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Trump 'cancelling' Biden orders signed by autopen

admin - Latest News - November 28, 2025
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Trump ‘cancelling’ Biden orders signed by autopen



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Nov. 28, 2025, 6:00 PM ESTBy Freddie Clayton and Fiona DayThe rolling plains of Kenya’s Maasai Mara and the millions of animals that live there face a shiny new intrusion: a gleaming Ritz-Carlton safari camp.With private plunge pools, butler service and panoramic views commanding more than $5,000 a night, the 20-hectare lodge has become a luxury lightning rod for controversy.Leaders of the Maasai — an ethnic group of traditionally nomadic herders with ancestral ties to the area — and conservationists warn the new tourist destination threatens a migration corridor vital to the movement of vast numbers of animals and have filed a lawsuit to halt its operations.What’s at stake, they argue, is not just a new lodge, but the accelerating pressures of tourism on wildlife, biodiversity and the very spectacle that draws these tourists in the first place. The camp opened on Aug. 15 during the height of the Great Migration, where millions of wildebeest, zebras and other grazing animals move back and forth between the Serengeti plains in Tanzania and the Maasai Mara National Reserve (MMNR) in Kenya, a process that researchers say allows animals to find food and water and maintain genetic diversity among herds.The Ritz-Carlton, Masai Mara Safari Camp. The rapid growth in lodges and camps has sometimes clashed with conservation efforts.Jiri Lizler / Marriott InternationalTourists have long flocked to the savannah by the hundreds of thousands, hoping to witness one of the largest movements of mammals in the world, as herds cross rivers and plains teeming with predators.But the new camp, which boasts “front-row seats to one of the world’s greatest natural wonders” on its website, may threaten the migration that visitors come to witness, conservations and Maasai leaders say. The Ritz-Carlton camp, on a bend in the Sand River, sits on “one of the most favored corridors for these animals,” Maasai elder Meitamei Olol Dapash told NBC News in an interview Sunday.“Any guide will tell you, that is the crossing they use,” said Dapash, who filed a lawsuit in August in a Kenyan court against Ritz-Carlton’s owner, Marriott International, the world’s largest hotel chain, as well as the project’s local owner and operator, Lazizi Mara Limited, and Kenyan authorities.Dapash, executive director of the Institute for Maasai Education, Research and Conservation (MERC), who has a PhD in Sustainability Education from Prescott College in Arizona, alleges in the lawsuit that the 20-suite camp obstructs the crucial migration corridor and is asking the court to restore the land to its original condition.He told NBC News in an interview there had been instances of wildebeest turning back to avoid the camp and that an elephant was seen struggling to find a path across the river after using the location for more than a decade.Female lions with cubs in Masai Mara, Kenya.Henrik Karlsson / Getty Images file“Attachment to the land and to the wildlife exists up to this very day,” Dapash said, adding that the Maasai had seen populations dwindling. The new camp, he added, “was the last straw for us, we just didn’t want to let this happen.”The Kenya Wildlife Service government agency pushed back at claims the lodge has impacted wildebeest migration, citing monitoring data that it says shows it does not “fall within, obstruct, or interfere with any wildebeest migration corridors” and adding that migrating wildebeest “are using the entire breadth of the Kenya-Tanzania border.”It said that “all ecological, environmental and regulatory requirements were thoroughly met and validated.”Marriott International told NBC News that the development underwent an environmental impact assessment (EIA) “in full compliance with” Kenya’s environmental protections.The company said it is committed to “the principles of responsible tourism” but declined to comment on Dapash’s claims that the Ritz-Carlton blocked a key route for local wildlife or its own steps to mitigate the construction’s impact, saying these were matters for Narok County, which manages the reserve on the Maasai’s behalf.Narok County did not respond to NBC News’ request for comment. In court documents seen by NBC News, the county claims that the safari camp complies with the Maasai Mara Management Plan, which imposes a moratorium on new developments amid concerns that poorly regulated tourism was stifling wildlife migration and threatening the reserve’s ecosystem.Lazizi Mara Limited said the moratorium is part of the case before the court, adding: “We wouldn’t want to comment on issues that are pending determination.”Dapash told NBC News that he had “no issue with business, but this is not just about hotel, it is about the long-term survival of the game reserve.” “We feel like we are losing the land, we are losing the wildlife,” he said.The lawsuit comes amid mounting concerns about the health of the 580-square-mile reserve, where tourist numbers have nearly tripled in recent decades. The Maasai Mara National Reserve reported over 300,000 tourists in 2023. In 1980, total visitor entry was 114,000. Tourism in the Mara generates an estimated $20 million annually and thousands more indirectly, according to the reserve. In 2023, tourism across the country contributed around 7% of Kenya’s gross domestic product, according to the World Travel and Tourism Council.But the rapid growth in lodges and camps has sometimes clashed with conservation efforts. “A hotel is never just a hotel,” Dr. Chloe Buiting, a vet and wildlife researcher working in the Maasai Mara, said in an interview. “It’s infrastructure, it’s roads, it’s changes to the water and the resources and the use of land.”Seasonal variation in the availability and quality of food forces animals to move around, said Joseph Ogutu, a Kenyan researcher at the University of Hohenheim in Germany. But he said developments like the Ritz-Carlton are having “a negative effect on migration, because most of these facilities are close to rivers where animals either drink water or breed or seek refuge.”Dapash’s cause has also found support among experts and tourism groups.Grant Hopcraft, a professor of conservation ecology at the University of Glasgow, who has been collaring migratory wildebeest in the Serengeti-Mara since 1999, presented maps and data to the court in October showing “regular cross-border movement of wildebeest” at the location of the lodge, according to his affidavit.RIDE International, a U.S.-based nonprofit providing cultural exchanges and immersive tours in East Africa, has also thrown its support behind Dapash’s lawsuit.The Mara has been suffering for a long time, said Riley Jon Blackwell, the company’s executive director, with “large hotel chains coming in and trying to service the luxury guests who command to see the best of the best for wildlife.”The Ritz-Carlton safari camp was “not surprising,” he added in an interview. “It’s just kind of a culmination of a long time, of a direction of things leading this way.”The camp holds a 2.2-star rating on Google Reviews, with many posters criticizing its environmental impact. Others have praised their stay at the park. A court is scheduled to hear the case in December.If Dapash is successful with his lawsuit, Buiting said it could “set a very interesting precedent” for future developments in the reserve.“From a legal perspective, this could actually be groundbreaking, a turning point,” she added.Freddie ClaytonFreddie Clayton is a freelance journalist based in London. Fiona DayFiona Day is a social news editor for NBC News based in London.Reuters contributed.
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Sept. 24, 2025, 5:00 AM EDTBy Lauren Sausser and Darius Tahir | KFF Health NewsTaking a page from the private insurance industry’s playbook, the Trump administration will launch a program next year to find out how much money an artificial intelligence algorithm could save the federal government by denying care to Medicare patients.The pilot program, designed to weed out wasteful, “low-value” services, amounts to a federal expansion of an unpopular process called prior authorization, which requires patients or someone on their medical team to seek insurance approval before proceeding with certain procedures, tests, and prescriptions. It will affect Medicare patients, and the doctors and hospitals who care for them, in Arizona, Ohio, Oklahoma, New Jersey, Texas, and Washington, starting Jan. 1 and running through 2031.The move has raised eyebrows among politicians and policy experts. The traditional version of Medicare, which covers adults 65 and older and some people with disabilities, has mostly eschewed prior authorization. Still, it is widely used by private insurers, especially in the Medicare Advantage market.And the timing was surprising: The pilot was announced in late June, just days after the Trump administration unveiled a voluntary effort by private health insurers to revamp and reduce their own use of prior authorization, which causes care to be “significantly delayed,” said Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services.“It erodes public trust in the health care system,” Oz told the media. “It’s something that we can’t tolerate in this administration.”But some critics, like Dr. Vinay Rathi, an Ohio State University doctor and policy researcher, have accused the Trump administration of sending mixed messages.On one hand, the federal government wants to borrow cost-cutting measures used by private insurance, he said. “On the other, it slaps them on the wrist.”Administration officials are “talking out of both sides of their mouth,” said Rep. Suzan DelBene, a Washington Democrat. “It’s hugely concerning.”Patients, doctors and other lawmakers have also been critical of what they see as delay-or-deny tactics, which can slow down or block access to care, causing irreparable harm and even death.“Insurance companies have put it in their mantra that they will take patients’ money and then do their damnedest to deny giving it to the people who deliver care,” said Rep. Greg Murphy, a North Carolina Republican and a urologist. “That goes on in every insurance company boardroom.”Insurers have long argued that prior authorization reduces fraud and wasteful spending, as well as prevents potential harm. Public displeasure with insurance denials dominated the news in December, when the shooting death of UnitedHealthcare’s CEO led many to anoint his alleged killer as a folk hero.And the public broadly dislikes the practice: Nearly three-quarters of respondents thought prior authorization was a “major” problem in a July poll published by KFF, a health information nonprofit that includes KFF Health News.Indeed, Oz said during his June press conference that “violence in the streets” prompted the Trump administration to take on the issue of prior authorization reform in the private insurance industry.Still, the administration is expanding the use of prior authorization in Medicare. CMS spokesperson Alexx Pons said both initiatives “serve the same goal of protecting patients and Medicare dollars.”Unanswered questionsThe pilot program, WISeR — short for “Wasteful and Inappropriate Service Reduction” — will test the use of an AI algorithm in making prior authorization decisions for some Medicare services, including skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy.The federal government says such procedures are particularly vulnerable to “fraud, waste, and abuse” and could be held in check by prior authorization.Other procedures may be added to the list. But services that are inpatient-only, emergency or “would pose a substantial risk to patients if significantly delayed” would not be subject to the AI model’s assessment, according to the federal announcement.While the use of AI in health insurance isn’t new, Medicare has been slow to adopt the private-sector tools. Medicare has historically used prior authorization in a limited way, with contractors who aren’t incentivized to deny services. But experts who have studied the plan believe the federal pilot could change that.Pons told KFF Health News that no Medicare request will be denied before being reviewed by a “qualified human clinician,” and that vendors “are prohibited from compensation arrangements tied to denial rates.” While the government says vendors will be rewarded for savings, Pons said multiple safeguards will “remove any incentive to deny medically appropriate care.”“Shared savings arrangements mean that vendors financially benefit when less care is delivered,” a structure that can create a powerful incentive for companies to deny medically necessary care, said Jennifer Brackeen, senior director of government affairs for the Washington State Hospital Association.And doctors and policy experts say that’s only one concern.Rathi said the plan “is not fully fleshed out” and relies on “messy and subjective” measures. The model, he said, ultimately depends on contractors to assess their own results, a choice that makes the results potentially suspect.“I’m not sure they know, even, how they’re going to figure out whether this is helping or hurting patients,” he said.Pons said the use of AI in the Medicare pilot will be “subject to strict oversight to ensure transparency, accountability, and alignment with Medicare rules and patient protection.”“CMS remains committed to ensuring that automated tools support, not replace, clinically sound decision-making,” he said.Experts agree that AI is theoretically capable of expediting what has been a cumbersome process marked by delays and denials that can harm patients’ health. Health insurers have argued that AI eliminates human error and bias and will save the health care system money. These companies have also insisted that humans, not computers, are ultimately reviewing coverage decisions.But some scholars are doubtful that’s routinely happening. “I think that there’s also probably a little bit of ambiguity over what constitutes ‘meaningful human review,’” said Amy Killelea, an assistant research professor at the Center on Health Insurance Reforms at Georgetown University.A 2023 report published by ProPublica found that, over a two-month period, doctors at Cigna who reviewed requests for payment spent an average of only 1.2 seconds on each case.Cigna spokesperson Justine Sessions told KFF Health News that the company does not use AI to deny care or claims. The ProPublica investigation referenced a “simple software-driven process that helped accelerate payments to clinicians for common, relatively low-cost tests and treatments, and it is not powered by AI,” Sessions said. “It was not used for prior authorizations.”And yet class-action lawsuits filed against major health insurers have alleged that flawed AI models undermine doctor recommendations and fail to take patients’ unique needs into account, forcing some people to shoulder the financial burden of their care.Meanwhile, a survey of physicians published by the American Medical Association in February found that 61% think AI is “increasing prior authorization denials, exacerbating avoidable patient harms and escalating unnecessary waste now and into the future.”Chris Bond, a spokesperson for the insurers’ trade group AHIP, told KFF Health News that the organization is “zeroed in” on implementing the commitments made to the government. Those include reducing the scope of prior authorization and making sure that communications with patients about denials and appeals are easy to understand.‘This is a pilot’The Medicare pilot program underscores ongoing concerns about prior authorization and raises new ones.While private health insurers have been opaque about how they use AI and the extent to which they use prior authorization, policy researchers believe these algorithms are often programmed to automatically deny high-cost care.“The more expensive it is, the more likely it is to be denied,” said Jennifer Oliva, a professor at the Maurer School of Law at Indiana University-Bloomington, whose work focuses on AI regulation and health coverage.Oliva explained in a recent paper for the Indiana Law Journal that when a patient is expected to die within a few years, health insurers are “motivated to rely on the algorithm.” As time passes and the patient or their provider is forced to appeal a denial, the chance of the patient dying during that process increases. The longer an appeal, the less likely the health insurer is to pay the claim, Oliva said.“The No. 1 thing to do is make it very, very difficult for people to get high-cost services,” she said.As the use of AI by health insurers is poised to grow, insurance company algorithms amount to a “regulatory blind spot” and demand more scrutiny, said Carmel Shachar, a faculty director at Harvard Law School’s Center for Health Law and Policy Innovation.The WISeR pilot is “an interesting step” toward using AI to ensure that Medicare dollars are purchasing high-quality health care, she said. But the lack of details makes it difficult to determine whether it will work.Politicians are grappling with some of the same questions.“How is this being tested in the first place? How are you going to make sure that it is working and not denying care or producing higher rates of care denial?” asked DelBene, who signed an August letter to Oz with other Democrats demanding answers about the AI program. But Democrats aren’t the only ones worried.Murphy, who co-chairs the House GOP Doctors Caucus, acknowledged that many physicians are concerned the WISeR pilot could overreach into their practice of medicine if the AI algorithm denies doctor-recommended care.Meanwhile, House members of both parties recently supported a measure proposed by Rep. Lois Frankel, a Florida Democrat, to block funding for the pilot in the fiscal 2026 budget of the Department of Health and Human Services.AI in health care is here to stay, Murphy said, but it remains to be seen whether the WISeR pilot will save Medicare money or contribute to the problems already posed by prior authorization.“This is a pilot, and I’m open to see what’s going to happen with this,” Murphy said, “but I will always, always err on the side that doctors know what’s best for their patients.”Lauren Sausser and Darius Tahir | KFF Health NewsLauren Sausser and Darius Tahir | KFF Health News
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Oct. 6, 2025, 9:18 AM EDTBy ReutersSAN FRANCISCO — AMD said on Monday it will supply artificial intelligence chips to OpenAI in a multi-year deal that would bring in tens of billions of dollars in annual revenue and give the ChatGPT creator the option to buy up to roughly 10% of the chipmaker.The deal offers OpenAI an opportunity to take a stake in one of Nvidia’s most formidable rivals and is a powerful endorsement of Advanced Micro Devices’ (AMD‘s) AI chips and software.“We view this deal as certainly transformative, not just for AMD, but for the dynamics of the industry,” AMD executive vice president Forrest Norrod told Reuters on Sunday.The agreement covers the deployment of hundreds of thousands of AMD‘s AI chips, or graphics processing units (GPUs), equivalent to six gigawatts, over several years beginning in the second half of 2026.AMD said OpenAI would build a one-gigawatt facility based on its forthcoming MI450 series of chips beginning next year, and that it would begin to recognize revenue then.AMD executives expect the deal to net tens of billions of dollars in annual revenue. Because of the ripple effect of the agreement, AMD expects to receive more than $100 billion in new revenue over four years from OpenAI and other customers, they said.“Other people are going to come along with it because this is really the pioneer, a pioneer in the industry that has a lot of influence over the broader ecosystem,” AMD strategy chief Mat Hein said.The deal with AMD will help OpenAI build enough AI infrastructure to meet its needs, OpenAI CEO Sam Altman said in a statement.Analysts, on average, estimate AMD will generate revenue of $32.78 billion this year, according to LSEG data.As part of the arrangement, AMD issued a warrant that gives OpenAI the ability to buy up to 160 million shares of AMD for 1 cent each over the course of the chips deal. The warrant vests in tranches based on milestones that the two companies have agreed on.The first tranche will vest after the initial shipment of MI450 chips set for the second half of 2026. The remaining milestones include specific AMD stock price targets that escalate to $600 a share for the final installment of stock to unlock.AMD has 1.62 billion shares outstanding and is valued at $267.23 billion, according to LSEG data. Its shares closed on Friday at $164.67.OpenAI has a valuation of $500 billion.OpenAI wants more GPUsOpenAI has worked with AMD for years, providing inputs on the design of older generations of AI chips such as the MI300X.The San Francisco-based AI company has been taking a number of steps to ensure it has the chips needed for its future needs.In September, Nvidia announced an investment of up to $100 billion in OpenAI that included a plan to supply at least 10 gigawatts worth of Nvidia systems. The plan includes OpenAI deploying a gigawatt of Nvidia’s next-generation Vera Rubin chips in late 2026.In addition to using Nvidia hardware, cloud computing giants such as Alphabet’s GOOGL.O Google and Amazon AMZN.O build their own in-house processors. Similarly, OpenAI is in the process of developing its own silicon for AI use and has partnered with Broadcom AVGO.O, Reuters reported last year.OpenAI and its main backer Microsoft also announced last month that they had signed a non-binding agreement to restructure OpenAI into a for-profit entity, signaling further changes in the governance of the fast-growing AI company.A person familiar with the matter said the deal with AMD does not change any of OpenAI’s ongoing compute plans, including that effort or its partnership with Microsoft.ReutersReuters
September 30, 2025
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