A New Review Regarding Construction

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Unlike a coal plant that has a ready stockpile, natural gas plants don't store as much on site, meaning any disruption at the supply source will lead to a disruption in turning on the lights. Carey King, an assistant director and research scientist at the Energy Institute at the University of Texas-Austin, said it's possible that power outages at natural gas production sites led to failures in the electric compressors that move the gas. "This is far beyond what the power system operators expected, a far deeper freeze and a far worse performance from our natural gas power plants than anyone anticipated," Cohan said. To help offset potential outages, ERCOT told customers Sunday to conserve power by turning down thermostats, turning off and unplugging appliances and lights and avoiding using large appliances. Rai said conservation was necessary to lessen the problem, but the issue was not at the margin. "The reality is very, very large. Thirty to 50% of capacity in parts of Texas went down," he said. "You're not out 5-10% of the power." ERCOT said it was implementing rolling blackouts Monday "to protect the electric grid from uncontrolled, cascading outages." Instead of the outages being spread across neighborhoods in shorter intervals, some areas have lost power for days while others have kept it the entire time, Cohan said. A look at Texas' net electricity generation Some have pointed to freezing on wind turbines as a potential cause of the widespread outages, saying the renewable energy source is not reliable, but Cohan called those arguments "a red herring." Rai said there are times of the year when wind is an extremely important energy source for Texas, powering half of the state's electricity supply. This week, operators planned for much less wind capacity, though, Cohan said. "Firm resources" – such as gas, coal and nuclear – failed to supply roughly 30,000 megawatts, which contributed to the bulk of the problem, Cohan said. Drone footage shows how major Texas cities look covered in snow A record-breaking winter storm continues to dump snow on the state of Texas. In 2011, a similar deep freeze event caused widespread power outages in Texas, but the extent was not as great, Cohan said. Grid operators learned some lessons from that experience and made adjustments, but they clearly underestimated that demand could rise even higher, Cohan said. Cohan said issues on the supply side better explain what happened. "I think there wasn't enough planning for how interdependent our natural gas and electricity systems were." Every summer during peak demand, the grid's reliability comes into question, Rai said, so it shouldn't be a shock that there could be a weather event that caused so much disruption.  Why is it so cold? How the polar vortex brings record low temperatures and winter storms Even though it occurred in the winter, there should be better planning, he said. Though climate change typically is thought of as leading to warmer temperatures, scientists suspect it could also cause more unpredictable and severe weather. Blaming the failures on this cold being a one-in-30-years weather event is not an excuse, knowing that those events could become more common, Rai said. "Why are we only thinking about 30 years as a society?" "One solution is if you can have capacity that is designed for conditions like this," Rai said. King, of the Energy Institute, said incentivizing power plants to better weatherize should also be prioritized.

https://www.usatoday.com/in-depth/news/nation/2021/02/16/texas-weather-power-outage-rolling-blackouts-leave-millions-dark/6764764002/

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Qualifications for some Medicaid providers came up short, audit finds Published 12:00 am Friday, February 19, 2021 RALEIGH — North Carolina’s Medicaid agency fell short on ensuring doctors and other medical providers met licensing and ownership qualifications to serve patients in the program, state auditors found. The report from State Auditor Beth Wood’s office examined samples from among the 90,000 Medicaid providers in the state in 2019. The performance audit found that the Division of Health Benefits, which is responsible for screening and enrolling providers, often failed to identify and remove those whose professional licenses has been suspended or terminated. The screening work is performed by a third-party contractor, the report said. Licenses can be removed for actions like malpractice, Medicaid fraud or sexual misconduct. These failures placed some Medicaid patients at increased risk for substandard care and resulted in 21 unlicensed providers receiving more than $1.6 million in Medicaid payments, according to the report. In one case, auditors said, a physician assistant whose license was suspended based in part on allegations regarding inappropriate exams of female patients continued to treat hundreds of patients even after the suspension. Auditors also found the division and its contractor failed to love it verify the professional credentials of enrolled providers seeking to continue to provide services. The credentials of only a handful of 191 approved providers within a sample had been verified, the report said. Six of the providers with unverified credentials actually lacked the required professional credentials, auditors said, resulting in $11.2 million in Medicaid spending to the ineligible providers. Auditors attributed the failure to weaknesses in an automated credentialing process. Department of Health and Human Services Secretary Mandy Cohen, responding to the audit in a letter attached by Wood’s office, agreed with the auditors’ findings. Recommendations include removing from the Medicaid program all providers lacking proper credentials to offer services. Cohen wrote that Medicaid program leadership at DHHS, which oversees the Division of Health Benefits, would make the issues in the report “a top priority.” Many recommended changes have already been implemented, including more routine, manual reviews of medical license board announcements, she added. And an improved credentialing program should come online in 2023, she said. “We take every instance of an unqualified provider very seriously and every overpayment is unacceptable,” Cohen wrote. While the Division of Health Benefits calculates the potential overpayments listed in the report subject to recoupment is more than $13 million, state auditors pointed out the amount only covered those providers within the statistical samples reviewed. “It does not include all overpayments that may exist in the entire population of payments made to Medicaid providers,” the audit said. North Carolina’s Medicaid program offers services to more than 2 million state residents, largely poor children, older adults and the disabled. The program spent $16.7 billion in federal and state funds for the year ending June 30, 2020. GOP Sen.

https://www.salisburypost.com/2021/02/19/qualifications-for-some-medicaid-providers-came-up-short-audit-finds/