said, he believes that the Courthouse will be a building dedicated to courts and the justice system.
Ostlund said that he thought that the county would be interested in no more than two floors and would probably want to “condo” them, but whether that is the case will be part of the feasibility study. He said that they will also be looking at the possibility of purchasing the Miller Building which is available for sale. It is where City/County Planning offices are housed and includes parking.
Iffland said that the city, too, is looking at other options but they aren’t “super looking”, just wanting to be aware of their options.
Ostlund said that the county plans to acquire whatever they need without having to ask for any tax increases. He said that the county had already set aside some capital funds for remodeling existing space or acquiring new that has not been used, and there are other capital reserves that can be pulled together which will most likely meet their financial needs.
The city would want the rest of the building that the county does not take, including basement and main floor and upper two floors. “We are in dire need of law and justice center space, and secondly, other city offices. Planning and community development and public works are in leased buildings and we would like to consolidate.
While there are sure to be benefits and cost savings for the city and county to do the purchase jointly, the real beneficiaries, said Iffland, will be the citizens in having all local government offices located in one area.
Letter to the Editor – Ellis
County Water District of the Billings Heights
I was appointed by the Yellowstone County Commissioners to serve on the Billings Heights Water District and attended my first monthly meeting in September 2020. Members of the public have a right to participate too. The basis for access to public participation in Montana is the Montana Constitution Article II, Section 8 Right to Participate. State Law MCA 7-13.22.32 which states that the purpose of this board is to oversee the management of the County Water District of Billings Heights. As required by the MT constitution, statutes and case law, the Heights Water Board is required to follow MT Open Meeting law.
Open Meeting law establishes that agendas and supporting material on which the board may make a decision be available to the public 48 hours in advance of the meeting. A single page of the 12 page agenda is available on the website.
MCA 2-3-203. States “All meetings of public or governmental bodies, boards, bureaus, commissions, agencies of the state, … supported in whole or in part by public funds or expending public funds, … must be open to the public”. On Wednesday, December 9th, Wynn Pippin who is President of the County Water Board sent an email stating …” we state on our web page that due to the pandemic unless it is for business a person cannot be at the meeting.” The explanation provided verbally at the meeting was that the public could provide comments in writing that would be read and included with the minutes. The absurdity of making public comments about items when there is no information defies credulity. Three members of the water district came to observe the meeting; Duke Nieskens, the director, locked the front door and refused them entrance.
In the November meeting, staff were given Christmas bonuses of $100 each and health insurance rates were confirmed. At the December meeting, staff were given the refund from the Worker’s Compensation fund to share. The assistant director passed out 2 pages of salary information, the Board President made a motion to increase salaries for all staff 2.5% which was not seconded. Roger Ostermiller made a motion to give all staff a 4% raise which was seconded and approved by 5 of the 7 board members. The salaries for staff were made without consideration for the total increases given for health insurance, bonuses and increase, without preparing an annual budget and explaining to the governing body the impact. The board had no information at the meeting about cost of living, what the salaries would be for each staff member with the increase, what the total impact would be for the budget. The comment made was, “our staff are not union” and it does not matter how our increases compare to other employees in Yellowstone County because we have a lean work force. For reference, social security recipients will see an increase of 1.3% in 2021.
The Heights Water Board of Billings Heights meets on the second Wednesday of each month, 1540 Popelka Dr, Billings, MT 59105,6:00 pm at their office. With the exception of myself, no board or staff member wears a mask; the board sits shoulder to shoulder at a table.
The board is elected by state law. Three positions are open February 1, 2021. Filing opened up for three seats on December 10th and closes on February 8th. If more than 3 people file, an election will be held on May 4th. Board members are paid $150 per meeting if they attend; $100 if they do not attend. These are the rules:https:// sosmt.gov/… /2021- Special- Purpose- District… You may download a Declaration for Nomination and Oath of Candidacy here: https://www.co.yellowstone.mt.gov/elections/information/DeclarationForNomination.pdf
If you have questions, you may want to email the Board of Directors CWDBHBoard@ gmail.com or myself pamellis50 @gmail.com I would be happy to speak with you.
Pam Ellis
2000 Outlook Drive
Billings, MT
Casinos Left in Lurch as City Council Adopts Project Recode
By Evelyn Pyburn
After making a number of changes to Project Recode, the Billings City Council passed the new zoning regulations in First Reading by a wide margin last Monday. On December 21, the City Council will take up Project Recode in Second Reading at which time more changes are possible.
A proposed amendment to a regulation that is perceived as especially onerous by casino owners failed to be passed. The amendment would have reduced from 350 –feet to 150 –feet as the distance that casinos must be located from the nearest residence. The new regulation immediately puts almost all 134 casino and bar owners in Billings out of compliance. Also left in place are regulations that will, over time, consolidate casinos into one or two areas in the city. Non-complying businesses are “grandfathered in” until they have to rebuild or remodel for some reason.
Questions about whether the city could “target” casinos in such a manner and whether it was legal was generally dismissed by city planners who pointed out that other cities have implemented similar regulations. City Council members who voted against the amendment said that regulations are being changed because they have been hearing for years from people who want them changed, because they don’t like living so close to casinos, and said council members, during the past weeks they had heard from only a few casino owners who objected.
Said City Councilwoman, Penny Ronning, the presence of casinos is “one of the major issues I have heard about more frequently than most other issues… the frustration that people have with casinos being close to their neighborhood.” Incidents of crime was pointed out by council member Denise Joy as a concern.
With one casino owner pointing out that bars and taverns have a much higher incident of crime associated with them than do casinos, (and that crime around convenience stores is four times higher) he wondered why the distance requirement for bars and casinos is only 150 feet. Mayor Bill Cole expressed his concerns that there is a difference between the two types of businesses, saying he prefers to see consistency in the codes.
The objections are about the risk to casino owners who could lose their business and property values should something happen in which they would have to rebuild and would be denied the ability to do so by city government. The risks also exist for other kinds of non-conforming businesses,
“This simply isn’t fair and is being pursued by a relatively small group,” said casino owner Dennis Benson, “There are thousands of people who go into the casinos.” The regulation, said Benson is not “healthy for the community” …. ”people who go into the casinos are being pushed into the underbelly of the community.”
“I don’t see it as an incredible hardship,” said City Council member, Danny Choriki, calling the objections “fear mongering.” Choriki was later chastised by one casino owner, Josh Benson, for jokingly calling gamblers “sinners.”
Other amendments to Recodes, which fared much better, addressed other issues such as requirements that would have forced new infill building or remodeling, to adhere to the current style of a neighborhood. Builders had said in earlier comments that the requirement could increase costs.
Another successful amendment extended from six months to 12 months a limitation on how much time businesses of non-conforming uses would have to sell or otherwise resume business, at their location, should they temporarily cease operation for some reason. To exceed that time frame would terminate the legality of the non-conforming use.
City Council members Pam Purinton and Frank Ewalt wanted to delay the decision on Project Recode until January 11, but the motion failed. They pointed out that there are a number of issues that have been brought forward that are still unaddressed, most especially the concern from builders that the new codes escalate the cost of building and will adversely impact affordable housing. There are also unaddressed requests for a legal review of the codes.
During the next city council meeting on December 21, the adoption of Project Recode will be considered again in Second Reading, with the possibility of additional amendments.
In earlier emails, builders pointed out many aspects of the codes that they believe will raise costs. For example the requirement to have a back road access to a multi-family development immediately doubles the cost.
Restrictions on building heights eliminate opportunities to gain the most value from available space.
There were questions and confusion about restrictions on the amount of frontage required for residential lots versus multi-family lots and about required sizes of garage doors. “Can you confirm if there will be a maximum garage square footage size, other than the max of 50% total garage door width on the front façade?” asked Brendon Hill of Diverse Construction.
“The 50% limitation in the proposed code applies only to the garage door opening on the front façade of the house. So if your house is 60 feet wide, 30 feet of garage door opening is allowed along the front façade,” replied Nicole Cromwell, Planning Department staff member who oversaw the three and a half-year effort writing the new codes. Cromwell explained on Monday night that she believes the garage door restrictions is a safety measure which will allow the home owner to better see if they accidently left their garage door open or to see the plight of a pedestrian who might fall in front of their house and need assistance.
Bill Hanser, a residential builder, pointed out that one regulation requires side or alley facing driveways, which “adds cost and reduces the available yard space…. adds expense and increase(s) the amount of snow removal for the homeowner.
If safety is the issue, said Pam Purinton, how can a home owner see a garage door off the alley?
Landscaping requirements are also a concern. A landscaping plan is required to be submitted with the building permit and that plan will be binding on successors. This seems to add a significant, hard- to- enforce burden, as well as additional cost to the housing market, said Hanser. Also, many homeowners choose to build sweat equity by doing their own landscaping, allowing them to purchase a property they otherwise would not be able to afford.
Purinton expressed surprise and concern to learn that under Recode the newly built Shiloh Commons would not have been allowed.
Developer of Shiloh Commons, Mike Stock, pointed out in an email that his company, Stock Development, has developed over a hundred million dollars in residential, commercial and multi-family real-estate in Billings over the last several years. “During the project re-code we were never given the opportunity to comment on any of the changes that have been made. Just reviewing the 400+ page document the parking for residential/multi-family has increased over 25%. This is astronomical in development worlds and will have a substantial increase in development costs! As it stands today we will no longer be able to consider Affordable housing or for that matter Housing in general. Costs due to this type of increase could be as much as 2 Million on a 200 unit complex. Stock Development is very energy conscious and all the work we put into making our buildings ENERGY EFFICIENT will be canceled out by the increase parking! 99% of all municipalities across the country are reducing parking codes not increasing them.”
Builders have said that the restrictions make using new kinds of materials and concepts impossible, and push them into building higher priced homes, for which there is a market which they can readily address, but leaves middle class buyers out of the market.
Recode advocates have repeatedly said they want “quality over quantity.”
“Anytime you say quality, you are raising the price,” said one builder.
Businesses Can’t Win with COVID
By Evelyn Pyburn
The number of confirmed COVID-19 cases in Montana has been declining since November 11, especially over the past two weeks while testing numbers have remained steady. But for closed and partially closed businesses there seems to be no winning, the decline in case numbers, just like the increase, has resulted in the extension of restrictions on business.
Last week, Montana Gov. Steve Bullock attributed the decline in case numbers to restrictions that went into place Nov. 20, which expanded the existing mask mandate to the entire state and required bars and casinos to close by 10 p.m. – a mandate that county health officer, John Felton then extended to all businesses through December, and which now, last Thursday, he extended again through January 31.
Confirmed cases of COVID are down 36% since Nov. 20, said the Governor, advocating that the restraints are working and should continue.
The state’s COVID website shows that daily confirmed cases peaked about Nov. 11 and averaged 1103 daily confirmed cases throughout the rest of the month. The average number of daily cases identified for the first 12 days of December has been 849.
While the number of hospitalized individuals remains relatively high — with 488 individuals reportedly hospitalized with the virus on Thursday (dropping to 365 by Sunday) — Bullock said he expected the number to drop after local data is reconciled with the state’s reporting system. The number of deaths reported statewide as of Sunday was 818 with 3,080 total hospitalizations.
The World Health Organization said in March that the fatality rate of COVID-19 was roughly three percent – meaning three out of a hundred people contracting the disease would die – today it is being estimated that a more accurate fatality rate is 0.2 or 0.3 percent. The reason for the change is researchers believe now that there were far more cases of COVID than has been realized and that the disease actually began in December rather than February and March 2020.
One researcher, Jay Bhattacharya, a Professor of Medicine, with a Ph.d. in Economics, at Stanford University, reported that in testing for antibodies, (which indicate that someone has had the disease) in San Diego County, CA, where about 1000 COVID cases had been identified, antibody tests indicated that 50,000 people had actually been infected. So the case numbers were off 50 fold.
Because of the controversy those findings, 82 similar studies have been conducted with the same extraordinary results, confirming that the average fatality rate is not three in one hundred, but two in one thousand.
Other research confirms that there is about a thousand-fold difference between the mortality rate in older people (70 and up) and that of children. For children COVID-19 is less dangerous than the seasonal flu, according to Bhattacharya. Two to three times more children die annually from the common flu than from COVID. For older people, however, COVID is much more deadly than the flu. About four in one hundred of those over 70 die from the disease.
Bhattacharya pointed out that the use of lockdowns have never before been used to control the spread of a disease. They were devised to slow the infection rate in order to prevent hospitals from being overwhelmed, a strategy with minimal results.
The lockdowns on businesses, however, are “turning out to have deadly effects.”
While many believe economic impacts are minor compared to health impacts, the reality is that more people will probably die of the economic impacts throughout the world than because of virus infections. The UN has estimated that 130 million additional people will starve this year as a result of the economic damage resulting from the lockdowns – a devastating reversal of the past 20 years during which a billion people have been lifted out of poverty.
Bhattacharya points out that deaths will also occur because other health treatments, including the immunization against other diseases, have not been pursued because people have had more fear of COVID than of the risks from other diseases. Deaths are expected to increase due to cancer and diabetes because of economic shutdowns. And, because of social isolation, suicide rates are already on the rise, especially true for youths, ages 18 through 24, who actually have little risk of death from the virus.
“Widespread lockdown policy has been a devastating public health mistake,” concludes Bhattacharya, who urges, “Our goal should therefore be to minimize mortality and social harm until we reach herd immunity.” He explained that herd immunity is not a strategy but a “biological fact that applies to most infectious diseases… The vaccine will help, but herd immunity is what will bring it to an end.”
Policies should be to allow those at minimal risk of death to live their lives normally, while better protecting those at highest risk.
The first 9,750 doses of the vaccine were delivered slated to be delivered to Montana ollowing its authorization from the Food and Drug Administration.
The first doses were delivered to 10 major hospitals in the state’s seven largest communities. Doses delivered to the state in subsequent weeks will be reserved for rural health care workers and staff and residents of nursing facilities.
Bullock said 284 contracted health care workers are currently deployed in the state to assist in hospitals seeing a large number of COVID-19 patients. Close to 200 health care workers in the state are in isolation or quarantine due to exposure to the virus.
More than 73,303 people across Montana have been diagnosed with COVID-19 since March.
Yellowstone County has experienced the highest number of cases at 12,722, with 2,469 active cases as of Sunday. Total deaths in the county is 144.
So far 3,080 people have been hospitalized.
Black Activists Praise Employment Boom That Defies COVID-19 Challenges
The latest federal employment report revealed yet another month of recovery for the American workforce. Members of the Project 21 black leadership network credited the Trump Administration for policies that have brought back jobs – particularly in black communities – after businesses were devastated earlier this year by COVID-19 lockdowns.
“The news just keeps getting better. The free-market policies of President Trump have lowered the unemployment rate at the fastest level in history! The jobless rate dropping from nearly 15% to under 7% in less than a year is stunning,” said Project 21 Co-Chairman Horace Cooper. “Incredibly, the unemployment rate is now lower than it was during Obama’s entire first term. Notably, black Americans lead the employment gains – the exact opposite of the experience of the Obama years.”
The American workforce added 245,000 new jobs in November – making it the seventh straight month of declining unemployment since the beginning of the COVID-19 pandemic lockdowns. The overall unemployment rate dropped two-tenths of a percentage point to 6.7%, according to a report from the U.S. Bureau of Labor Statistics. Prior to the lockdowns, unemployment rates posted record lows.
“Unemployment continues to decline fastest for those who need jobs the most right now – black Americans, Hispanics and other minorities. These positive jobs numbers represent another example of the Trump Administration’s commitment to the black community,” said Project 21 member Donna Jackson. “Even in the face of ill-advised lockdowns, I’m grateful that the White House continues to deliver for all Americans – especially black Americans like me.”
In the black community, total unemployment fell once again by half a percentage point to 10.3%. Approximately 136,000 blacks entered the workforce in November, and black participation in the workforce increased for the third straight month. More than half of black Americans who were forced out of work by the lockdowns are employed again – far outpacing the progress of the Obama Administration after the 2008 recession. Additionally, the U-4 alternative unemployment measure that includes discouraged workers who leave the workforce – often considered the true unemployment indicator – also fell to just 7.1%. That figure has dropped 4.3% since June.
“The cause of the earlier collapse – and what’s preventing the economy from returning to pre-pandemic levels – has been the destructive and punitive response to COVID-19. Job gains in November showed the economy remains resilient despite the addiction of liberal state governments to socioeconomic lockdowns,” noted Project 21 member Derryck Green. “In my opinion, the employment rate would be much lower, and the labor force participation rate much higher, if business owners were allowed to decide which safety protocols were in the best interests of their employees and customers. The gains we see today will almost certainly be undone – and jobs won’t return – if more states follow California in forcing business owners to shut their doors and ‘temporarily’ lay people off. on.
Founded in 1982, the National Center for Public Policy Research is a non-partisan, free-market, independent conservative think-tank. Ninety-four percent of its support comes from some 60,000 individuals, less than four percent from foundations and less than two percent from corporations.
BEA Reports Personal Income Increase of 2.4%
Real state personal income grew 2.4 percent in 2019 after increasing 3.1 percent in 2018, according to estimates released by the Bureau of Economic Analysis (BEA).
Montana’s Real Personal Income, 2018-2019, increased 1.8 percent.
Real state personal income is a state’s current-dollar personal income adjusted by the state’s regional price parity and the national personal consumption expenditures price index. The percent change in real estate personal income ranged from 4.1 percent in Maine to 0.7 percent in Hawaii, Wyoming, and Rhode Island. Across metropolitan areas, the percent change ranged from 7.6 percent in Hanford-Corcoran, CA, to –3.2 percent in Panama City, FL, and Wheeling, WV-OH.
In North Dakota it increased 3.3 percent, South Dakota, 2.1 percent and Idaho, 3.6 percent.
Real Personal Income in 2019
Large metropolitan areas—those with populations greater than two million—with the fastest growth in real personal income were Austin-Round Rock-Georgetown, TX (5.3 percent), Denver-Aurora-Lakewood, CO (4.0 percent), and Riverside-San Bernardino-Ontario, CA (3.7 percent).
Large metropolitan areas with the slowest growth in real personal income were Miami-Fort Lauderdale-Pompano Beach, FL (1.4 percent), Chicago-Naperville-Elgin, IL-IN-WI (1.4 percent), and Detroit-Warren-Dearborn, MI (1.4 percent).
Regional price parities (RPPs) measure the differences in price levels across states and metropolitan areas for a given year and are expressed as a percentage of the overall national price level. RPP covers all consumption goods and services, including housing rents.
States with the highest RPPs were Hawaii (119.3), California (116.4), and New York (116.3) (table 3).
States with the lowest RPPs were Mississippi (84.4), Arkansas (84.7), and Alabama (85.8).
Across states, California had the highest RPP for housing rents (153.6), and Mississippi had the lowest (60.0).
Large metropolitan areas with the highest RPPs were San Francisco-Oakland-Berkeley, CA (134.5), New York-Newark-Jersey City, NY-NJ-PA (125.7), and Los Angeles-Long Beach-Anaheim, CA (118.8).
12 Counties Establish Big Sky Passenger Rail Authority
Twelve Montana counties have officially founded the Big Sky Passenger Rail Authority to advocate for the return of passenger rail service across southern Montana.
The finalized joint resolution, fully executed the last of November, seals the commissioner actions and provides for the appointment of one representative from each county to serve on the authority.
Gallatin County was the first to act on July 28, and Powell County the last on Nov. 18.
“Counties in Montana have done what has never been done before: establish the first regional passenger rail authority in the state. This will set the stage for re-establishing regular passenger rail service through the southern tier of the state—a transformational project for Montana that will add to and complement the Empire Builder along the Hi-Line,” Missoula County Commissioner Dave Strohmaier said.
“We hope to schedule our first board meeting of the authority in December or January and get this train moving!” The purpose of the authority is to provide for the preservation and improvement of abandoned rail service for agriculture, industry or passenger traffic and to provide for the preservation of abandoned railroad right-of-way for future transportation uses, when determined to be practicable and necessary for the public welfare.”
The authority constitutes the governance structure to investigate, analyze, seek funding for and develop long-distance, inter-city rail service to further the health, safety, welfare and economic prosperity throughout Montana. The Big Sky Passenger Rail Authority board comprises commissioner-appointed representatives from each of the following counties: Broadwater; Butte-Silver Bow; Dawson; Gallatin; Granite; Jefferson; Missoula; Park; Powell; Prairie; Sanders and Wibaux.
New Model will Reduce Medicare Part B Drug Costs, Save Taxpayers $85 billion over Seven Years
By Bethany Blankley, The Center Square
President Donald Trump and the U.S. Department of Health and Human Services announced a new drug payment model a week ago that will significantly lower the cost of Medicare Part B drugs, in a move the president said was a threat to “Big Pharma.”
Beginning in early January, the Most Favored Nation Model will test an innovative way for Medicare to no longer pay high-cost, physician-administered Medicare Part B drugs than the lowest price charged in similar countries.
Following the president’s recent Executive Orders to lower drug prices and improve access to life-saving medications, the MFN Model will protect current beneficiary access to Medicare Part B drugs, make them more affordable, and address the disparity of drug costs between the U.S. and other countries, Trump said at a White House news conference at the White House.
The program is being administered through the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services and is estimated to save American taxpayers and beneficiaries more than $85 billion over seven years.
The model “will be the most significant single action any administration has ever taken to lower American drug costs,” HHS Secretary AJ Azar said.
CMS Administrator Seema Verma said the president was taking on “the entrenched special interests that have stymied patient-centered reforms in Washington for generations” and that the new model will protect seniors, not the middle men.
“The current system creates incentives for drug manufacturers to price Medicare Part B drugs as high as they can in the U.S. system because the program pays doctors more when they prescribe more expensive drugs, even when a lower cost, clinically-equivalent alternative is available,” Varma said. “The Most Favored Nation Model will lead to lower drug prices for seniors.”
She also noted that premiums are down in Medicare Part B from 34 to 60 percent. In the last three years, the Trump administration has lowered premiums across the board on the exchange, increased price transparency, enabled portable digital records, reduced regulatory burdens, and afforded more options for patients, she said.
As of November 2020, patients have more than 1,600 plans offering insulin at 66 percent less the cost than they did three years ago, she said.
Historically, Part B costs resulted in taxpayers paying “whatever drug companies wanted to charge,” Varma said. “It’s no wonder that American seniors are paying twice as much as seniors in other countries are paying.”
A new rule change, the American Patients First drug pricing blueprint, released in May 2018, addressed high out-of-pocket costs, foreign subsidies plaguing Medicare Part B, Azar said.
Over the last five years, Medicare Part B drug costs increased at an annual rate of 11.5 percent, accounting for 37 percent of the change in Medicare Fee-for-Service Part B benefit spending from 2015 to 2019. Medicare Part B drug spending of $30 billion in 2019 made up 14 percent of total Medicare Fee-for-Service Part B spending, up from 11 percent in 2015.
Medicare Part B drug spending has also grown faster than drug spending in Medicare Part D and the U.S. as a whole, HHS notes.
In a new report, the HHS Office of the Assistant Secretary for Planning and Evaluation found that between 2006 and 2017, Medicare Part B Fee-For-Service drug spending per enrollee grew at 8.1 percent, more than twice the per capita spending on Medicare Part D (3.4 percent), and nearly three times as high as overall retail prescription per capita drug spending (2.9 percent).
While state Medicaid programs and Medicare Advantage plans have tools in place to reduce certain drug costs through price negotiations, current law requires the Medicare Part B program to pay for most drugs administered by physicians at the average sales price in the U.S. in addition to a percentage-based add-on payment. Manufacturers have largely been able to set these prices independent of market forces, which has resulted in Americans paying more than double in other countries, according to the study.
“This anti-competitive system leaves taxpayers and American seniors on the hook for paying the highest drug costs in the world,” HHS said in a statement.
The model payment will include two parts: a drug payment amount that will phase in the lowest price in other similar countries by blending it with the average sales price, and a flat add-on amount per dose that will be the same for each model drug, HHS reports. The model will accelerate the phase-in of the MFN Price if drug manufacturers increase U.S. prices faster than inflation and the lowest price in other similar countries. The model’s flat per-dose add-on will remove the incentive for participating physicians, hospitals and other providers to furnish high-cost drugs, HHS says. Beneficiaries’ cost sharing on this add-on payment will be waived.
The CMS will test paying based on the MFN Price for 50 Medicare Part B drugs and biologicals with the highest Medicare Part B spending. These 50 drugs and biologicals account for approximately 73 percent of Medicare Part B drug spending although they only represent less than 10 percent of Medicare Part B drugs.
Under the new model, all Medicare-participating physicians, hospitals and ambulatory surgical centers in the U.S. and territories will be paid through this new payment system instead of the current average sales price plus 6 percent add-on.
Bureau of Alcohol, Tobacco, Firearms, and Explosive
Billings has partnered with the Motor Vehicle Division (MVD) of Montana for a new REAL ID campaign in 2020-2021.
As the extended deadline of REAL ID approaches, a 2021 REAL ID campaign is being created by MSUB students and faculty members. Less than a year away, on October 1, 2021, domestic travel and entering federal institutions will no longer be accessible without a REAL ID or passport identification.
This academic year, MSUB students enrolled in Integrated Marketing Communications and Research Methods participated in a study similar to that of 2017-2018, to design the “Real Me” campaign featuring historical figures Lewis and Clark. Marketing Instructor, Dr. A.J. Otjen of the College of Business and Dr. Sarah Keller of the Department of Communication lead the courses.
Campaign work began by sending a survey on the effectiveness of the campaign, to 5,000 registered Montana voters. An analysis of these results showed that people exposed to the Real Me ads on TV, radio or social media were more likely to have a REAL ID, or intend to get one in the near future. People who saw or heard the ads were also more likely to believe that the REAL ID process was easy to understand. Students enrolled in these courses have crafted new messages to further clarify how to get a secure driver’s license or identification. Production of the new REAL ID campaign is underway.
In 2017-2018, MVD partnered with students and faculty of MSU Billings to create and promote the REAL ID campaign. The award-winning campaign was produced to inform Montana citizens about the costs, benefits, and requirements of the REAL ID, with a Lewis and Clark theme.
