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Top story: Humboldt physician installed as CMA's 147th president
CMA has installed Humboldt County physician Luther Cobb, M.D., as its 147th president. He takes office on the heels of the momentous defeat of Proposition 46, a campaign in which doctors and health care providers across California rallied together to oppose the measure that ultimately failed 33-67 percent.
Also in this issue:
- 2014 election wrap up: Physician-friendly candidates win majority of their races
- Supreme Court to hear ACA subsidy case
- United issues new Premium Designation physician results
- CMS starts ICD-10 claims testing this week
- Physicians encouraged to familiarize themselves with exchange plan changes heading into Covered California open enrollment
- Blue Shield announces changes to 2015 exchange/mirror products
- ACA meets goal of covering more Americans
- CMA now accepting online testimony on resolutions and reports for 2014 House of Delegates
- Medicare finalizes fee schedule changes for 2015
- Are you having problems with the new prescription drug prior authorization form?
- Medi-Cal UCR web app for CHDP primary care rate increases now available; deadline to submit is Nov. 28
- CMA Foundation launches free antibiotic clinical guidelines mobile app
- Highlights from AMA's 2014 interim meeting
- Marin urologist receives AMA community service award
- Upcoming webinars:
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1. Humboldt physician installed as CMA's 147th president
The California Medical Association (CMA) has installed Humboldt County physician Luther Cobb, M.D., as its 147th president. He takes office on the heels of the momentous defeat of Proposition 46, a campaign in which doctors and health care providers across California rallied together to oppose the measure that ultimately failed 33-67 percent.
"What a thrilling time to be assuming the role of CMA president," said Dr. Cobb. "The health care community has stood tall in protecting our patients and their access to care and as we look ahead to the year in front of us, I am confident that we will continue to do so."
After attending Stanford Medical School, Dr. Cobb went onto do his residency at Stanford as well, taking a two year fellowship to study pancreatic islet transplantation for diabetes. He later joined the Stanford faculty and worked at the affiliated county hospital in Santa Clara County, Santa Clara Valley Medical Center.
"Becoming a doctor was something I wanted to do because not only would it be an avenue to help the greatest number of people I could, but it was and continues to be an evolving field with new discoveries around each corner," he said.
Dr. Cobb is a former chair of the CMA Council on Legislation and has served on the organization's executive committee since 2006. He is also past president of the Humboldt-Del Norte County Medical Society.
"Dr. Cobb brings the experience, leadership and fortitude to CMA's presidency that will lead us into an incredible time in the health care," said CMA CEO Dustin Corcoran. "As we look ahead to the changes that lie in front of us, I have the utmost faith in Dr. Cobb's ability to lead the 40,000 plus members of CMA as we advocate for quality and for timely access to safe and affordable health care."
Dr. Cobb's term as CMA president will run from November 2014 through October 2015.
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2. 2014 election wrap up: Physician-friendly candidates win majority of their races
On Election Day, the California Medical Association (CMA) made history by resoundingly defeating the trial attorneys' attempt to overturn California's Medical Injury Compensation Reform Act (MICRA) protections. This was one of the most contentious and high-stakes ballot fights in California history. The voters sent a clear message: Californians simply don't want to increase health care costs and reduce health access so trial attorneys can file more lawsuits.
But the Election Night celebration was not limited to Prop. 46: CMA's priority candidates also performed exceedingly well. CMA participated in "independent expenditure" campaigns for six candidates. Sacramento Pediatrician and Assemblyman Richard Pan, M.D., was at the top of the list.
Dr. Pan faced off against fellow democrat Roger Dickinson in California Senate District 6 in one of the most hotly-contested races of the election. Conventional wisdom gave Dr. Pan very little chance to defeat Dickinson, who has spent more than 30 years as a career politician. However, CMA built a coalition of labor and business allies to put together a full-fledged campaign that helped overcome a double-digit deficit in the primary to place Dr. Pan in the State Senate.
In another tight race, two liberal Democrats, David Chiu and David Campos, squared off for San Francisco's Assembly District 17. The candidates agreed on many issues, but David Chiu believes in and publicly advocates for the protection of MICRA. Chiu's advocacy on the matter became a critical point of contention in the campaign, transforming this race into a proxy race for Proposition 46. Once again, the advocate for protecting access to care prevailed, CMA-endorsed David Chiu will be heading to Sacramento.
CMA emerged from the election with a perfect score on the six independent expenditure campaigns for our endorsed candidates. In total, the 15 CMA-endorsed candidates for state Senate all won their election. In the state Assembly, 65 out of our 70 endorsed candidates triumphed. (Please note there are a few races that are too close to call.)
Click here to see the full roster of candidates CMA supported and the results of their races.
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3. Supreme Court to hear ACA subsidy case
Earlier this month, the U.S. Supreme Court unexpectedly said it will hear King v. Burwell—a case that questions whether premium subsidies can be provided under the Affordable Care Act (ACA) to individuals purchasing health insurance coverage on exchanges run by the federal government. The lawsuit has the potential to affect 36 states that use the federal health care exchange, but would not change the subsidies in states like California that run their own exchanges.
The decision to hear the case comes just one week before the second exchange open enrollment period begins on November 15. Consumer uncertainty could affect whether those that are eligible, enroll. If the subsidies are struck down, some 5.4 million Americans who signed up for coverage in 2014 through the federal exchange, could be left holding the bag for much higher than anticipated premiums, threatening the future of the ACA in the affected states.
California is one of fourteen states (and the District of Columbia) that are fully running their own exchanges. The other states rely on the federal government for some or all of their exchange operations.
A Rand Corporation study published last month found that of the 5.4 million people who signed up for health insurance on federal-run exchanges last year, 87 percent of them received subsidies. According to the Rand study, without the subsidies, premiums would be 43.3 percent higher on average in the individual market in 2015, while enrollment would drop by 68 percent.
The King v. Burwell case arrived at the Supreme Court after a 4th U.S. Circuit Court of Appeals panel in Virginia in July unanimously ruled in favor of the administration, saying subsidies should be allowed in all 50 states. This case marks the law's third trip to the high court. In 2012, Chief Justice John Roberts joined four more liberal justices to uphold the constitutionality of the ACA, with four conservative justices dissenting. Earlier this year, Chief Justice Roberts and the four conservative justices carved out an exception to providing contraceptive coverage for employers who object on religious grounds.
Many had speculated that the court would wait to hear King v. Burwell until after the full U.S. Circuit Court of Appeals for the District of Columbia Circuit issues a decision in a separate but similar case, Halbig v. Burwell. Oral arguments in that case are scheduled for Dec. 17.
Arguments at the high court in King v. Burwell are likely in March, with a decision expected before July.
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4. United issues new Premium Designation physician results
United Healthcare recently sent California physicians their latest Premium Designation assessment results. These latest results will be released publicly via the payor's online physician directory beginning January 1, 2015.
Physicians within the designated 27 specialty areas, including ear, nose and throat (ENT) and gastroenterology (new for 2015), will again be ranked by UHC on both national and specialty-specific measures for quality and various cost-efficiency benchmarks. Physicians meeting or exceeding these benchmarks will receive a Premium Designation notation on their physician profiles, marketed to UHC enrollees through the payor's online physician directory. In addition, employers may choose to offer health benefit programs (e.g., reduced cost-sharing or tiered benefit programs) that offer benefit incentives, such as lower copays or coinsurance, for members that use physicians with the United Healthcare Premium Designation.
According to United Healthcare, the latest assessment, released on November 3, is based on claims data from January 1, 2011, through February 28, 2014. the California Medical Association (CMA) has repeatedly voiced concerns about the fact that United Healthcare is basing its current physician designations on data that is more than a year old and for failing to adequately address those physicians who have modified their practice patterns since their last Premium Designation assessment.
While UHC has stated that a central goal of the program is to modify physician practice patterns to reduce cost and improve quality, the insurer has verbally acknowledged to CMA that it will likely take two years before a change in practice pattern is reflected on a physician's assessment and the doctor is able to achieve a favorable Premium Designation status.
Additionally, UHC markets benefit tiered health plans to employer groups that incentivizes members to obtain care from select providers recognized for providing quality and cost efficient care, also known as Premium Tier 1. Because the benefit to members who select Tier 1 providers is lower co-pays and co-insurance amounts, the impact of use of the stale data is significant to members as well.
Although UHC indicates that physicians who dispute their assessment results may submit a request for reconsideration until mid-year 2015, a physician wishing to alter public display of their November 3 assessment results prior to public distribution in January 2015 must submit reconsideration no later than 30 days from the date UHC notifies the physician of his or her results.
CMA successfully advocated for UHC to alter its notification letters to proactively inform physicians about the availability to speak to a market medical director upon request regarding their assessment results. Further, UHC also committed to providing additional educational resources and educational webinars on the Premium Designation program. While these changes are viewed as a step in the right direction, UHC has regrettably chosen not to make any of the substantive changes to the Premium Designation program recommended by CMA.
Physicians who encounter problems with their physician assessment reports or who have concerns regarding their Premium Designation can contact United Healthcare at (866) 270-5588. Practices that are unable to obtain answers to their questions or resolve the issue with United Healthcare directly should contact CMA.
United hosting webinars on Premium Designation program
At CMA's request, United Healthcare is inviting physicians and practice administrators to attend a special webinar presentation about its Premium Designation program in California. The webinars will be offered in mid-November and will provide an overview on the background and methodologies of the Premium Designation program and allow physicians an opportunity to ask specific questions they may have.
The webinars will take place on the following dates and times. Participants will need to register with United Healthcare prior to attending. Click the registration links below for more information.
- November 13, 2014, 12 p.m.
- November 20, 2014, 5 p.m.
For more information about the Premium Designation program, visit the United Healthcare website at www.unitedhealthcareonline.com.
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5. CMS starts ICD-10 claims testing this week
On October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. To help physicians prepare for this transition, the Centers for Medicare & Medicaid Services (CMS) will be conducting a national testing week from November 17 to 21, 2014.
This testing week will give trading partners access to the Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support.
While participants will not be able to conduct true end-to-end testing at this time, they will be able to test whether the contractor received a claim and learn whether it was accepted or rejected. The testing will not allow participants to determine whether the claim will be paid or if payment will be reduced.
Although registration is not required to participate, physicians should contact their local MAC (Noridian in California) for more information about how to submit test claims. Physicians participating in the testing will be able to determine their practices' readiness for ICD-10 implementation and provide CMS with data to help the agency prepare for industry-wide use of the code set next fall.
Two additional ICD-10 claims acknowledgment testing weeks will take place next year in March and June. CMS will be conducting more robust end-to-end testing with a limited number of physicians and other health care providers next year.
Additional information and resources to help physicians get ready for ICD-10 are available on the AMA ICD-10 Web page.
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6. Physicians encouraged to familiarize themselves with exchange plan changes heading into Covered California open enrollment
Covered California began enrollment for its second year on November 15 and exchange officials are predicting a 45 percent jump in enrollment, from 1.2 million in 2014 to 1.7 million in 2015. Last year, open enrollment was a six-month process, this year it will be half as long, starting Nov. 15 and ending Feb. 15.
In anticipation of this year's open enrollment, some payors have updated their exchange plan offerings for 2015, including plan types and plan names. The California Medical Association (CMA) will be publishing details of these changes as they are announced. See the most current exchange-related news and updates at www.cmanet.org/exchange (click on "Exchange News" in the left sidebar).
Physicians are encouraged to familiarize themselves with the changes and to verify their exchange plan participation status on the plans' websites. When searching the provider directories, it's important to select the correct exchange product type, as Anthem Blue Cross and Blue Shield of California are utilizing significantly narrowed networks for their exchange products. Health Net has also announced changes to their product types that will utilize new provider networks, so it's extremely important practices re-verify their participation status in exchange/mirror products for 2015.
It is also imperative that front office staff have a clear understanding of their physicians' participation status. With some plans utilizing narrowed networks, it is no longer satisfactory to simply accept "I have Blue Shield" as an indication of whether the patient can be seen in-network. It is important, when scheduling, to determine in advance if the physician is indeed in the patient's network.
For more information, CMA members can access our tool titled, see "Covered California: Know Your Participation Status."
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7. Blue Shield announces changes to 2015 exchange/mirror products
On October 1, 2014, Blue Shield of California notified participating physicians that it was making changes to its Individual and Family Plan (IFP) EPO and PPO products, which are its exchange/mirror products. According to Blue Shield, the changes aim to expand access for EPO enrollees and reduce confusion by simplifying its plan names.
Effective January 1, 2015, Blue Shield exchange/mirror EPO patients will have access to additional providers who are located outside of their county of residence. Previously, the Blue Shield IFP EPO limited in-network services to providers within the patient's county of residence. According to the notice, Blue Shield is making this change to provide greater access to care and reduce out-of-network costs for enrollees. Patients and referring physicians will be able to find these additional providers by searching the Blue Shield provider directory on its website under "Find a Provider." PPO physicians in affected counties were notified that they will be listed as in-network for EPO patients and that they will be paid at their current PPO rates.
Additionally, Blue Shield announced changes to its exchange/mirror plan names. Effective January 1, 2015, its exchange/mirror products will use the same plan/product naming conventions. Product names will also include the metal tier of the product:
|2015 PPO Plan Names
|EPO Plan Names
|Platinum 90 PPO
|Platinum 90 EPO
|Platinum 90 PPO AI*-AN
|Platinum 90 EPO AI-AN
|Gold 80 PPO
|Gold 80 EPO
|Gold 80 PPO AI-AN
|Gold 80 EPO AI-AN
|Silver 70 PPO
|Silver 70 EPO
|Silver 70 PPO AI-AN
|Silver 70 EPO AI-AN
|Silver 94 PPO
|Silver 94 EPO
|Silver 87 PPO
|Silver 87 EPO
|Silver 73 PPO
|Silver 73 EPO
|Bronze 60 PPO
|Bronze 60 EPO
|Bronze 60 HSA PPO
|Bronze 60 HSA EPO
|Bronze 60 HSA PPO AI-AN
|Bronze 60 HSA EPO AI-AN
|Minimum Coverage PPO
|Minimum Coverage EPO
|$0 Cost Share PPO AI-AN
|$0 Cost Share EPO AI-AN
*AI designates an American Indian plan
The new plan names will be reflected on patient ID cards to help practices easily identify patients with exchange or mirror products. Blue Shield has confirmed that all of its exchange/mirror product enrollees will receive new ID cards reflecting the new plan names.
Practices with questions about the changes should contact Blue Shield Provider Information and Enrollment at (800) 258-3091.
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8. ACA meets goal of covering more Americans
A little over 10 million uninsured have gained health care coverage throughout the U.S., either through Medicaid or state and federal exchanges, since the Affordable Care Act (ACA) coverage expansion programs opened for enrollment last year, according to a new report from U.S. Department of Health And Human Services' (HHS).
According to the report, the uninsured rate among adults ages 18 to 64, as of June 2014, was 15.1 percent, down 5 percent from September 2013.
The percentage of those with health coverage improved most among blacks and Latinos throughout the U.S. The number of uninsured blacks dropped 6.8 percent, as of June 2014, with more than 1.7 million gaining health insurance. The Latino uninsured rate fell 7.7 percent, as more than 2.6 million got coverage.
The 2014 reduction in the number of uninsured adults builds on earlier effects of the ACA on health insurance coverage. Nearly 950,000 individuals in six states (California, Colorado, Connecticut, Minnesota, New Jersey, and Washington) and the District of Columbia gained coverage before January 1, 2014, from early Medicaid expansions under the Affordable Care Act.
And an estimated 3.1 million young adults gained coverage under a parent's employer-sponsored or individual market plan under the ACA's expansion of dependent coverage up to age 26, which was effective for plan years beginning on or after September 23, 2010.
In California, the Kaiser Family Foundation estimates that 3.4 million previously uninsured Californians now have gained health care coverage through ACA programs, which include the Medi-Cal expansion and subsidized premiums for Covered California health plans. The Commonwealth Fund estimates that California's uninsured rate dropped from 22 percent to 11 percent since the exchange opened for business.
The HHS report is based partially on Gallup poll data released last week and backs up July estimates from the New England Journal of Medicine, both of which said the ACA has been a factor in the decline of the country's uninsured rate.
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9. CMA now accepting online testimony on resolutions and reports for 2014 House of Delegates
The California Medical Association (CMA) 2014 House of Delegates (HOD) will convene in San Diego, December 5-7. The HOD is CMA's legislative body, which establishes the policies that govern the association. All members are invited to provide online testimony on this year's resolutions and reports.
This year, testimony for Reference Committees A, B, and F will take place only online. There will be no in person hearings for oral testimony at the meeting. Reference committee members review all posted remarks, which are given the same weight and consideration as oral testimony presented in traditional committee hearings. Please read what your colleagues post and add your own written arguments and comments.
The deadline for online testimony for Committees A, B and F is November 20, at 11:59 p.m. The deadline for Committees C, D and E is December 3, at 11:59 p.m.
We strongly urge all members to comment on all resolutions and reports online in advance of the meeting. Testimony is open to all members, and is not limited to members of the House of Delegates.
To view individual resolutions and reports and submit testimony online, visit www.cmanet.org/hod. You will be prompted to log in (if you are not already logged in) and then will take you directly to the HOD landing page. From there, click on the Resolutions and Reports tab. Beneath each resolution and report in this section, you can view comments posted by your colleagues and add your own written testimony. Please note that there is a 500-word comment limit on each resolution, and posting multiple sequential comments to avoid the 500-word limit is not permitted. Comments in violation of this policy will be deleted.
If you have not already done so, you will have to activate your CMA web account in order to access this private area of the website. If you have any trouble activating your account or accessing the HOD section of the website, please contact CMA's member service center for assistance at (800) 786-4262 or firstname.lastname@example.com.
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10. Medicare finalizes fee schedule changes for 2015
The Centers for Medicare and Medicaid Services (CMS) published its 2015 Medicare Physician Fee Schedule final rule Thursday in the Federal Register. The 1,200 word payment rule contains several notable changes.
As earlier proposed, the rule expands the services eligible for telemedicine reimbursement and extends the new payment policies for non-face-to-face care coordination. It allows primary care physicians to be paid for care management of Medicare beneficiaries with two or more chronic conditions. These are tasks (including managing lab and imaging reports, medications and care plans in addition to talking with patients and families on the phone) physicians commonly provide, but have not been paid for in the past.
Although CMS continues to move up the implementation timeline for the Value-Based Payment Modifier (VBM), the final rule scales back the penalties for practices with fewer than 10 physicians as urged by the California Medical Association (CMA) and the American Medical Association (AMA). While the final rule still maintains a potential pay cut of 4 percent for larger medical groups, practices with fewer than 10 physicians will not be subject to more than a 2 percent VBM penalty. AMA and CMA have called for a slower phase-in of the VBM. CMA is supporting the VBM program reforms in the Medicare sustainable growth rate (SGR) overhaul legislation (HR 4015/S 2000). CMA also continues to fight the inappropriate implementation of the value modifier that discriminates against physicians caring for frail, elderly patients.
Also removed from the final rule was CMS's earlier proposal to eliminate the CME exemption in the Physician Payments Sunshine Act, which requires reporting and public posting of financial interactions between medical device and drug manufacturers and physicians and teaching hospitals. CMA and AMA joined dozens of other medical associations in calling on the agency to eliminate this requirement because it would "chill physician participation in independent [continuing education] programs."
CMS is moving forward with the public disclosure of physician quality and meaningful use information on the Physician Compare Website. However, at CMA's and AMA's urging, physicians will be allowed to review the information and correct inaccurate data prior to publication. CMS also pulled back its proposal to publish benchmark information.
CMS is also proceeding with the plan to require physicians to report nine quality measures in three "domains" and one "cross-cutting" measure in 2015 for the Physician Quality Reporting System (PQRS).
And in 2015, the Physician Quality Reporting System (PQRS) becomes a penalty-only program. No bonuses will be paid. Physicians must successfully report in 2015 to avoid penalties in 2017.
The final rule includes 350 CPT codes identified as new, revised or potentially misvalued—318 of these changes were based on physician input. These changes represent 86 percent of those recommended by the AMA/Specialty Society Relative Value Scale Update Committee, an expert panel of more than 300 participants that includes physician advisers from every medical specialty. The panel develops and provides relative value recommendations annually to CMS.
Despite strong opposition from AMA, CMA and others in organized medicine, CMS moved forward with the elimination of all 10- and 90-day global surgical packages because CMS says it lacks the ability to verify the number, type and relative costs of postoperative visits. Packages would only include preoperative services and care given the day of surgery. CMS will be transitioning all services with a 10-day global period to a 0-day global period by 2017. All 90-day global periods will be shifted to 0-day global periods by 2018.
CMA continues to urge Congress to pass the bipartisan, bicameral SGR repeal and Medicare physician payment reform legislation (HR 4015/S 2000), which would provide bonuses to physicians for meeting the Medicare PQRS and value modifier standards and overhaul the Medicare payment framework.
For more information about these and other components of the 2015 Medicare Physician Payment Rule, see the AMA summary or the CMS fact sheets.
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11. Are you having problems with the new prescription drug prior authorization form?
A new law recently took effect that streamlines and standardizes the prior authorization process for prescription drugs for most patients with PPO products. The new law (SB 866) requires all insurers, health plans (and their contracting medical groups/IPAs) and providers to use a standardized two-page form for prior authorizations of prescription medications.
The law also requires plans and insurers to make a determination on prescription drug prior authorization requests within two days of receipt. If they fail to do so, the requests will be deemed authorized. The new law does not expand the list of medications that require a prior authorization.
The requirement for HMO products, including Anthem Blue Cross and Blue Shield of California, becomes effective on January 1, 2015. The regulation for Department of Insurance-regulated products, including all other PPOs and Blue Cross and Blue Shield Life & Health products, became effective on October 1, 2014. However, in an effort to avoid confusion for practices, many plans/insurers implemented the new form across most, if not all, of their product lines on October 1.
The California Medical Association (CMA) is interested in hearing from practices that have experienced difficulties with the new form. If your practice has run into any problems with the form itself, integration into your EHR, submission of the form to the payor, multiple requests for medical records from the payor, delays in processing by the payor, etc., please contact CMA at (916) 551-2061 or firstname.lastname@example.com to share your experience.
For information on the new form and accompanying regulations, including a chart of the effective dates by payor and product, see the CMA physician FAQ, "A Physician's Guide to Implementation of SB866: The new standardized prescription drug prior authorization form." This document is available free to members.
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12. Medi-Cal UCR web app for CHDP primary care rate increases now available; deadline to submit is Nov. 28
The California Department of Health Care Services (DHCS) has taken steps to correct a problem with the Affordable Care Act primary care rate increase unique to Child Health and Disability Prevention Program Services (CHDP) providers.
Before the rate increases were implemented, some practices were previously instructed by DHCS to bill at their Medi-Cal rates. This caused concern—based on DHCS's pricing logic of paying the lesser of Medicare's rate or the billed charges—that some practices would not qualify for the retroactive increases once the systems were updated to process claims at the higher rates. At CMA and other stakeholders' urging, DHCS agreed to a workaround to allow these practices to be paid at the higher rates.
DHCS has created a web application for onetime submission of the physician's usual and customary rates (UCR), which will allow the practice to receive the higher reimbursement intended by the rate increase.
After receipt of UCR submissions from physicians, DHCS will replace billed amounts with the UCR rates submitted to calculate ACA payments due. The UCR web application is now open for submission but only for a limited time. To access the UCR application, log in to the Medi-Cal website using a valid existing user ID (National Provider Identifier) and then click on the "Elig" tab. The deadline to submit your usual and customary rates is November 28, 2014. Note the system updates that will allow physicians to submit claims at their UCR amount isn't scheduled until late December and any claims billed after the deadline will be caught in the true up scheduled for the first half of 2015.
Also not all vaccine codes are listed, for example Vaccine for Children (VCF), as they are already systematically set to pay at Medicare rates. For further clarification, access the "UCR Web Application instructions" linked in Medi-Cal's November 3 provider bulletin.
Remember, to qualify for enhanced payment for fee-for–service Medi-Cal and Medi-Cal managed care plans, you must first self-attest to your eligibility. The deadline to attest, if you haven't already done so, is December 31, 2014. Practices that have attested but have not yet received any addition funds are encouraged to confirm the accuracy of the information submitted through the attestation process. Practices with question can call Medic-Cal's Telephone Service Center at (800)541-5555.
For more information on this topic, see CMS's "Medi-Cal Primary Care Physician Rate Increase FAQs," available free to members in CMA's online resource library.
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13. CMA Foundation launches free antibiotic clinical guidelines mobile app
The week of November 17-23, 2014, is "Get Smart About Antibiotics Week" – a campaign to highlight the problem of antibiotic resistance and the importance of appropriate antibiotic use. Every year at least 2 million Americans become infected with antibiotic resistant bacteria and at least 23,000 people die from these infections. This cold and flu season, the California Medical Association (CMA) Foundation's Alliance Working for Antibiotic Resistance Education (AWARE) project reminds physicians and patients to reduce the unnecessary use of antibiotics.
To assist physicians and other clinicians in these efforts, the CMA Foundation has launched the "AWARE Toolkit" mobile app containing clinical guidelines for appropriate antibiotic use. The app is free for both Android and iOS platforms in the Google Play and iTunes stores.
For more information about "Get Smart About Antibiotics Week" and for physician and patient resources, including the newly released 2015 AWARE Toolkit, visit www.aware.md.
Contact: CMA Foundation, (916) 779-6624 or firstname.lastname@example.com
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14. Highlights from AMA's 2014 interim meeting
The nation's physicians gathered at the 2014 American Medical Association (AMA) interim meeting in Dallas, Texas, this past week. The delegates debated a large number of resolutions, establishing new policies related to the worldwide Ebola epidemic, expanded network access for the Affordable Care Act and electronic health records. A number of these resolutions were put forward by the California delegation. Below are highlights of some of the resolutions adopted as policy.
Ebola: Resolution 925 put forth by the California delegation was incorporated into AMA policy that calls on AMA to strongly support U.S. and global efforts to fight the Ebola epidemic and support health care workers and volunteers that are fighting Ebola worldwide. The policy also supports the use of quarantine and isolation when it is based on science and asks AMA to make emergency recommendations on Ebola for the medical community and the general public.
Adequate Networks for Patient Access, Choice: AMA adopted policy that calls for health insurers to make updates to their provider networks prior to the open enrollment period begins each year to avoid patient confusion. The policy also reiterates the need for health insurers to provide patients with an accurate, complete directory of participating physicians through multiple media outlets. These lists also should identify physicians who are not accepting new patients.
Medicaid Enhanced Rates: The AMA delegates adopted policy (Report 7) that requires AMA to advocate for the Affordable Care Act's Medicaid primary care payment increases to continue past 2014 in a manner that does not negatively impact payment for any other physicians.
AMA Promotion of Improved Electronic Records: The delegates passed a resolution (210) that asks AMA to continue advocating with the Centers for Medical & Medicaid Services (CMS) for a halt to meaningful use penalties.
Hospital Sponsored Electronic Health Records: The delegates referred for study a California resolution (825) that asked AMA continue to urge Congress and the CMS to mandate that all EHR systems be interoperable, and to require hospitals to protect physician rights to control and have access to their patients' medical records. The resolution was referred so that current regulations, practices and legal implications could be reviewed.
Preventing Drug Manufacturers from Restricting their Distribution Networks: AMA reaffirmed policies D-110.993, H-110.992 and H-110.998 in lieu of California resolution 229 that asked the AMA to oppose attempts by drug manufacturers and distributors to increase profits by restricting the distribution of their medications. The resolution also asked AMA partner with the American Hospital Association, the federal government and other interested parties, to oppose Genentech's plan to restrict the distribution of its products as a restraint of trade.
Facilitating Multiple State Licensure: AMA delegates voted to support the Federation of State Medical Boards compact designed to facilitate a speedier medical licensure process with fewer administrative burdens for physicians seeking licensure in multiple states (Report 3). The compact includes model legislation to make it easier for physicians to obtain licenses in multiple states while providing access to safe, quality care. The California Medical Association will be working with the Medical Board of California to review the compact and determine the best course of action in our state.
Cannabis: The delegates adopted a resolution (213) asking AMA to encourage model legislation to put a warning on all cannabis products not approved the U.S. Food and Drug Administration that says: "Marijuana has a high potential for abuse. It has no scientifically proven, currently accepted medical use for preventing or treating any disease process in the United States." The resolution also urges legislatures to delay full legalization of any cannabis product until further research is completed on the public health, medical, economic and social consequences of chronic use of cannabis.
More news from the AMA Interim Meeting is available on the AMA website.
Contact: Elizabeth McNeil, (800) 786-4262 or firstname.lastname@example.com.
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15. Marin urologist receives AMA community service award
Marin County urologist and transplant surgeon Peter N. Bretan Jr., M.D., was presented with the Benjamin Rush Award for Citizenship and Community Service by the American Medical Association (AMA) during the 2014 AMA Interim Meeting in Dallas, Texas.
The award recognizes physicians who have gone above and beyond their professional call of duty to make an outstanding public service contribution. Dr. Bretan was chosen for his exceptional work as an innovator in renal transplant surgery and urology, and his disaster relief efforts around the globe to help save lives.
Dr. Bretan is the founder of Life Plant International, a charitable organization that promotes disaster preparedness, organ donation and early disease screening worldwide. He has also has also provided care around the world as a member of medical missions. Following the devastating impact of Hurricane Katrina on New Orleans in 2005, Dr. Bretan provided free medical care as part of "Team Orleans." Since 2002, he has also made several medical mission trips to the Philippines to perform and teach local physicians about kidney transplantation and laparoscopic kidney removals. More recently, he served as part of a medical mission to the Philippines to provide care to victims of Typhoon Haiyan.
Dr. Bretan is a trustee for the California Medical Association (CMA) and past president of Marin Medical Society. He currently serves as an adjunct clinical professor of urology at Touro University, as well as chief of surgery at Novato Community Hospital, where he has worked since 2000. He is also member of the U.S. Surgeon General's Deployable Surgical Team and serves on county and state panels to educate physicians on disaster preparedness.
As an innovator in his field, Dr. Bretan has received national recognition and numerous awards for his work including the Disaster Service Medal and Outstanding Unit Award from the U.S. Surgeon General, and the 2011 Excellence in Service Award from the University of California, Berkeley Alumni Association.
Dr. Bretan earned his Bachelor of Science degree in physiology from University of California, Berkeley and his medical degree from the University of California, San Francisco, where he completed residencies in general surgery and urology, as well as a fellowship in radiology. He also completed a fellowship at The Cleveland Clinic Foundation in transplantation and renovascular surgery.
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12/2: Coordinated Care Initiative (CCI): What Physicians Need to Know: This webinar will cover the basics of the program and how physicians can continue to see their patients - specifically Cal MediConnect continuity of care and what Medi-Cal managed care means for Medicare FFS physicians.A second live webinar on this topic will occur on December 3 from 6 to 7 p.m.
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Business type: Services ×
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Subcategory: Cogeneration ×
Location: Africa ×
Location: Central African Republic ×
Biogas-Ost Unternehmensgruppe
based in Gehaus, GERMANY
We plan, build and maintain with sustainability, flexibility and quality in order to be able to offer you highly economical biogas plants. As a reliable and competent partner for our customers, we have made ourselves known in Germany and abroad. With high-quality expertise and innovative products we supply mainly customers from: agriculture, industry and communes.
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GPEKS contributes to the exponential growth of the renewable energy sector so that it can become the mainstream sector in the energy industry globally by the year 2022. OUR VISION: We envision an energy sector that is not only clean and safe, but that is also affordable, empowering citizens, businesses and local governments with decentralized, abundant sources of energy ...
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EDF Energy produces, distributes, and supplies energy in Great Britain. EDF Energy is one of the largest energy companies in the UK. We employ over 12,000 people, are the largest electricity supplier for London, the south east and the south west of England and supply energy to around 5.1 million customers. We own and manage the electricity distribution network covering ...
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subset: commoncrawl


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The following bibliography has been generated by bringing together all references provided by our content partners. There may be duplication.
- Bockmann, Flávio A., and Gizelani M. Guazzelli / Reis, Roberto E., Sven O. Kullander, et al., eds. 2003. Family Heptapteridae (Heptapterids). Check List of the Freshwater Fishes of South and Central America. 406-431
- WoRMS (2014). Heptapteridae. In: Froese, R. and D. Pauly. Editors. (2014) FishBase. Accessed through: World Register of Marine Species at http://www.marinespecies.org/aphia.php?p=taxdetails&id=267036
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Michigan dismantles Florida en route to Final Four
With Nik Stauskas draining 3-pointers, Mitch McGary dominating the paint and Trey Burke running the show, Michigan quickly dismantled Florida on the way to a 79-59 victory in the South Regional final Sunday afternoon at Cowboys Stadium.
So Michigan (30-7) will play Syracuse in a national semifinal on Saturday in Atlanta. It's the Wolverines first trip to the Final Four since the Fab Five lost to North Carolina in the 1993 national championship game.
Meanwhile, Florida (29-7) lost in the Elite 8 for the third consecutive season.
Michigan jumped ahead early behind breakout star McGary, who scored eight points as the Wolverines established a 13-0 lead.
McGary came into the NCAA Tournament averaging 7.3 points and 6.1 rebounds. But entering the Wolverines' fourth game of the postseason, he was contributing a team-leading 19.7 points and 12.3 rebounds. He finished with 11 points, nine rebounds, two blocks and five steals against the Gators.
McGary's two baskets to start the game -- a fast-break layup on an assist from Tim Hardaway Jr. and a dunk on an assist from Stauskas -- and Stauskas' 3-pointer from the corner set the tone as Michigan grabbed a 7-0 lead in the game's first 94 seconds.
Burke drove for a basket, dished to McGary for an inside hoop and hit a 3-pointer to boost the Wolverines to a 16-2 start. Florida never climbed back within 10 points.
From there, Stauskas stretched the lead to as many as 24 in the first half by hitting 5 of 6 3-point attempts. He went to the break with 19 points and Michigan led, 47-30.
Stauskas scored a game-high 22 points. Burke finished with 15 points and seven assists.
Michigan out-rebounded Florida 21-14 in the first half and the Wolverines, who made seven of their first nine shots, shot 51.4 percent from the field in the first half.
Will Yeguete and Kenny Boynton each scored 13 points to lead Florida.
NOTES: Michigan and Florida met for only the second time in the NCAA Tournament. Michigan won the previous contest in 1988 with a 108-85 win in the West Regional second round. ... Florida entered the South Regional final with an 0-6 record this season in games decided by single digits. The Gators won their three previous NCAA Tournament games by margins of 32, 14 and 12 points. ... By totaling 23 points and 10 assists, Burke became the first player to record a 20-plus-point, 10-assist game in the Sweet 16 since Florida coach Billy Donovan did it while playing at Providence in 1987. ... The 14-point margin Michigan erased against Kansas was the largest deficit the Wolverines have overcome to win this season. ... The last time Michigan reached the Elite 8, the Wolverines also played in Texas, losing to eventual national champion Arkansas 78-71 at Reunion Arena in Dallas.
City's "ugly" Christmas tree causes controversy
WWII vet shoots wife, kills self, Allentown police say
2nd truck drops into sinkhole in Bethlehem Twp. neighborhood
State police seek missing Palmerton teen
Man struck, trapped by leaf collector in Kutztown
Local residents urged to be on alert for high levels of deadly gas
One year since mysterious disappearance of local woman
Education fund set up for crash victim's young sons
Construction worker struck by vehicle on turnpike
Survivor of deadly crash: 'It happened in the blink of an eye'


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Hair Vibration Comb+ Gift
Note* this item is not medical treatment device. The Vibrate Hair Comb is powered by AAA batteries, The Power Vibrate Hair Comb also features a vibration mode. This feels like a comfortable scalp massage and increases circulation and blood flow to help accelerate the hair growth process. …
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Location: Auckland City, Auckland
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A reward is being offered for information about a mid-day high-dollar heist.
Surveillance video caught a thief stealing from outside a business near 127th Street and West Dodge Road on Jan. 6.
-- Watch the surveillance video
Then, the thief stole more than $1,000 worth of tools from a truck bed.
The man was seen driving a Chevy Silverado. It could be silver.
Anyone with information on the case should call a detective at 402-444-5652. If you want to remain anonymous and be eligible for a cash reward, call Crime Stoppers at 402-444-7867.
The views expressed are not those of this site, this station or its affiliated companies. By posting your comments you agree to accept our terms of use. Your comment will not appear here until you verify your email address with Disqus. KETV NewsWatch 7 encourages users to report violations of our terms of use by flagging the inappropriate comment. Hold your mouse over the comment to reveal the flag on the right side, then click the flag.blog comments powered by Disqus


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Welcome to the best source for Heart of The Valley real estate information
This website is one piece of a multi-faceted service commitment that combines personal, one-on-one attention with dynamic web and e-mail resources to deliver the most comprehensive and timely service to you.
As your real estate agents, We bring many years of experience successfully listing and selling homes in the local market. We know the neighborhoods, schools, market conditions, zoning regulations and what it takes to make the deal go through.
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STIGLER — A suspect in a 25-year-old cold case murder is mentally competent and will face trial in the shooting death of former Haskell County Commissioner Leo Reasnor, a judge ruled Monday.
Oklahoma cold case murder suspect is mentally competent and will stand trial, judge rules
Clifford Eagle, 55, has been jailed since April after he walked into a police station in Billings, Mont., and confessed to killing Reasnor.
Eagle, a convicted rapist with a lengthy criminal history in Oklahoma, is now scheduled to be arraigned April 8.
Eagle was scheduled to have a preliminary hearing in January, but prosecutors and his defense attorney filed a joint motion to have his mental health evaluated before the hearing could take place.
Haskell County District Attorney Farley Ward said the defendant's attorneys suggested a mental health evaluation.
Reasnor was found dead inside his pickup on June 25, 1987, by his son and son-in-law.
Reasnor had a gunshot wound to the temple and was found slumped over in his truck on some land he owned about four miles southwest of Lequire.
His slaying remained a mystery for nearly a quarter decade before Eagle walked into a police station in Billings, Mont., and confessed to the killing.
Billings police say Eagle — who is from Oklahoma — walked into their station in April and told them he wanted to get "something off his chest."
Eagle would go on to tell investigators he and another man, Vince Allen Johnson, were on a county road in Haskell County when they encountered Reasnor, who was 49.
He said Reasnor accused Johnson of "stealing some of his property" a few moments before the county commissioner was shot dead.
Johnson was executed in 2001 for another slaying in Oklahoma.
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Travel articles, books, maps, photography & travel information. Where to go, what to do & great tips and tricks, as well as what to watch out for.
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, China Official Info - U.S. Department Of State information for The People's Republic of China.
, China Videos - Try out the traditional cuisine of Dim Sum in Hong Kong. A great place to check out is Wan Chai. Watch more videos at www.Tripfilms.com
, China Articles - China is a country of amazing contrast. If you are a nature lover, it's easy to find a scenic city in China. If you are interested in Chinese history, you can visit historic cities like Beijing and Xi'an.
, China Official Info - US State Department Travel
, China Articles - Kashgar, once a key centre of the ancient silk road, now lies in the autonomous region of North Western China.
, China Official Info - US State Department Travel Considerations for Macau
, China Official Info - US State Department Travel Considerations for China
Xishuangbanna, China Photography - In Xishuangbanna, there are approximately 100,000 hectares of virgin forest with over 5,000 species of woody and herbaceous plants, ranging from huge arbors to primitive ferns. Rare and precious animals and birds thrive in the dense tropical jungles
, China Articles - Cruising downtstream on the Yangtze River, the third largest river in the world and going through the ship locks is not to be missed when visiting China. See the spectacular scenery along the river and don't forget to taste the Peking Duck!
|Page: 1 2 >


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Boiler Tune-up and Steam Trap
Apps are being accepted now!
Applications for the $10 Boiler Tune-up Bonus and $10 Steam Trap Survey incentive are being accepted now for processing by our Program Team.
To download the applications for either/or both offers, click on the links in the column at left.
To qualify for the $10 Boiler Tune-up Bonus, you must complete your work and submit the application between now and Jan. 31, 2015.
The $10 Steam Trap Survey incentive is available for each survey performed – up to 50% of the paid incentives on repaired and/or replaced failed steam traps submitted as part of the same Application. Repair work must be completed within 6 months of survey.
If you have questions, contact your Program Outreach Team representative at 866.796.0512 (press Option 3) or email us at firstname.lastname@example.com.
Submit your Reservation Applications,
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If you have a project that's been completed, now is the time to submit your Final Application for processing and payment.
To ensure fast processing, make sure your Application includes all required documentation, such as invoices and specification sheets. The Application is available for download by clicking on the link in the column at left.
In addition, although funding for the 2014 Program year remains 100% Fully Allocated,* we're still accepting Reservation Applications, and our Program Team is processing projects on a first-come, first-served basis.
You can submit your Reservation and Final Application electronically by hitting the "submit" button on the last page – or you can attach it to an email, print and fax it or mail it to our office.
If you have questions about your project, contact your Program Outreach Team representative at 866.796.0512 (press Option 3) or email us at firstname.lastname@example.com.
*To read the 100% Fully Allocated FAQs, click here.
Need a refresher on changes for 2015?
For a complete list of changes made to the 2015 Program, click here.
Three of the major changes have involved caps:
· There are no Facility caps for either electric or gas projects.
· The Project caps have been increased: to $250,000 for electric; to $200,000 for gas
· The Customer caps have been increased: to $1 million for electric customers; to $300,000 for gas customers.
Watch for new events to be listed
Over the coming weeks and months, we will be hosting a number of events that will not only cover the changes to the 2015 Program, but also will review the process for submitting a project for incentives from DTE Energy.
In addition, we will be scheduling workshops, seminars and other special events that will highlight specific and emerging energy efficiency technologies.
Click on our Events page link above to see the latest scheduled events and links to the registration for each.


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Food + Travel
The Smelliest Cities on the Planet
Chandler Burr, our globe-trotting scent critic, anoints the 10 best—and single worst—smelling cities in the world
9. London
I agree with Samuel Johnson's oft-quoted "when a man is tired of London, he is tired of life; for there is in London all that life can afford," and while being able to afford London is no small feat, if you just walk the streets, the scent of the city, at least, is free. Mist, rain, peppermint, wet pavement. You can smell the Thames and leather seats and aged Persian rugs. Thank Christ, there's much less cigarette fumes these days. Some people complain that London is a gray scent, but what they smell is actually the opalescent energy of Britain.
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- Children's Drum Set from Latin Percussion
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Servings Per Recipe: 11
Every recipe, menu, tip and how-to is right here, at your service.


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Welcome to TalkBass, the Premier Bass Player Community and Information Source. We've been uniting the Low End Since 1998!
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This Freeman Combo features three guns and a compressor.
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(Enterolobium cyclocarpum) Reddish-brown, lightweight (density 0.34–0.6 g/cm³) and water-resistant. Typically used to make items such as doors, windows, furniture, cabinets, and for shipbuilding. Guanacaste trees are found in Mexico and Central America and are especially abundant in the Guanacaste province of Costa Rica (also their national tree). Grows easily from seed and is one of the largest, shadiest and longest lasting trees reaching heights of up to 40 meters (approx. 131 ft.) with a trunk measuring more than 3.5 meters (approx. 11 ft.) in diameter.
Other common names: Elephant Ear Tree, Monkey Ear, Ear Pod Tree, Parota and Orejon (Spanish) and Conacaste (El Salvador).
Each piece is unique. Ideal for tables, headboards, bar tops and other large furniture pieces.
Due to the nature of wood movement, shrinkage and expansion are possible. Please measure each piece carefully before starting any project.
Wood is a product of nature, and as such, no two pieces are alike to start with, while the same wood growing in different locales can vary greatly even though it is the exact same species.
Thin Stock. The thin stock is cut to size from quality, kiln-dried stock. Dimensions are +/- 1/8" of size listed.
Carving and Turning Blocks. Blocks are sawn to +/- ¼" of size listed.
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Mo Farah, how are you?
I'm fine. I am happy to be here. It was a bit of a bumpy ride. Now, I am eager to get started. I won my very first major championship medal at the Europeans in Goteborg. And four years later, in Barcelona, I took my first titles.
What would it mean to you to become European champion once again?
A lot. An athlete never forgets where it all started. And for me, it all started at European Athletics Championships. Europeans are still huge for me. Two years ago, I won the 5000m, but could not run the 10000m in Helsinki. Now, I will try to win gold in both events.
Are you ready for the championships?
I had some health issues and was forced to forego the Commonwealth Games. I am not running, if I am only 75 or 80 per cent ready. But by now, I have had some weeks of tough training, and I am quite happy with where I am. Two weeks ago, I would have answered the question differently, though.
What kind of health issues did you have to deal with?
I had to have a tooth out and caught an infection in the process. After a training session, I suddenly had severe abdominal pain. I even spent four days in hospital. After that, I gradually started to recover. But I had missed some training and therefore cancelled Glasgow. I am ok now. I just spent three and a half weeks at Font-Romeu in the French Pyrenees, training at high altitude.
You collapsed during a test race for your marathon debut in London. And then suffered from an infection recently. Are you worried about your health?
No, not really. I collapsed again this time, before I went into hospital. But I am not worried. I have had a thorough checkup back home. You have to remember that athletes keep pushing their body to the limit. That's how we become champions. I run 120 miles every week. Whatever the weather, I go out and run, sometimes at high altitude. Quite a challenge for the body. But with hindsight, I realized that the body needs rest after a marathon. Maybe I was rushing things a bit because of the Commonwealth Games.
You tweeted a picture of yourself running with a pacemaker on a bicycle in a training session. It's probably a good sign if your pacemaker needs a bicycle.
That was actually one of the key trainings to get ready for Zurich. But it does not mean that I am running as fast as Usain (Bolt). I would love to train like that all the time, but the guy on the mountain bike was there only once. A pacemaker on a bicycle can monitor the pace at all times, and he can drive at a consistent speed.
Yes, that was what I had in mind originally. I was going to make final decisions depending on how I was doing after my first marathon in April. My body did not let me follow through with the initial plan.
The crowd is always awesome. I remember that from running at the Diamond League meetings I ran here. A great crowd is a huge support for any athlete. Four years ago, I ran my first sub-13-minute 5000m in Zurich, breaking the British record in the process. To me, Letzigrund Stadium is a magic place.
For the moment, I have. Marathon is entirely different from the 5000m or 10000m. But 2014 is a good year to try new things, as there are no world championships or Olympics. It was tough, and my 2:08 were not good enough. Last year, I ran 3:28.81 in a 1500m race, and tackled the marathon this year – quite a switch. I was having a hard time. But you always have to try new things in life.
What did you learn during your side trip to the marathon.
That there is a lot of work to be done. That I can't run the 1500m European record one year and a very fast marathon the next. But I would not prepare for my first marathon differently if I had the chance to do it again. I just have to be patient in getting to know this event. You don't become a great marathon runner in a jiffy.
So the marathon is off the cards. A final decision?
No. I would like to try again towards the end of my career. Right now, I am going to concentrate on the Europeans, then on the 2014 world championships, and after that, on the Olympics in 2016. Right now, I am better at track races than at the marathon.
How difficult was it to return to the 5000m and 10000m after training for the marathon?
It was quite difficult. For the marathon, you complete many long training units, you run many, many miles. For 1500m, 5000m, and 10000m, you need speed, you need to run hard. So, it was tough, but I am happy with the way things are now.
You are known for your speed. Last year, at the championships in Moscow, you ran your final lap in 53 seconds. Can you still do that?
Yes, I hope I have not lost that.
You have not run many track races this year. A handicap?
Well, I did not plan the season like that. I wanted to have three or four track races. Now, the race in Portland was the only one I did since Moscow. It is what it is.
Are the Europeans an attempt at saving your 2014 season after the unsatisfactory result of the London marathon and after missing the Commonwealth Games?
It does feel a bit like that. But then again: I always go out to win. But maybe I just want to win a bit more badly this time.
During the London Olympic Games, you slept in an altitude tent. Will you do that in Zurich?
Leichtathletik - EM 2014 AG, Baslerstrasse 71, 8048 CH-Zürich, +41 44 388 2014, email@example.com


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'Killer Elite' Critic Reviews
MovieWeb: 5 reviews
Rotten Tomatoes: 125 reviews
Derek Malcolm This is London40The plot is over-complicated, the screenplay limp and some of the subsidiary acting is hardly up to the mark.
Stephen Whitty Newark Star-Ledger63The movie's not stupid. And that makes it more than bearable and often a little fun.
Jim Judy Screen It!Filled with action but not terribly engaging and certainly not surprising, this is a mediocre action film at best. (Parental Movie Review also available)
Jeffrey M. Anderson Combustible Celluloid63Killer Elite has enough good scenes to satisfy action fans, as well as those looking for a bit more depth, but as a cohesive whole, it's rather mixed.
Willie Waffle WaffleMovies.com50There is so much testosterone in this movie, women walk into the theater looking like Taylor Swift, but they walk out looking like Chaz Bono.
Radheyan Simonpillai NOW Toronto40Though the film tries to achieve Bourne-style grit and depth, it lacks the intelligence and flair that made the Matt Damon franchise so compelling.
Boo Allen Denton Record Chronicle (TX)40Despite the presence of some notable acting talent, this not-Elite work turns out to be just another dumb Jason Statham film.
Grae Drake Movies.com60Have fun, action junkies.
Terry Staunton Radio Times40The permanently scowling Statham borders on caricature, while the talents of De Niro and Owen are completely wasted.
Peter Sobczynski eFilmCritic.com40The only remotely surprising thing about the new thriller Killer Elite is just how resoundingly unsurprising the entire enterprise is and as it plods on and on.
Nick Rogers Suite101.com50"Killer Elite" sticks to the ribs when it sticks to simple skullduggery and Stathamian standards of busting heads. Whenever it strives for warrior poetry, it's more like a Nantucket-esque limerick scribbled in a London pub's bathroom.
Rob Humanick Slant Magazine63Killer Elite is a throwback to an era when action movies still had balls, when muscular bravado easily overcame banal screenwriting and corny narrative earnestness.
Robert Levin Film School Rejects75The picture entertains, at times legitimately and at others in a cheesy, '80s action sort of way
Kevin Williamson Jam! Movies40Ask yourself: Would The Parallax View and Three Days of the Condor be better with scissor kicks? Are The Conversation and Marathon Man a few dislocated bones short of greatness? Even if you answered yes, you should lower your expectations.
Widgett Walls Needcoffee.com30Pockets of really interesting action in a sea of tedious exposition.
Brian Tallerico HollywoodChicago.com20Features characters less three-dimensional than most cartoons doing and saying things that are only done and said in movies. Bad movies. Really bad movies.
Frank Swietek One Guy's Opinion42Its visual and narrative emptiness is almost beyond comprehension, but there seems to be an audience for such brainless actioners out there.
Bill Gibron Filmcritic.com60much of Killer Elite is flummoxed by its own make-up
Nathan Rabin AV Club25[It] purports to be based on actual events, chronicling the sinister machinations of a shadowy military organization. But this clumsy action movie feels too generic to be real.
MaryAnn Johanson Flick Filosophergrunt grunt grunt *glower* [insert mockney swearing] bash crash punch kick [insert closeup of unshaven stubble]
Sara Maria Vizcarrondo Boxoffice Magazine30Killer Elite has plenty of killing, but the only thing elite about it is the cast.
Kristian M. Lin Fort Worth WeeklyLook closer at Killer Elite, and you'll see an inky portrait of a world that has lost all moral compass. That's stronger stuff than most action thrillers give you.
Brian Orndorf BrianOrndorf.com25Isn't a terribly convincing movie, and while it's difficult to take lightly, it's best to approach the picture as a brainless creation out to quicken pulses. Accepting any of this as serious business is only going to lead to a headache.
Mark Dujsik Mark Reviews Movies25A mess from the bottom up.
Jeff Meyers Metro Times (Detroit, MI)42...ust another middle-of-the-road, choppily edited, unsatisfying mess of an action movie. Think of it as The Killer Mediocre.
- Star Wars: The Force Awakens
- Marvel Phase 3
- Avengers 2
- Batman vs Superman
- The Walking Dead
- Justice League Movie
- Avengers 2
- Avengers 3
- Avengers 4
- Doctor Strange
- Captain America 3
- Dawn of the Planet of the Apes
- Fast And Furious 7
- Godzilla
- Interstellar
- James Bond
- Jurassic Park 4
- Justice League
- Mad Max
- Robocop
- Robopocalypse
- Star Trek
- The Amazing Spider-Man 2
- The Hobbit
- The Hunger Games
- Transformers 4


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Weirs Beach House Rental Photos and Description
3 bedrooms, 1 3/4 bath, 1 half bath, sleeps 7
This property is a newly renovated year round home, in the heart of 'The Weirs'. Within a short walking distance to the Boardwalk, you will find arcades galore, mini-golf, restaurants, water slides, go-carts, batting cages, and The Hobo Train station for a ride to downtown Laconia or downtown Meredith, each with its many shops and restaurants.
The Mt. Washington boat also docks at the Boardwalk and offers themed rides and sunset cruises. There are numerous restaurants in the area as well as 'Funspot Family Center' named 'World's Largest Arcade' by Guinness World Records in 2008. Take the kids on a two minute drive to the Weirs Drive-in, spread out a blanket next to you car and watch the latest movies. If you would like to vacation with extended family or friends, we also have a waterfront cottage adjacent to this property with boat dock and waterfront patio. See Property #398459 for info on that property. It is the grey waterfront cottage seen in the outside photo of this home.
- Suitability:
- Long-term Renters Welcome
- children welcome
- non smoking only
- pets not allowed
- wheelchair inaccessible


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Some hedge analysts might be saying that Apple is having to delay its foray into wearables (i.e. the "iWatch"), but Re/code's well-informed John Paczkowski said that Apple will unveil it "alongside" new iPhones at the September 9th media event he also broke. Bryan Chaffin says if it's true, it means the iWatch is being built in Arizona.
China Hopes to Unseat Apple, Microsoft, Google with Linux-Based OS
China is going to stick it to those Western tech giants dominating the Chinese desktop and mobile platforms, according to a local report. The country's communist government is backing development of a homegrown, though Linux-based, operating system to compete with Apple, Microsoft, and Google.
Apple Fitness Sensors Everywhere: It's More than the iWatch
HealthKit in iOS 8 offers the promise of a centralized system so iPhone owners can collect and track their own health and fitness data in a single place, and it gives other companies a common platform to feed information into. Apple will no doubt capitalize on that with the rumored iWatch as its first move into the fitness tracking market. But it doesn't seem likely the company will be content to stick to just our wrists, which opens the door for a whole line of wearable tech -- including versatile sensors that know what data to collect based on where they are on your body.
Apple's Stock Sets Record Closing High, Market Cap Record Still Waits
Shares of Apple Inc. set an all-time closing high on Tuesday, ending the day at $100.53 per share, a gain of $1.37 (+1.38 percent), on heavy volume of 69.4 million shares trading hands. The previous closing record was $100.30 per share, set on September 19th, 2012.
Apple Adds 5 Vice Presidents to Leadership Page
Apple significantly expanded the ranks of executives featured on its leadership page Friday. That page previously featured Apple CEO Tim Cook and the company's nine senior vice presidents, but now features an additional five vice presidents, all of whom report to CEO Tim Cook.
Samsung gets Serious about Home Automation with SmartThings Purchase
SmartThings announced on Thursday that it has been purchased by electronics maker Samsung. The acquisition means Samsung is serious about wanting to own the smart home market and give Apple's HomeKit in iOS 8 a serious run for its money.
Report: An Amazing Customer Experience with Apple
Yesterday, John Martellaro's wife had a truly remarkable customer experience at the Apple retail store in Lone Tree, Colorado. The experience demonstrates something very interesting about Apple that makes it unique and hard to compete with.
A Mad Magazine Experiment with iPad Gone Sour
Back in 2010, John Martellaro said good-bye to paper and started moving all his magazine subscriptions to digital versions on an iPad. Here's an update on how that project went. Hint: the technology didn't develop well, and John is going back to paper. For now.
Apple Diversity Report Offers Mixed Ethnic and Gender Bag
Apple released a corporate Diversity report on Tuesday, laying out the ethnic and gender breakdown of its work force and leadership ranks. That report shows that Apple's work force is more diverse than the population as a whole, with under-representation of whites, Hispanics, and blacks, and an over-representation of Asians. At the same time, males are massively over-represented as a whole, and in its leadership ranks, white males in particular rule the roost.
Google TV 78-Button Remote and Apple's Design Process
Ever wondered why the remote for the Apple TV has just three buttons? According to an inside look at Apple University, Apple's team started with the idea of what a remote control does. Then they pared it down until it was stripped to its purest form, an aluminum stick with three buttons. Compare that to one of Sony's remotes designed for Google TV. 78 buttons. It's a mess.
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This 2006 Bentley Continental GT 2dr 2006 Bentley Continental GT AWD Coupe features a 6.0L 12 CYLINDER 12cyl Gasoline engine. It is equipped with... More
All service been done. This car like new.... Not a Single Scratch On The Car... Porpoise Gray Leather Interior with Navy Accents. Automatic Deploying Active Rear Spoiler. Infotainment... More
Marino Performance Motors is proud to announce the new arrival of this stunning 2013 Bentley Continental GT V8 finished in Moonbeam Silver and wrapped... More
2005 BENTLEY CONTINENTAL GT $74,995.00 There are not many car companies in this World that knows how to blend luxury, performance and gorgeous styling... More
Carriage House Motor Cars is selling a beautiful 2005 Bentley Continental GT with 44,275 miles. The car has been adult driven and maintained since... More


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Mission Impossible Gets Fifth Installment
Kaley Cuoco Shows Off Her Tennis Skills
10 Infuriatingly Bad Endings to Good Movies
'Furious 7' First Trailer Released: Video
14 Shows We Wish Were Still On Air
A New Batman and New Batmobile for 2016 Movie
Tune In Tokyo Presents Akihabara Happy Holiday Cosplay Party
8 Historical Facts That Will Change Your Concept of Time Forever
What The Average American Male's Body Looks Like
Mike Nichols: Remembering The Legend
Batfleck: One Year After
Is Christian Bale Ready To Take On His Toughest Role Yet?
Dina Manzo's Extreme Diva Behavior on Set
7 Things You Didn't Know About 'The Big Bang Theory'
Extended Trailer for Avengers: Age of Ultron Brings Even More New Footage!
Lisa Rinna Reveals Why She Joined The Real Houswives
Get Your First Look at Katie Cassidy as Black Canary on Arrow
Heather Dubrow Tries To Stand By Terry's Side
Suicide Squad Targeting Jared Leto as the Joker!
The Best Female Superheroes of All Time
Controversial "Skinny Pill" Sweeps the Nation
The 10 Best Batman Moments on Film
Big Bang Fans: The Sad Truth?
Barbie Messed Up Big Time
Are The Beador's Finally Splitting Up?
10 Tricks to Instantly Look More Attractive in Photos
What's Up With The New Star Wars Movie Title?
First Official Photos from Avengers: Age of Ultron
15 Horror Movies Only Adults Will Understand
Bill Murray Casts All-Female Ghostbusters


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More than 700 flights canceled as travelers on their way to Thanksgiving celebrations contend with a nor'easter packing rain and snow
22-year-old Darsh Patel photographed 300-pound black bear with his cellphone before it mauled him to death
Parents of boy killed over fake gun say police reacted too quickly and believe his death could have been avoided
Don't let the joy of the season be overshadowed by stress; try these strategies to stay sane while spending time with loved ones.
Nearly 30 years later, Bob Simon travels to Ukraine and discovers the reactor still has the power to kill
Watch CBS News anytime, anywhere with the new 24/7 digital news network. Stream CBSN live or on demand for FREE on your TV, computer, tablet, or smartphone.


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This Thanksgiving, Let's Talk About Genocide Rather Than Pilgrims and 'Friendly Indians'
Russians Invade Afghanistan (Again!), Chinese Fight Iraq War (Again!)
Shaking the Heavens in Ferguson, Missouri
Russell Brand on Ferguson Decision: Are We Living in a Corrupt World With No Possibility for Change?
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Asteroids and satellites, oh, my! Two reports warn us to cast a wary eye above as space debris—natural and man made—drops from the sky. But don't over-fret: Odds of getting hit are very small, though experts warn that the right-size asteroid would cause major damage.
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"I've never seen anything like this. Ever," says OPP Sergeant Kerry...
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Mary Anne Barkhouse
What: Reins of Chaos: The Apocalypse as a Four Part Concerto
Where: Grimsby Public Art Gallery, 18 Carnegie Lane, Grimsby
When: until Jan. 20
Phone: 905-945-3246
If wishes were horses, then beggars would ride.
All of us can ride Mary Anne Barkhouse's horses — imaginatively and, sometimes, physically.
Horses take centre stage in Reins of Chaos: The Apocalypse as a Four Part Concerto, an absolutely must-see exhibition at the Grimsby Public Art Gallery.
Barkhouse, an award-winning artist, belongs to the Nimpkish band, Kwakiuti First Nation. She's created a highly ordered installation that explores chaos through traditional and contemporary narratives — and toys.
A white donkey meets us. It's a child's pull toy, complete with green wheels and a bright blue rope. Barkhouse calls it the Donkey of Eternal Salvation.
The donkey belongs with the group of four vintage coin-operated horses on the left. Children used to ride on them. Gallery visitors are encouraged to do so.
By playing with toy donkeys and riding fake horses, children can establish a relationship with animals.
Romanticists two centuries ago debated the idea of humans interacting with nature. Riding a horse, for instance, was an example of the human conquering nature. And it's easy to abuse the conquered.
Abuse works in many ways. Barkhouse identifies this equine group as Four Horses of the Apocalypse, a subject known to earlier artists.
In the biblical Apocalypse, or Revelation, four riders on horses of different colours bring conquest, war, famine and death to humanity.
Barkhouse's horses have the same colours — white, red, black and palomino. Presented as pretty playtime horses, with children as occasional riders, they soften the biblical vision of the world's end. But does toy imagery defuse the horror, or teach us that war and destruction are fun?
Banners on the wall behind the horses bear images and matching phrases. One says Re-search and Destroy next to a ship and a whale.
Across the room, another group of four horses faces this one. Each of these bronze horses stands on a tall white plinth. A bendable toy horse was Barkhouse's model.
She's called this group Quadriga, Latin for a four horse group and for a four horse chariot. Ancient Roman emperors rode such chariots in processions celebrating military victories. I'm also thinking of the four bronze horses at San Marco in Venice. They are the spoils of war.
As we move farther back, we encounter more toys: four rocking horses. Their colours echo those of the Apocalypse group. One rocking horse carries the names of battles: Hastings, Waterloo, Vimy, Kabul. Barkhouse calls this group Destrier, the word for a medieval knight's warhorse.
Destrier includes silhouettes of birds and warplanes on the wall. Winged nature becomes an inspiration for human-made machines that destroy.
The last item in the installation, Fin de Monde, is almost hidden. It's a small handmade book. The text and illustrations comment on how humans have mistreated animals and nature.
The narrator, a beaver, reminds us, for instance, how people complain about beaver dams, but build architectural monstrosities. But the book offers hope: the donkey, "compassionate and not stupid," comes to save the animals — and us.
Regina Haggo, art historian, public speaker, curator and former professor at the University of Canterbury in New Zealand, teaches at the Dundas Valley School of Art.
Want more?
If you want to see more of Mary Anne Barkhouse's work, check out Covenant, a pair of bronze coyotes in front of the McMaster Museum of Art. They were installed this summer.
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Paul J. Larkin Jr. directs The Heritage Foundation's project to counter abuse of the criminal law, particularly at the federal level, as senior legal research fellow in the Center for Legal and Judicial Studies. This "overcriminalization" project is part of Heritage's Rule of Law initiative.
Before joining Heritage in September 2011, Larkin held various positions with the federal government in Washington, D.C. At the U.S. Department of Justice from 1984 to 1993, Larkin served as an assistant to the solicitor general and as an attorney in the Criminal Division's section on organized crime and racketeering. He argued 27 cases before the U.S. Supreme Court.
In 1996-1997, Larkin served as counsel to the Senate Judiciary Committee and head of the Crime Unit for Sen. Orrin Hatch (R-UT), then the panel's chairman. He worked in the Environmental Protection Agency from 1998 to 2004 as a special agent for criminal enforcement, also serving as acting director in 2004.
His honors include the Secretary of Defense Medal for Meritorious Civilian Service, which he received in 1994 for representing the military before the Supreme Court.
In the private sector, he worked at two top law firms in Washington, D.C., and as assistant general counsel for Verizon Communications from 2004 to 2009.
Larkin received his law degree in 1980 from Stanford Law School, where he was a published member of the Stanford Law Review. He clerked for Judge Robert H. Bork of the U.S. Court of Appeals for the D.C. Circuit.
In 2010, he received a master's degree in public policy from George Washington University. He also holds a bachelor of arts degree in philosophy from Washington and Lee University in Lexington, Va., where he graduated summa cum laude with honors.
Larkin, born and raised in New York, N.Y., is a life-long New York Giants fan. He and his wife Lee currently reside in Alexandria, Va. They have three sons and a chocolate Labrador retriever named Cocoa.
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Watermelon Favors DIY
Nothing screams summer more than watermelon (well, maybe ice cream does, too). It just so happens that August 3rd is National Watermelon Day. Who knew?! This party favor, ready to stuff with treats and goodies, is made out of plain old paper plates from the grocery store. (PS – Watermelon pinatas!)
Click through for instructions!
Carnival Party Ideas
Growing up, I loved going to the county fairs and carnivals that happened around my hometown in the summertime. So I think it would be fun to host a carnival-themed party before summer ends! On Oh Happy Day, we've done a bunch of DIYs that would work great with a theme like this. With the party already planned, all you need is to set a date and invite over your friends!
A. Carnival Cake Topper | B. Streamer Garlands | C. Caramel Apple Kits | D. Mini Cotton "Candy" Invites | E. Spinning Carousel Centerpieces | F. Weather Balloon Signage | G. Fringey Streamers | H. Tightrope Walker Cake Topper | I. Cotton Candy Garland | J. Circus Party Hats
Hidden Prize Birthday Cake
A little while ago I was looking through a 1950s craft book and read about the Christmas tradition of a Jack Horner pie. Traditionally, the book says you wrap small presents, tie each one to a string, and put all the presents in a box/basket with the string tails hanging out of the box – then your party guests each take a string and pull it to see which prize they get.
This tissue paper birthday cake was inspired by that idea – instead of loot bags, have party guests each grab a string, pull, and see what they get! Alternatively, this would also be a fun way to distribute prizes for game-winners throughout the party. (P.S. Fan of paper cakes? Make these candle and cake hats for your guests!!)
Click through for full instructions … (more…)
Spinning Carousel Centerpiece
Lately I've been super inspired by circuses and carnivals, so when I saw these mini horse figurines I couldn't help but make a mini carousel to match. This carousel is not only a decorative centrepiece – it actually spins too! If you're hosting a circus party, there are no shortage of fun projects for you to do: try these cotton candy invitations, circus party hats, & carnival cake toppers!
Click through for details … (more…)
Sandcastle Place Cards
Remember the mini Putz houses that you see in the winter time? Well that's what inspired these glittering sandcastle place cards! Eating picnic snacks was one of my favorite things about going to the beach when I was younger – if you're not close to the water, wouldn't it be fun to host a beach picnic party indoors? And if you're looking for more miniature beach party supplies, try these beach cake toppers!
Click through for instructions … (more…)