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When will Medicare cover medical marijuana?

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When will Medicare cover medical marijuana?

Many older adults are using medical marijuana to treat a variety of conditions, but experts say that conflicting laws, unclear safety standards and complicated rulemaking processes mean it could be years before Medicare may cover the drug.

One in five Medicare recipients currently uses medical marijuana, according to an April 2022 poll by the Medicare Plans Patient Resource Center, an organization that provides Medicare guidance and information. And nearly a quarter have used it in the past. Two-thirds of Medicare recipients think Medicare should cover it, the poll found.

But Medicare doesn’t cover medical marijuana because it’s not federally legal and not approved by the Food and Drug Administration. Here’s where the situation stands.

WHY COVER MEDICAL MARIJUANA FOR OLDER ADULTS?

In one analysis of data from a large cannabis dispensary in New York, 60% of patients were 50 or older, according to an April 2022 paper in the journal, Cannabis and Cannabinoid Research. The patients used cannabis for severe or chronic pain, cancer, Parkinson’s disease and neuropathy, among other things.

And marijuana isn’t cheap: Patients might pay as much as $5 per dose for edible products or $5 to $20 per gram for plant buds, according to New York Cancer & Blood Specialists, which provides care to patients with cancer and blood disorders . (That’s about $142 to $567 per ounce.) Even in states where medical marijuana can be legally prescribed, patients might not be able to afford the prescription.

“This medicine is so expensive,” says Debbie Churgai, executive director of Americans for Safe Access, a nonprofit dedicated to ensuring safe and legal access to cannabis for therapeutic use and research. “There are some states now where insurance will cover the cost of the doctor visit or the cost of the marijuana card, but no insurance will cover the cost of the actual products.”

WHAT ARE THE FEDERAL ROADBLOCKS?

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Two significant issues stand between medical marijuana and Medicare coverage. The first is that the government classifies marijuana as a Schedule I drug, a category of drugs with “no currently accepted medical use and a high potential for abuse” in the United States, according to the Drug Enforcement Administration.

“There is no way the federal government is going to reimburse people through a federal program for a substance they deem as illegal,” says Paul Armentano, deputy director of NORML, the National Association for the Reform of Marijuana Laws.

The second issue is that Medicare requires that the FDA approve a covered drug as safe and effective. Although the FDA has approved one cannabis-derived drug product and three synthetic cannabis-related drug products for prescription use, the agency hasn’t approved the marketing of cannabis for medical treatment.

WHAT ABOUT IN STATES WHERE IT’S LEGAL?

Sure, marijuana is illegal at the federal level, but medical marijuana is now legal in 37 states and Washington D.C. Could private insurers — companies that offer Medicare Advantage, for instance — decide to cover it?

Not likely, says Kyle Jaeger, a cannabis policy reporter and senior editor at Marijuana Moment, a cannabis news site. Like banking institutions that have hesitated to offer services to marijuana businesses, major health insurers will likely decline to cover cannabis as long as it remains a Schedule I drug under federal law.

Also, private insurers rely on the FDA to guide them on which drugs to cover. Consider that the FDA released a statement in January saying that current regulatory pathways are insufficient to allow the agency to classify CBD as a dietary supplement.

“It’s incredibly frustrating for consumers, because all they want is a safe, consistent product,” Jaeger says.

HOW HIGH IS THE BAR FOR CANNABIS COVERAGE?

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Among other things, the marketplace needs more data on the medicinal use of cannabis. “(Insurers) need data to show that the outcomes from cannabis care are equivalent to, if not better than, existing options that they do cover,” says Dr. Benjamin Caplan, founder and chief medical officer of CED Clinic, which provides services to people seeking cannabis treatment.

This is partly complicated by the free-market dispensary system in which patients are free to buy any product. “The system has to be tweaked,” Caplan says. “Patients can’t just have carte blanche to buy whatever they want and the insurance companies are on the hook to cover that.”

Considering the breadth of legal and regulatory obstacles facing the process, plus an overhaul of the dispensary system, the road to cannabis coverage is lengthy, says Jaeger. “I’d say we are many years from having that conversation and rulemaking for something like Medicare.”

_________________

This article was provided to The Associated Press by the personal finance site NerdWallet. Kate Ashford is a writer at NerdWallet. Email: [email protected]. Twitter: @kateashford.

RELATED LINKS:

NerdWallet: What is Medicare, and what does it cover? https://bit.ly/nerdwallet-what-is-medicare-and-what-does-it-cover Department of Justice/Drug Enforcement Administration: Drug Fact Sheet, Marijuana/Cannabis https://www.dea.gov/sites/default/files/2020-06/Marijuana-Cannabis-2020_0.pdf

U.S. Food and Drug Administration: FDA concludes that existing regulatory frameworks for foods and supplements are not appropriate for Cannabidiol, will work with Congress on a new way forward. https://www.fda.gov/news-events/press-announcements/fda-concludes-existing-regulatory-frameworks-foods-and-supplements-are-not-appropriate-cannabidiol

The survey from MedicarePlans.com was conducted online by the survey platform Pollfish from April 1 to 2, 2022. The survey polled 1,250 Americans 65 and older who have health insurance through Medicare.

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Medicare Plans Patient Resource Center. (April, 2022). “1 in 5 Medicare recipients use medical marijuana.” https://www.medicareplans.com/1-in-5-medicare-recipients-use-medical-marijuana/

The UC San Diego Health study used a trend analysis of data from the Department of Healthcare Access and Information related to cannabis-related emergency department visits by California adults age 65 and older from 2005 to 2019.

UC San Diego Health. (January, 2023). “Cannabis-related emergency department visits among older adults on the rise.” https://health.ucsd.edu/news/releases/Pages/2023-01-09-cannabis-related-emergency-department-visitis-among-older-adults-on-the-rise.aspx

The study published in Cannabis and Cannabinoid Research analyzed invoice data on purchases of cannabis products from a large medical cannabis dispensary in New York between Jan. 1, 2016, and Dec. 31, 2017. Data came from 11,590 patients ages 18 and up.

Cannabis and Cannabinoid Research. (April, 2022). “Patterns of medical cannabis use among older adults from a cannabis dispensary in New York State.” https://www.liebertpub.com/doi/10.1089/can.2020.0064

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Israel hails ‘success’ after blocking unprecedented attack from Iran

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Israel hails ‘success’ after blocking unprecedented attack from Iran

TEL AVIV, Israel (AP) — Israeli leaders on Sunday credited an international military coalition with helping thwart a direct Iranian attack involving hundreds of drones and missiles, calling the coordinated response a starting point for a “strategic alliance” of regional opposition to Tehran.

But Israel’s War Cabinet met without making a decision on next steps, an official said, as a nervous world waited for any sign of further escalation of the former shadow war.

The military coalition, led by the United States, Britain and France and appearing to include a number of Middle Eastern countries, gave Israel support at a time when it finds itself isolated over its war against Hamas in Gaza. The coalition also could serve as a model for regional relations when that war ends.

“This was the first time that such a coalition worked together against the threat of Iran and its proxies in the Middle East,” said the Israeli military spokesman, Rear Adm. Daniel Hagari.

One unknown is which of Israel’s neighbors participated in the shooting down of the vast majority of about 350 drones and missiles Iran launched. Israeli military officials and a key War Cabinet member noted additional “partners” without naming them. When pressed, White House national security spokesman John Kirby would not name them either.

But one appeared to be Jordan, which described its action as self-defense.

“There was an assessment that there was a real danger of Iranian marches and missiles falling on Jordan, and the armed forces dealt with this danger. And if this danger came from Israel, Jordan would take the same action,” Jordanian Foreign Minister Ayman al-Safadi said in an interview on Al-Mamlaka state television. U.S. President Joe Biden spoke with Jordan’s King Abdullah on Sunday.

The U.S. has long tried to forge a regionwide alliance against Iran as a way of integrating Israel and boosting ties with the Arab world. The effort has included the 2020 Abraham Accords, which established diplomatic relations between Israel and four Arab countries, and having Israel in the U.S. military’s Central Command, which oversees operations in the Middle East and works closely with the armies of moderate Arab states.

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The U.S. had been working to establish full relations between Israel and regional heavyweight Saudi Arabia before the Oct. 7 Hamas attack sparked Israel’s war in Gaza. The war, which has claimed over 33,700 Palestinian lives, has frozen those efforts due to widespread outrage across the Arab world. But it appears that some behind-the-scenes cooperation has continued, and the White House has held out hopes of forging Israel-Saudi ties as part of a postwar plan.

Just ahead of Iran’s attack, the commander of CENTCOM, Gen. Erik Kurilla, visited Israel to map out a strategy.

Israel’s military chief, Lt. Gen. Herzi Halevi, on Sunday thanked CENTCOM for the joint defensive effort. Both Jordan and Saudi Arabia are under the CENTCOM umbrella. While neither acknowledged involvement in intercepting Iran’s launches, the Israeli military released a map showing missiles traveling through the airspace of both nations.

“Arab countries came to the aid of Israel in stopping the attack because they understand that regional organizing is required against Iran, otherwise they will be next in line,” Amos Yadlin, a former head of Israel’s military intelligence, wrote on X, formerly Twitter.

Israel’s defense minister, Yoav Gallant, said he had spoken with U.S. Defense Secretary Lloyd Austin and that the cooperation “highlighted the opportunity to establish an international coalition and strategic alliance to counter the threat posed by Iran.”

The White House signaled that it hopes to build on the partnerships and urged Israel to think twice before striking Iran. U.S. officials said Biden told Israeli Prime Minister Benjamin Netanyahu that Washington would not participate in any offensive action against Iran.

Israel’s War Cabinet met late Sunday to discuss a possible response, but an Israeli official familiar with the talks said no decisions had been made. He spoke on condition of anonymity because he was discussing confidential deliberations.

Asked about plans for retaliation, Hagari declined to comment directly. “We are at high readiness in all fronts,” he said.

“We will build a regional coalition and collect the price from Iran, in the way and at the time that suits us,” said a key War Cabinet member, Benny Gantz.

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Iran launched the attack in response to a strike widely blamed on Israel that hit an Iranian consular building in Syria this month and killed two Iranian generals.

By Sunday morning, Iran said the attack was over, and Israel reopened its airspace. Iran’s president, Ebrahim Raisi, claimed Iran had taught Israel a lesson and warned that “any new adventures against the interests of the Iranian nation would be met with a heavier and regretful response from the Islamic Republic of Iran.”

The foes have been engaged in a shadow war for years, but Sunday’s assault was the first time Iran launched a direct military assault on Israel, despite decades of enmity dating back to the country’s 1979 Islamic Revolution.

Iran said it targeted Israeli facilities involved in the Damascus strike, and that it told the White House early Sunday that the operation would be “minimalistic.”

But U.S. officials said Iran’s intent was to “destroy and cause casualties” and that if successful, the strikes would have caused an “uncontrollable” escalation. At one point, at least 100 ballistic missiles were in the air with just minutes of flight time to Israel, the officials said.

Israel said more than 99% of what Iran fired was intercepted, with just a few missiles getting through. An Israeli airbase sustained minor damage.

Israel has over the years established — often with the help of the U.S. — a multilayered air-defense network that includes systems capable of intercepting a variety of threats, including long-range missiles, cruise missiles, drones and short-range rockets.

That system, along with collaboration with the U.S. and others, helped thwart what could have been a far more devastating assault at a time when Israel is already deeply engaged in Gaza as well as low-level fighting on its northern border with Lebanon’s Hezbollah militia. Both Hamas and Hezbollah are backed by Iran.

While thwarting the Iranian onslaught could help restore Israel’s image after the Hamas attack in October, what the Middle East’s best-equipped army does next will be closely watched in the region and in Western capitals — especially as Israel seeks to develop the coalition it praised Sunday.

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In Washington, Biden pledged to convene allies to develop a unified response. Secretary of State Antony Blinken said the U.S. would hold talks with allies. After an urgent meeting, the Group of Seven countries unanimously condemned Iran’s attack and said they stood ready to take “further measures.”

Israel and Iran have been on a collision course throughout Israel’s war in Gaza. In the Oct. 7 attack, militants from Hamas and Islamic Jihad, also backed by Iran, killed 1,200 people in Israel and kidnapped 250 others. Israel’s offensive in Gaza has killed over 33,000 people, according to local health officials.

Hamas welcomed Iran’s attack, saying it was “a natural right and a deserved response” to the strike in Syria. It urged the Iran-backed groups in the region to continue to support Hamas in the war.

Hezbollah also welcomed the attack. Almost immediately after the war in Gaza erupted, Hezbollah began attacking Israel’s northern border. The two sides have been involved in daily exchanges of fire, while Iranian-backed groups in Iraq, Syria and Yemen have launched rockets and missiles toward Israel.

___

Federman reported from Jerusalem. Associated Press writers Zeke Miller and Michelle L. Price in Washington; Amir Vahdat in Tehran, Iran; Samy Magdy in Cairo; Omar Akour in Amman, Jordan; and Giada Zampano in Rome contributed to this report.

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How to get rid of NYC rats without brutality? Birth control is one idea

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How to get rid of NYC rats without brutality? Birth control is one idea

New York lawmakers are proposing rules to humanely drive down the population of rats and other rodents, eyeing contraception and a ban on glue traps as alternatives to poison or a slow, brutal death.

Politicians have long come up with creative ways to battle the rodents, but some lawmakers are now proposing city and statewide measures to do more.

In New York City, the idea to distribute rat contraceptives got fresh attention in city government Thursday following the death of an escaped zoo owl, known as Flaco, who was found dead with rat poison in his system.

City Council Member Shaun Abreu proposed a city ordinance Thursday that would establish a pilot program for controlling the millions of rats lurking in subway stations and empty lots by using birth control instead of lethal chemicals. Abreu, chair of the Committee on Sanitation and Solid Waste Management, said the contraceptives also are more ethical and humane than other methods.

The contraceptive, called ContraPest, is contained in salty, fatty pellets that are scattered in rat-infested areas as bait. It works by targeting ovarian function in female rats and disrupting sperm cell production in males, The New York Times reported.

New York exterminators currently kill rats using snap and glue traps, poisons that make them bleed internally, and carbon monoxide gas that can suffocate them in burrows. Some hobbyists have even trained their dogs to hunt them.

Rashad Edwards, a film and television actor who runs pest management company Scurry Inc. in New York City with his wife, said the best method he has found when dealing with rodents is carbon monoxide.

He tries to use the most humane method possible, and carbon monoxide euthanizes the rats slowly, putting them to sleep and killing them. Edwards avoids using rat poison whenever possible because it is dangerous and torturous to the rodents, he said.

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Some lawmakers in Albany are considering a statewide ban on glue boards under a bill moving through the Legislature. The traps, usually made from a slab of cardboard or plastic coated in a sticky material, can also ensnare small animals that land on its surface.

Edwards opposes a ban on sticky traps, because he uses them on other pests, such as ants, to reduce overall pesticide use. When ants get into a house, he uses sticky traps to figure out where they’re most often passing by. It helps him narrow zones of pesticide use “so that you don’t go spray the entire place.”

“This is not a problem we can kill our way out of,” said Jakob Shaw, a special project manager for People for the Ethical Treatment of Animals. “It’s time to embrace these more common sense and humane methods.”

Two cities in California have passed bans on glue traps in recent years. On the federal level, a bill currently in committee would ban the traps nationwide.

“It ends a really inhumane practice of managing rat populations,” said Jabari Brisport, the New York state senator who represents part of Brooklyn and sponsored the bill proposing the new guidelines. “There are more effective and more humane ways to deal with rats.”

Every generation of New Yorkers has struggled to control rat populations. Mayor Eric Adams hired a “rat czar” last year tasked with battling the detested rodents. Last month, New York City reduced the amount of food served up to rats by mandating all businesses to put trash out in boxes.

While the war on rats has no end in sight, the exterminator Edwards said we can learn a lot from their resilience. The rodents, he said, can never be eradicated, only managed.

“They’re very smart, and they’re very wise,” he said. “It’s very inspiring but just — not in my house.”

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Coachella: Earthquake shakes SoCal desert during music fest

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Coachella: Earthquake shakes SoCal desert during music fest

RIVERSIDE, Calif. (AP) — A small earthquake shook the Southern California desert Saturday near Coachella, where the famous music festival is being held this weekend. No damage or injuries were reported.

The quake, with a preliminary magnitude of 3.8, hit at 9:08 a.m. about 8 miles (13 kilometers) northeast of Borrego Springs in Riverside County, according to the U.S. Geological Survey.

The epicenter was about 20 miles (32 kilometers) southeast of Coachella. It struck at a depth of about 7 miles (11 kilometers), the USGS said.

A dispatcher with the Riverside County Sheriff’s Department said there were no calls reporting any problems from the quake.

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