Check In with Your Lung Health: Navigating Care
ComplexBy Dr. Matthew A. Gaudet, M.D., FACS
Legal Matters pg.3
Healthy Heart pg.5
Mental Health pg.7
Framework pg.8
Financial Forecast pg.12
Normal Is Not the Same as Optimal: What Your Lab Results May Not Be Telling You See pg. 11 INDEX
World Lung Cancer Day is August 1, and this summer is a great time to check in with your lung health. The early stages of lung cancer may not have obvious symptoms, which is why awareness and regular screening play such an important role. Whether you are a current smoker, a former smoker, or have never smoked, you can take preventative steps and discuss cancer risk with your provider or care team.
Risk Factors and Prevention
Smoking is the leading cause of lung cancer for the majority of cases. Environmental exposure to secondhand smoke, radon, asbestos, or air pollution may also increase your chances of developing lung cancer, as well as family history.
If you smoke or have smoked in the past, quitting can have real benefits for your health at any stage. Quitting smoking can reduce your lung cancer risk by half (and up to 90% if you quit under age 40), and reduce the risk of heart disease, stroke, and Alzheimer’s disease. There is no single “right” way to quit — some people prefer gradual reduction, some go “cold turkey” all at once, while others use nicotine replacement options like patches, gum, or lozenges. Most people make several attempts before quitting for good.
approach that feels manageable for you. Keeping busy, finding ways to occupy your hands and mouth, and choosing activities or restaurants where smoking is prohibited can all help. Support can
For smokers and non-smokers, changes to your habits and environment can reduce the risk of lung cancer. Lung cancer can also be caught early through regular screenings. Talk to your healthcare provider to see if you are at risk.
make a big difference. Friends, family members, healthcare teams, and online programs can offer encouragement. You can also use free resources like the Texas Tobacco Quitline 1-877-YES-QUIT (1-877-937-7848) that provide coaching and support by phone or text.
radon and minimizing exposure to harmful substances at work or in daily life can help lower risk. While most of us are aware of second-hand smoke (when others are smoking near you), if you live in a home or workplace where people smoked previously, you may be exposed to third-hand smoke. Third-hand smoke includes particles that remain behind in clothing, furniture, buildings, and other items, and may require special cleaning to remove. In addition, people with a parent or sibling who had lung cancer may have a higher-than-average risk, even if they do not smoke. Eating a balanced diet with fruits and vegetables and staying physically active are additional ways to support overall lung health.
Why Screening Matters
What matters most is finding an
Even if you don’t smoke, it’s still helpful to be aware of your risk. About 2 in 10 people with lung cancer have never smoked. Testing your home for
Lung cancer screening is one of the most effective tools for detecting disease early. However, only around 2 in 10 eligible Americans get screened for
A breakthrough does not begin in a lab. It begins much earlier, with the materials researchers rely on to ask the right questions and pursue the next discovery. In the high-stakes world of drug development and clinical trials, biospecimen quality is more than a logistical detail, it is the foundation of scientific integrity.
The
Integrity of the Sample
When biospecimens come from fully traceable donors and are collected through rigorous standards, they do more than support research. They strengthen reproducibility, protect outcomes, and ensure that every conclusion is built on something reliable.
At Gulf Coast Blood Research, we provide that foundation with ethically sourced blood products and GMP-aligned workflows designed to meet the demands of modern research. We bridge the gap between donor altruism and laboratory precision, ensuring that the human element of research remains its strongest link.
Versatility in Sourcing
We recognize that research is never one-size-fits-all. The path to a new therapy is rarely linear, and the requirements for success can shift overnight. Our team is built to adapt, offering flexible solutions that align with the unique needs of your work:
• Precise Donor Criteria: Narrowing the field to meet specific demographic or health profiles.
• Recallable Donor Options: The ability to return to the same source for longitudinal consistency.
• Customized Sourcing Strategies: Tailored collection protocols that align with the urgency of your mission.
A Culture of Collaboration
We believe in collaboration. By partnering with us, you gain access to a wealth of resources and expertise that can propel your research forward. When you choose Gulf Coast Blood Research, you are not just selecting a vendor; you are aligning with a partner committed to your success.
Still unsure? Consider the success stories of others. Many of our partners and clients have experienced notable results thanks to our blood products. These testimonials highlight how ethical sourcing and quality assurance can transform research outcomes.
We are here to help you move science forward with biospecimens you can trust, processes you can rely on, and support you can count on. Because when you are working toward the next therapy, the next treatment, or the next cure, every sample matters.
Start your next project with confidence at gulfcoastbloodresearch.org/contact/
Legal Matters
Federal Agencies Finalize Long-Pending No Surprises Act IDR Operations Rule
By Joshua D. Arters, J.D.,
Olivia D. Winnett, J.D. Polsinelli, PC
After more than two years, federal agencies have finalized the Federal Independent Dispute Resolution (IDR) Operations final rule under the No Surprises Act. The final rule follows the proposed rule issued in November 2023 and focuses on how the federal IDR process is supposed to work in practice.
What Facilities and Providers Should Watch as the Rule Takes Effect
As the final rule takes effect, several
implementation issues are likely to shape how the federal IDR process works in practice:
• The administrative fee will drop to $15, but volume may become the next pressure point. The final rule lowers the federal IDR administrative fee to $15 per party per dispute. The relatively low fee may increase dispute volume, which could create capacity issues for the agencies, certified IDR entities, payors, facilities, providers and the portal. The agencies did not finalize direct federal collection of administrative fees or separate reduced fees for low-dollar or ineligible disputes.
• Open negotiation and IDR initiation will move further into thefederalportal. Once the required portal functionality is available, open negotiation will be initiated through the federal IDR portal. The responding party must submit
an open negotiation response notice by the 15th business day of the 30-business-day open negotiation period. The rule may create a clearer record of when open negotiation began and whether the other side responded. It may also reduce disputes over payor-specific portals because plans and issuers cannot require facilities and providers to use proprietary payor portals instead of the federal IDR portal for open negotiation notices. But a missed day-15 response does not let a party skip ahead. The
30-business-day open negotiation period still must run.
• Clean front-end documentation will matter more. The final rule revises the notice of IDR initiation and creates a more formal response process for non-initiating parties. Facilities and providers should expect more focus on payor identification, claim information, QPA disclosures, remittance documentation and eligibility-related information.
MMalcolm Brenner to lead newly-formed Houston Methodist Center for Cell and Gene Therapy
alcolm Brenner, an internationally recognized physician scientist renowned for his leadership in cell and gene therapy, has been tapped to lead the newly formed Houston Methodist Center for Cell and Gene Therapy.
The center will bring together scientists and clinicians across Houston Methodist’s academic research and clinical care settings to discover and advance new therapies for a wide range of diseases. Its collaborative approach will unite expertise across disciplines and accelerate the translation of promising pre-clinical discoveries into clinical evaluation. The center will also support the development of both genetic and cellular therapies designed to address congenital and acquired conditions throughout the body.
“Malcolm Brenner is a pioneer in the field of cell and gene therapy and is uniquely qualified to lead Houston
Methodist’s research efforts in this field,” said Jenny Chang, president and CEO of the Houston Methodist Academic Institute. “His vision and leadership will play a pivotal role in advancing our work in this space.”
In addition to Brenner, the center will house a team of translational research scientists, physician-scientists, and support staff. Brenner and team will continue their long-term collaborations at Baylor College of Medicine and Texas Children’s Hospital.
Brenner, a professor of pediatrics, medicine, molecular and human genetics and translational biology at Baylor College of Medicine, is known for his foundational contributions to cell and gene therapy as viable clinical treatments. Trained as a physician-scientist in immunology and hematology, he helped redefine bone marrow transplantation as a form of cell therapy and was among the first to show
that engineered immune cells could safely and effectively treat infection and cancer. His research established the clinical potential of virus-specific T cells and gene-modified hematopoietic stem cells, laying the groundwork for therapies that provide durable, and in some cases lifelong, benefits for patients.
Beyond his scientific discoveries, Brenner has played a key role in shaping the global infrastructure for cell and gene therapy research. A leader
in major scientific societies and an architect of early standards for the field, he helped guide how these complex therapies are developed, regulated and delivered. Elected to the National Academy of Medicine and National Academy of Inventors, Brenner has received numerous honors recognizing his scientific impact and mentorship. He earned his medical degree and doctorate from the University of Cambridge in England.
the practice of good medicine.
NOW AND FOREVER.
However you practice in today’s ever-changing healthcare environment, we’ll be there for you with expert guidance, resources, and coverage. It’s not lip service. It’s in our DNA to continually evolve and support the practice of good medicine in every way. That’s malpractice insurance without the mal. Join us at thedoctors.com Scan here for a rapid premium indication, and discover the unrivaled rewards of The Doctors Company.
Malcolm Brenner
Mental Health
How To Maintain Mental Strength as an Athlete
By Eric Alan Storch, Ph.D
Athletesat any level, including highlevel professionals, experience pressure. Elite athletes thrive under pressure by maintaining mental toughness in their game. Baylor College of Medicine experts explain how athletes stay mentally tough – behaviors anyone can adopt.
“It is critical to develop a healthy cognitive mindset so you can effectively manage your emotions through the successes and inevitable failures,” said Dr. Eric Storch, professor and executive vice chair of psychology in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor. “Being able to train yourself to pick yourself up when something doesn’t go well and to move forward is a critical element to being a successful athlete.”
The ability to eventually move forward comes naturally to athletes, which allows them to reevaluate their
moving forward and gives you direction on what you may have to work on. This is what successful athletes can do well: not collapse in the face of adversity or a negative outcome but view it in that mentality of ‘How do I move forward based on this analysis,’” Storch said.
The noise of social media and negative self-talk might affect an athlete’s well-being and performance. Athletes should try to not compare themselves to others, no matter the public discourse.
“Comparison and distraction are certainly obstacles that anyone expected to perform at a high level are going to face. While it is tempting to seek community and comfort in social media, I think these outlets generally only build the tendency to compare and create unrealistic expectations,” said Dr. Sarah-Anne Keyes, assistant professor in the Physician Assistant Program at Baylor. “Hearing our own inner voice of wisdom around what works for us and
successes and failures in an adaptive, objective manner. But individuals may catastrophize, put themselves down or have a hopeless mindset when things do not go well. According to Storch, those who take care of themselves and surround themselves with supportive peers and coaches are able to keep performances in context, learn how to manage the highs and lows and feel supported when things don’t go well. He emphasizes using outcomes as a manner of feedback to grow athletically as well as individually.
“If you give up a goal in soccer, for example, look at it and think if there is something you could’ve done differently, or was it just a great play by the opposing team. That’s feedback for performance
what we need is paramount, and the noise of the world is very loud.”
Sleeping well, eating well and being around positive, supportive people is crucial not only for athletic performance, but for overall health. When feeling down, try to get in that cognitive mindset to approach the outcome of an important match or game. Talk to coaches or other players to keep everything in perspective in terms of the outcome or mistakes during the match and try to de-catastrophize those mistakes. Keyes recommends having structure around performance to stay motivated: a song or playlist that
see Mental Health. ...page 14
Healthy Heart
Local Company Head to Lead 2026 Heart Walk and Citywide Push for CPR Readiness
By Dion Bart
The American Heart Association
Bundy joins the American Heart Association in engaging companies in Houston to create a community of lifesavers
According to the American Heart Association, 9 in 10 people who suffer cardiac arrest outside of the hospital die, and more than half don’t receive bystander CPR. CPR — especially if performed immediately — can double or triple a person’s chance of survival. To help improve cardiac arrest outcomes in Houston, Jeffrey M. Bundy, Ph.D., president and chief commercial officer at United Imaging Healthcare North America, will chair the 2026 Houston Heart Walk, leading a year-round effort to rally companies and community members to raise critical funds and expand CPR education.
Heart Walk is the largest community-facing initiative of the
American Heart Association, a relentless force changing the future of health for everyone everywhere. Through fundraising, community education and corporate engagement, Heart Walk aims to make CPR education and training more accessible, fund vital research and drive equitable health for all. Under Bundy’s leadership, top executives in Houston will work to recruit other organizations to join the local Heart Walk campaign and help build a community of lifesavers.
“The success that the American Heart Association has had educating communities on CPR and ensuring AEDs are ubiquitous is remarkable,” said Bundy. Although cardiac disease doesn’t just happen overnight, the first recognized symptoms might be sudden and deadly. In many of these situations, you aren’t in a place where a physician can help. That’s where the Heart Walk can really make a difference. It requires us all to learn, for the good of our families and communities. I hope that people will engage in this activity and
learn something that may save a life of a family member, friend or neighbor, or colleague.”
According to the American Heart Association’s 2024 CPR Perceptions Survey, 39% of people — or approximately 103 million U.S. adults — now feel “extremely confident” or “very confident” they could correctly perform CPR, up from 33% in 2021. That’s roughly 17.7 million more adults who are highly confident in their ability to conduct CPR, yet 61% still lack high confidence to act in a cardiac emergency.
“While we’re extremely proud of the progress that’s been made over the last several years, our work is far from over,” said Rod Larson, chief executive officer of Oceaneering Inc. “Bundy has dedicated his career to cardiac diagnosis and hopes that his involvement can also open the eyes of participants that avoiding cardiac disease is their best option for a long life with loved ones. His commitment to making Houston a safer, stronger community is proof he’s the right person for the role. We’re see Healthy Heart. ...page 13
The Framework
St. Luke’s Health Breaks Ground on Inpatient Rehabilitation Hospital
By Sara Parker
St. Luke’s Health, a member of CommonSpirit Health, and Lifepoint Rehabilitation, an operating division of Lifepoint Health, joined by community stakeholders recently celebrated the ground breaking of a new free-standing hospital designed to expand access to crucial rehabilitation services.
Located on the campus of St. Luke’s Health - Springwoods Village Hospital in Spring, the 40-bed, 58,000-square-foot facility will address a community need by expanding access to comprehensive inpatient rehabilitation services for adults recovering from stroke, neurological disease, brain or spinal cord injuries, orthopedic procedures and other debilitating illnesses or injuries. A team of expert rehabilitation professionals will provide intensive nursing care, physical therapy, occupational
therapy and speech pathology services to help patients regain independence and safely return home.
“This expansion will enable St. Luke’s Health to deliver excellent inpatient rehabilitation services with human kindness to a rapidly growing part of Greater Houston,” said Jim Parisi, President of St. Luke’s Health - Springwoods Village Hospital. “The project aligns with our strategy of offering integrated, whole-person care convenient to home across clinics, acute care and post-acute facilities.”
The rehabilitation hospital will be specially designed to create a therapeutic environment for patients and will be equipped with cutting-edge amenities and adaptive units, including multidisciplinary therapy gymnasiums, a specialized “activities of daily living” suite, and outdoor courtyards designed to encourage patient movement and activity. Upon completion, Lifepoint Rehabilitation will manage
day-to-day operations.
“We are excited to break ground alongside our partners at St. Luke’s Health,” said Russ Bailey, president, Lifepoint Rehabilitation. “We share a vision to provide patient-centered care that restores patients to their lives, families and communities as functionally as
possible. A dedicated facility like this enables our teams to provide the seamless and adaptive care that makes this possible, and we look forward to welcoming our first patients next summer.”
The facility is slated to open in summer 2027.
St Lukes Ground Breaking
Grant Supports New Effort to Bring Artificial Intelligence Into Residency Training
By Brittany Foreman
Sam Houston State University College of Osteopathic Medicine (SHSU-COM) has been awarded $25,000 through the Innovations in Graduate Medical Education (GME) Development Grant from the American Association of Colleges of Osteopathic Medicine (AACOM). The three-year award will support a new initiative, AI Across Residency, focused on bringing artificial intelligence training into residency programs.
Artificial intelligence (AI) is already showing up in healthcare, helping with diagnosis, patient communication and everyday clinical work. But while many doctors in residency may have been exposed to AI tools, few have received formal education on how to evaluate and use them in practice as the technology evolves.
At its core, AI Across Residency focuses on helping physicians learn how
to use emerging technology in ways that support patient care, not distract from it. As more healthcare systems adopt new tools, doctors who are trained to use them well can help reduce delays, improve efficiency and support better outcomes, especially in rural and underserved communities.
The program will be based at SHSU-COM and carried out across residency programs connected through the Sam Houston Regional Education Consortium. It focuses on training doctors in family medicine, internal medicine and rural medicine while building a model other residency programs can adopt.
Support for the program also comes from SHSU-COM’s Medical Artificial Intelligence Institute, which brings together clinicians, researchers and educators to advance responsible, patient-centered use of emerging technologies in healthcare.
“This work is about preparing
physicians for the reality of modern medicine,” said Thomas J. Mohr, DO, vice president for medical affairs at Sam Houston State University and dean of SHSU-COM. “We want our residents to understand these tools, think critically about them and use them in ways that support better care for patients.”
Rather than focusing on a single set of tools, the program introduces AI in stages, moving from basic understanding to real-world use in patient care.
Key components include:
• Learning how artificial intelligence
works and how to use it responsibly
• Practicing with real-world case examples and simulations
• Using technology to support clinical workflows and quality improvement
• Training faculty and building support across residency programs
• Resident-led projects focused on improving patient care
• Tracking results to better understand how these tools affect care and efficiency
NOW HIRING IN CLINICAL, ACADEMIC, AND LEADERSHIP ROLES
Testosterone Therapy: Who Benefits?
Understanding Who Is an Appropriate Candidate for Testosterone Replacement Therapy—And Why a Medical Evaluation Is Essential
nterest in testosterone replacement therapy (TRT) has grown significantly in recent years as more men seek treatment for fatigue, low libido, reduced muscle mass, and other symptoms commonly associated with declining testosterone levels. While TRT can improve quality of life for men with medically confirmed testosterone deficiency, specialists emphasize that it is not a treatment for normal aging and should only be prescribed after a comprehensive medical evaluation.
Testosterone, produced primarily
Because these symptoms can also result from conditions such as diabetes, obesity, thyroid disease, sleep apnea, depression, or certain medications, physicians recommend a thorough medical evaluation before making a diagnosis.
Potential Benefits of TRT
For men with clinically confirmed testosterone deficiency, TRT may provide meaningful health benefits. Research has shown that appropriately prescribed therapy can improve sexual desire, increase lean muscle mass, strengthen bones, enhance mood in some patients, and restore energy levels. Many men also report improved quality
in the testes, plays a vital role in maintaining muscle mass, bone density, red blood cell production, sexual function, mood, and overall well-being. Although testosterone levels gradually decline with age—typically beginning around age 30—not every man with lower levels requires treatment.
Recognizing
the Symptoms
According to leading clinical guidelines, testosterone replacement therapy should be considered only for men who have both symptoms of testosterone deficiency and consistently low testosterone levels confirmed by laboratory testing.
Common symptoms include reduced libido, erectile dysfunction, fatigue, decreased muscle mass, increased body fat, diminished strength, depressed mood, difficulty concentrating, and loss of bone density.
of life after their testosterone levels return to a normal range.
Houston physicians have also seen growing interest in testosterone therapy as awareness increases among middle-aged and older men seeking solutions for persistent fatigue and declining physical performance. Specialists caution, however, that treatment decisions should always be based on medical evidence—not advertising or online claims.
Understanding
the Risks
Like any medical treatment, testosterone therapy is not without potential risks. Patients receiving TRT require ongoing monitoring to ensure therapy remains both safe and effective. Physicians typically
Normal Is Not the Same as Optimal: What Your Lab Results May Not
Be Telling You
By Patrice M. Pompey, MS, PA-C
Iwonder how many patients and providers would be surprised to learn that the health goals we reach for may not always keep us safe.
When clinicians review a patient’s labs, most of the time we are comparing the results to normal. Normal is reassuring. It is the word patients wait to hear, and often the word that ends the conversation. But here is something I have come to appreciate over more than a decade of practice: normal can still leave a person vulnerable to disease.
For years, I gave patients guidance built around a single line. Hemoglobin A1c, the lab value that reflects your average blood sugar over the past two to three months, has a normal cutoff just below 5.7 percent. Anything from 5.7 to 6.4 is labeled prediabetes. So I would tell patients that as long as they stayed under that line, they were fine.
As I became more precise in my
guidance, my viewpoint shifted from a goal of normal to a goal of optimal. The research is clear that risk does not switch on the moment you cross a cutoff. It rises gradually as the number climbs. Someone sitting at the very top of the normal range is not in the same position as someone resting comfortably below it, even though both will hear the same word: normal.
That is what made me question the standard. A normal result is, in many ways, just a line someone has drawn in the sand. It is useful. It helps us screen large populations and decide when to act. But it does not always reflect the optimal goal for the person in front of me. And as we learn more about how the body works, some normal standards are revealed to be less protective than we once believed. Years ago, a blood pressure of 130 over 85 was called normal. In 2017, the guidelines changed, and that same reading became elevated. The patients did not change.
Only our understanding caught up.
I share this not to create anxiety over a single value, and not to suggest clinicians are doing anything wrong. We rely on these reference ranges for good reason, and they save lives. My point is gentler: a normal result is a starting point for a conversation, not always the end of one.
So what can you do with this?
Pay attention to where your numbers fall within the normal range, not just whether they cleared the line. Ask your provider about your trend over time, since the direction your numbers are
moving often tells a more useful story than any single reading. Bring your family history and your own patterns into the conversation, because your personal context shapes what optimal looks like for you. And give yourself permission to aim higher than normal. Normal is not a bad place to be. But it is not the same as optimal. The patients who do best, in my experience, are the ones who learn to see their lab results not as a verdict, but as information
Financial Forecast
When Should You Start Social Security?Planning for Longevity Instead of “Breaking Even”
OneBy Grace S. Yung, CFP Midtown Financial Group, LLC
increases. That higher payment can make a meaningful difference later in life, especially if you live into your 80s or 90s.
Why Longevity Matters
of the most common questions
people ask approaching retirement is: “When should I start Social Security?” Many people focus heavily on a “break-even analysis,” trying to determine whether it makes sense to start benefits early or delay them. But often, this mindset is really planning from a “what if I die early?” perspective. A better question may be: “What if I live a long life?”
With advances in healthcare and
Many retirees underestimate how long they may live. It is increasingly common for one spouse in a couple to live well into their 90s. That means retirement income may need to last decades longer than previous generations experienced. Delaying Social Security not only increases the starting benefit, but future COLA increases are also applied to a larger base amount. Over time, this may provide stronger protection against inflation and rising healthcare costs. Rather than focusing solely on maximizing cumulative dollars received, retirees may
longer life expectancies, retirement can easily last 25 to 35 years. Social Security was designed to provide guaranteed lifetime income, and for many retirees, it is one of the few income sources that includes annual cost-of-living adjustments (COLAs) to help keep pace with inflation.
Understanding the Basics
You can begin Social Security retirement benefits as early as age 62, but your benefit will be permanently reduced if you claim before your Full Retirement Age (FRA), which for many people is between ages 66 and 67. If you delay benefits past FRA, your monthly benefit increases by approximately 8% per year until age 70. For example, someone entitled to $3,000 per month at FRA could potentially receive approximately $3,720 per month at age 70, not including future COLA
benefit from thinking about protecting future income needs later in retirement.
Planning for Married Couples
For married couples, Social Security decisions can become even more important because they may affect surviving spouse benefits. When one spouse passes away, the surviving spouse generally keeps the higher of the two Social Security benefits while losing the smaller one. Because of this, many couples consider having one spouse — often the lower earner or older spouse — begin benefits at Full Retirement Age, while the higher income earner delays until age 70. Why delay the higher earner’s benefit?
Because doing so may increase the surviving spouse benefit for the remainder of the survivor’s lifetime.
Healthy Heart
Continued from page 7
looking forward to seeing incredible results from this year’s Heart Walk campaign and hope the community will join us in making it a success.”
The Heart Association is a global leader in resuscitation science, education and training, and the official publisher of CPR guidelines. Through
Continued from page 9
the Nation of Lifesavers™ movement, the Association is working to ensure that more people are ready to perform CPR and be a vital link in the chain of survival, supporting its goal of doubling the survival rate from out-of-hospital cardiac arrests by 2030.
The Houston Heart Walk will
take place on 24 October 2026 at TMC Helix Park. An estimated 10,000 participants are expected to walk in celebration of local survivors and the lifesaving progress made in Houston. Companies interested in participating can contact local vice president of Heart Walk, Tracie Morden at Tracie.
“Artificial intelligence is already changing how care is delivered in real clinical settings,” said Vinoth Sittaramane, PhD, DVM, director of the Medical Artificial Intelligence Institute at SHSU-COM. “This program helps residents learn how to work with these tools in a thoughtful way, so they can spend more time focused on patients while using technology to support their decisions.”
With support from the Innovations in Graduate Medical Education Development Grant, AI Across Residency helps ensure future
Testosterone
Continued from page 10
monitor testosterone levels, red blood cell counts, prostate-specific antigen (PSA) levels, and overall cardiovascular health throughout treatment.
TRT is generally not recommended for men with untreated prostate cancer or breast cancer. It should also be used cautiously in patients with elevated red blood cell counts, untreated severe sleep apnea, or men planning future fertility, as testosterone therapy can reduce sperm production.
The relationship between testosterone therapy and cardiovascular health continues to be studied. Current evidence suggests TRT can be used safely
Financial
Continued from page12
This can be especially valuable for women, who statistically tend to live longer than men. For example:
• One spouse claims $2,200 per month at FRA
• The higher earning spouse delays and receives $4,000 per month at age 70
If the higher earner passes away first, the surviving spouse may step up to the larger benefit amount, including future COLAs. This strategy can provide additional income security for a surviving spouse who may spend many
in appropriately selected men under medical supervision, but treatment should always be individualized based on each patient’s medical history and overall risk profile.
Lifestyle Still Matters
Medical experts emphasize that healthy lifestyle choices remain an important part of maintaining normal testosterone levels. Regular resistance exercise, maintaining a healthy weight, getting adequate sleep, reducing stress, and managing chronic medical conditions can improve symptoms and, in some cases, naturally support testosterone production.
The Bottom Line
For men with clinically confirmed testosterone deficiency, testosterone replacement therapy can be an effective treatment when prescribed and monitored appropriately. Experts agree that the decision to begin therapy should be based on symptoms, laboratory testing, and an individualized discussion of the potential benefits and risks between patient and physician.
Clinical Takeaway
Testosterone replacement therapy is intended for men with symptoms of testosterone deficiency and consistently low testosterone levels confirmed by laboratory testing. Proper diagnosis, ongoing monitoring, and
Morden@heart.org Learn more and register at houstonheartwalk.org
years in retirement alone.
There Is No One-Size-Fits-All Answer
The right age to begin Social Security depends on several factors, including:
• Health and family history
• Marital status
• Income needs
• Employment plans
• Other retirement assets
• Survivor protection goals
• Tax considerations
Some retirees may need benefits earlier for cash flow purposes, while
others may benefit from delaying to maximize guaranteed lifetime income.
The key is to avoid viewing Social Security solely through the lens of “breaking even.” Retirement planning is not just about total dollars collected — it is also about creating sustainable income and reducing the risk of outliving your assets.
Social Security remains one of the few sources of guaranteed, inflation-adjusted lifetime income available to retirees. Making thoughtful decisions about when to claim benefits can have a lasting impact on retirement
physicians are prepared to use emerging technology in ways that strengthen patient care, improve access and better serve the communities they call home.
physician supervision are essential to achieving safe and effective outcomes.
Sources
• Endocrine Society Clinical Practice Guideline: Testosterone Therapy in Men With Hypogonadism (2018)
• American Urological Association: Evaluation and Management of Testosterone Deficiency
• National Institutes of Health
• Peer-reviewed clinical research on testosterone replacement therapy
security for both individuals and couples. Before making any decisions, consider working with a Certified Financial Planner professional and consult the Social Security Administration to evaluate the strategy that best aligns with your long-term retirement goals.
Lung Health
Continued from page 1
lung cancer, even those who generally stay up to date with other screenings. Because lung cancer is frequently diagnosed at later stages when it is more difficult to treat, early detection through screening has been shown to reduce deaths, especially among people at higher risk. Talking with your healthcare provider can help you determine whether screening is appropriate for you.
Screening is typically
Legal Matters
Continued from page 3
Remittance advice, plan identifiers, QPA disclosures, service codes, denial language and open negotiation correspondence should be captured early in the revenue cycle process, not reconstructed after the IDR deadline is already running.
• Payor disclosures should become more standardized, but not immediately. The final rule requires plans and issuers to provide additional information with initial payment or denial communications. It also requires standardized claim adjustment reason codes and remittance advice remark codes, known as CARCs and RARCs, for certain NSA-related remittance communications. The goal is to help facilities and providers determine earlier whether a claim may be subject to the NSA, whether federal IDR may be available, whether a state law or all-payor model may apply and which plan or issuer is responsible. The agencies still need to identify the specific codes and set the implementation timeline.
Mental Health
Continued from page 6
is motivating, a meal that fuels, talking to someone who provides mental clarity or rewarding oneself after a challenging session.
“When we have a modest level of arousal, that’s best for maximizing performance. However, when not ‘pumped up’ or excessively anxious,
recommended for people ages 50 to 80 with a history of heavy smoking, who smoke now or who quit within the past 15 years, and who have a history of smoking at least 1 pack/day for 20 years = 20 pack-years . A yearly low-dose CT scan is commonly used for screening because it can identify small changes in the lungs early on with minimal exposure to radiation. In between screenings, stay aware of possible symptoms of a lung condition or cancer, such as a persistent cough, pain with deep breathing, chest discomfort, hoarseness, or shortness of breath.
Lung cancer treatment has come
• Eligibility review will remain with IDR entities. Certified IDR entities remain the primary decisionmakers on federal IDR eligibility. The final rule adds more structure, including timelines and an additional-information process. Payors may continue to raise eligibility objections, IDR entities will need to apply the rules consistently and facilities and providers will need to respond quickly when more information is requested.
• Batching and bundling will get revised, not simplified. The final rule allows batched disputes to include up to 50 line-items and clarifies when claims may be batched based on a single patient encounter, same or comparable service codes and certain Category I CPT code ranges. For batched disputes, the cooling-off period will be shortened to 30 business days. But batching remains technical, and the rule will eventually narrow the ability to fix improperly batched disputes after the fact.
• Payor registration may help, if the data connects. The final rule creates a federal IDR registry for plans and issuers. The hard part will likely be matching registry information to remittances,
that is often associated with more detrimental outcomes,” Storch said.
Athletes should prioritize their physical and mental health for performance and to prepare for positive or negative outcomes in their sport.
“When anyone is expecting performance at a high level, a holistic viewpoint is necessary. Everything around the actual performance matters. That means recovery, rest, recharging
a long way, especially personalized treatment plans that honor patient goals. Thanks to new technologies and better teamwork among healthcare providers, people are getting diagnosed earlier and recovering faster, with less invasive methods.
Regardless of your smoking history, knowing your risk of lung cancer can help you stay proactive about your health. Whether you’re reducing tobacco use, removing environmental risks, or getting screened, each step supports your lung health and overall well-being.
claim-level data, plan identifiers and real-world payor workflows. What Facilities and Providers Should Do Now
The final rule generally becomes effective on August 3, 2026; however, the $15 administrative fee applies beginning June 11, 2026, and certain batching provisions will apply to disputes with open negotiation periods beginning November 1, 2026.
Facilities and providers should use the implementation period to pressure-test their NSA workflows. That includes open negotiation, IDR initiation, eligibility screening, batching protocols, remittance retention, QPA tracking, payor identification and vendor coordination.
They should also track how payors implement the new disclosure, remittance-code, registry and portal requirements. Payor compliance will be central to whether facilities and providers receive the information they need early enough to evaluate eligibility, preserve deadlines and file clean disputes.
Facilities and providers should be identifying operational issues now, especially where payor disclosures, remittance codes, registry information or portal workflows may affect access to federal IDR.
and getting early and frequent support. This is not to say that everything is in service of performance, it just means that to maintain mental strength and stability, athletes, students or anyone training for something (whether mental or physical) needs to stay connected to the idea that they are human and have human needs,” Keyes said.
Houston Medical Times is Published by Houston Medical Times News. All content in this publication is copyrighted by Houston Medical Times and should not be reproduced in part or at whole without written consent from the Editor. Houston Medical Times reserves the right to edit all submissions and assumes no responsibility for solicited or unsolicited manuscripts. All submissions sent to Houston Medical Times are considered property and are to be distributed for publication and copyright purposes. Houston Medical Times is published every month
P.O. Box 57430 Webster, TX 77598-743
NEAR
