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  1. N.J.'s Pallone Wields Power in Key Post Year After Winning Fight with Pelosi

    Sep 7, 2015 | NJ.com

    By Jonathan D. Salant

    Last year, U.S. Rep. Frank Pallone had a big fight on his hands.
  2. US University Evaluates Triclosan Exposure from Products

    Sep 7, 2015 | Chemical Watch

    A newly-launched pilot study seeks to measure levels of triclosan in a cohort of breastfeeding women. It aims to determine if exposure to the chemical from personal care products like toothpaste and soap leads to elevated levels in breast milk.
  3. Seven Substances Proposed As SVHCs

    Sep 7, 2015 | Chemical Watch

    By Geraint Roberts

    Reports setting out the case for designating seven chemicals as substances of very high concern (SVHCs) have been published on Echa’s website.
  4. California Agency Amends Prop 65 Website Proposal

    Sep 7, 2015 | Chemical Watch

    California's Office of Environmental Health Hazard Assessment (Oehha) has published changes to its proposal to develop a Proposition 65 warning website (CW 25 June 2015).
  5. Chemical Security News

  6. CSB Sets Houston Meeting on DuPont La Porte Release

    Sep 7, 2015 | Occupational Health & Safety

    The U.S. Chemical Safety Board will hold a public meeting Sept. 30 in Houston to consider recommendations following the methyl mercaptan gas release that killed four workers at the DuPont La Porte facility on Nov. 15, 2014, ultimately causing OSHA to place the company in its Severe Violator Enforcement Program.
  7. EPA Faces Grilling over Toxic Mine Spill

    Sep 7, 2015 | The Hill - E2 Wire

    By Timothy Cama

    The Environmental Protection Agency (EPA) will face tough questions as lawmakers return and examine the mine waste spill it caused in Colorado.
  8. Energy and Environment News

  9. Nine Obama Regulations to Watch

    Sep 7, 2015 | The Hill - Regulation

    By Lydia Wheeler

    The window is already closing on President Obama’s regulatory agenda, and agencies across the federal government are moving to crank out a slew of new rules before election year politics bring business in Washington to a virtual standstill.
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    Chemical Management News

  1. N.J.'s Pallone Wields Power in Key Post Year After Winning Fight with Pelosi

    Sep 7, 2015 | NJ.com

    By Jonathan D. Salant

    Last year, U.S. Rep. Frank Pallone had a big fight on his hands.

    He wanted a coveted spot as the top Democrat of the powerful House Energy and Commerce Committee, but his party's House leader, Nancy Pelosi, wasn't having any of it.  She campaigned for a fellow Californian, Anna Eshoo, to win the job. 

    The battle waged on behind the scenes as the New Jersey congressman, a Washington veteran with more seniority, used his longtime contacts to prevail over Pelosi's choice.

    The election made Pallone, 63, one of the most powerful Democrats in the House and in the New Jersey congressional delegation, giving him a big platform to shape legislation and ensure that the state's interests are represented. The Energy and Commerce Committee has jurisdiction over legislation dealing with trade, telecommunications, energy, health and the environment.

    EARLIER: Pallone wins top House committee post, defeating lawmaker backed by Nancy Pelosi

    Now nine months into his new post, Pallone (D-6th Dist.), is gaining a reputation as a Democrat who is not afraid to work with House Republicans — or to publicly criticize the GOP.

    For example, legislation passed by the Republican-dominated U.S. House in June to update a 40-year-old law regulating toxic chemicals included Pallone as a co-sponsor.

    So too did a House-passed bill designed to speed research, development and release of new cures for diseases.

    But when Gov. Chris Christie withdrew from a mulitistate compact to limit the emissions blamed for global warming, Pallone, who succeeded California's Harry Waxman in the post, didn't hesitate to blast the Republican governor who is now seeking his party's 2016 presidential nomination.

    "Frank Pallone's ability to be an effective advocate of the Democratic position coupled with his ability to find common ground with Republicans on those areas where there is a common interest has been a major contribution to how the House works," said former Rep. Phil English (R-Pa.), now a lobbyist at the law firm Arent Fox. "He is by all accounts as staunch a partisan as Mr. Waxman and yet he's found some ways to find common ground with Republicans." 

    Pallone put it this way: "I see it more in terms of being able to help the state. So many issues relate to New Jersey jobs and New Jersey interests."

    Waxman said the Democrats chose well.

    "I'm delighted that Frank Pallone succeeded me," said Waxman, who had chaired the committee before Republicans won a House majority in 2011. "I have enormous respect for him. I felt comfortable leaving the top spot on the committee in his hands."

    Current chairman Fred Upton (R-Mich.) once told the New York Times that one of his predecessors, Michigan Democrat John Dingell, explained the panel's jurisdiction this way: "If it moves it's energy, and if it doesn't, it's commerce."

    When possible, Pallone has tried to work with Upton to develop legislation that can win the support of lawmakers from both parties.

    "We respect each other," Pallone said. "We have a joint goal of trying to accomplish something."

    Rich Gold, a partner in the lawyer-lobbying firm Holland & Knight who has met with Pallone on behalf of clients, calls Upton and Pallone "old school — and old school works."

    "They're both pragmatic problem-solvers at a time when the Democratic caucus has become much more liberal and the Republican caucus has leaned much more heavily toward the Tea Party," Gold said.

    The Senate version of the chemical regulation act is named for the late U.S. Sen. Frank Lautenberg (D-N.J.) and is co-sponsored by his successor, U.S. Sen. Cory Booker (D-N.J.). The 21st Century Cures Act includes a provision that could funnel millions of federal research dollars to New Jersey's pharmaceutical industry.

    Pallone's committee post also gives him added stature by which to point out differences as well. He is passionate about the need for the government to curb the emissions contributing to climate change, even more so after Hurricane Sandy ravaged the Jersey Shore, parts of which lie in his congressional district.

    "I'm constantly bringing up climate change," Pallone said. "I sound like a broken record."Rep. Frank Pallone in his Washington office.Jonathan D. Salant | NJ Advance Media for NJ.com 

    With the demise of a special House committee to handle climate issues, Pallone's position on Energy and Commerce allows him to lead the fight alone.

    "It's a position to speak out on the issue," said Waxman, who as chairman pushed legislation through the House in 2009 to reduce greenhouse gas emissions, only to see the bill die in the Senate. "It has an important impact if they hear people they know and respect speak out about climate change."

    Pallone is a leader of efforts to block the Obama administration from opening part of the Atlantic coast to offshore oil drilling. Emissions from burning fossil fuels are among those helping to fuel climate change.

    "The environment is his top personal issue," said Jeff Tittel, president of the New Jersey Sierra Club, an environmental advocacy organization. "He's not just doing it because it's good politics, He really cares about this issue.'

    In March, Pallone used a committee hearing to charge Christie with costing New Jersey $500 million by withdrawing from a northeastern compact designed to reduce greenhouse gas emissions. By leaving the Regional Greenhouse Gas Initiative, the state missed out on revenue from selling permits to emit carbon dioxide, Pallone said. The loss: more than $114 million so far, plus an additional $387.1 million through 2020.

    The following month, Pallone unsuccessfully tried to amend legislation in order to prevent governors like Christie from unilaterally withdrawing from federal multi-state compacts designed to reduce emissions.

    "When Christie did the right thing, I would commend him," Pallone said. "But many times he does the wrong thing. I dont like to see his political ambitions drive him to take a position that I think is detrimental to the state."

    Christie spokeswoman Nicole Sizemore declined to comment.

    RELATED: Menendez, Booker, and Pallone mark Earth Day by seeking Atlantic Ocean drilling ban

    Others said Pallone's decision to side with environmentalists and oppose projects such as the Keystone XL pipeline from Canada to the Gulf Coast served only to drive up energy prices.

    "Higher energy prices are particularly bad for our poorest, most vulnerable citizens, for whom every additional dollar spent on heating and cooling is one less dollar to pay for food, medicine, and the savings that will enable them to move out of poverty," said Erica Klemens, New Jersey director of Americans for Prosperity, an advocacy group financially supported by energy executives Charles and David Koch.

    Should the Democrats win control of the House in a future election, Pallone would be in line to chair the committee and set the agenda on health and environmental issues.

    "He has been playing a hand very effectively," English said. "It's fair to say he's positioned himself well so that when his party at some point might be back in the majority, he would have all of the working relationships he would need to drive a very aggressive agenda. That's as good as it gets."

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  2. US University Evaluates Triclosan Exposure from Products

    Sep 7, 2015 | Chemical Watch

    A newly-launched pilot study seeks to measure levels of triclosan in a cohort of breastfeeding women. It aims to determine if exposure to the chemical from personal care products like toothpaste and soap leads to elevated levels in breast milk.

    The pilot is one of eight at the University of California, Davis's new Environmental Health Sciences Center.

    According to Candace Spier Bever, assistant project scientist at UC Davis, triclosan was selected for several reasons:assays for triclosan had already been developed;researchers had access to lactation samples from a separate ongoing study; andtriclosan has already been found in breast milk (CW 3 December 2014).

    In the EU and Canada, triclosan's use in cosmetics is restricted to concentrations under 0.3%. Several companies have voluntarily worked to phase triclosan out of their products (CW 10 April 2014), and Minnesota has banned the chemical's use in soaps effective January 2017 (CW 22 May 2014).

    The substance has been the subject of review by the Food and Drug Administration (FDA) for several years, but the agency does not currently regulate its use. More recently, the US EPA rejected a citizen petition to cancel the registration of products containing the biocide, but said it would further assess its safety (CW 2 June 2015).

    “We hope that demonstrating exposure to triclosan with the best science we can will provide enough data for regulatory agencies to decide if the exposures are worth the risk,” said Dr Bever.

    More broadly, a goal is to develop an antibody-based assay tool that could be used to gather exposure data to other chemicals for large population studies, says Dr Bever. Such a high-throughput tool could allow researchers to analyse a high volume of samples very quickly, and assist in identifying exposure pathways to chemicals of concern.

    According to Dr Bever, a potential future study using the new tool could evaluate firefighters' exposure to brominated flame retardant chemicals (BFRs) immediately following fires. Also under consideration would be a study to characterise sources of BFRs in household dust, such as those from furniture and electronics.

    The UC Davis centre that the study comes under has been funded close to $8m by a five-year grant from the National Institute of Environmental Health Services (NIEHS). The NIEHS funds more than 20 such “environmental health sciences core centers” across the country.

    UC Davis's Center has also established a Community Stakeholder Advisory Committee (CSTAC), whose members can serve as “advocates for appropriate policies on air, water, food and other routes of exposure to potentially harmful (or beneficial) chemicals,” according to the university's Irva Hertz-Picciotto.

    Participating members in the CSTAC include representatives from:the Office of Environmental Health Hazard Assessment (Oehha);the California Department of Public Health;Californians for Pesticide Reform; andthe Counsel for Justice and Accountability.

    These may recommend studies on specific areas of concern, review pilot projects, and will advise on how study results should be disseminated, added Dr Hertz-Picciotto.

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  3. Seven Substances Proposed As SVHCs

    Sep 7, 2015 | Chemical Watch

    By Geraint Roberts

    Reports setting out the case for designating seven chemicals as substances of very high concern (SVHCs) have been published on Echa’s website.

    The reports – known as Annex XV dossiers – are for:

    HDDA: This acrylic chemical used in UV-cured inks, adhesives and sealants, is proposed on the grounds that it is a skin sensitiser. The risk management option analysis says occupational exposure to the skin sensitiser is “widespread and increasing” and can cause allergic contact dermatitis (CW 12 May 2015).

    The phthalate DCHP: This is used in plastisol and in PVC, rubber and plastic articles, plus as phlegmatiser and dispersing agent for formulations of organic peroxides. Echa’s Risk Assessment Committee agreed late last year that it should be classified as a category 1B reprotoxicant, and the Annex XV dossier says it is also a substance with endocrine disrupting properties for which there is evidence of probable serious effects to human health and the environment.

    PFNA and its sodium and ammonium salts: submitted by the Swedish Chemicals Agency (Kemi) and the German Federal Environment Agency (UBA). The report says the substance has been found in:nanosprays and impregnation sprays;outdoor textiles;carpets;gloves;leather;awning cloth;paper-based food contact materials; andski waxes.

    It is found, the report says, in the ambient environment, indoors, in food and in drinking water.

    Last year, the report notes, Echa’s Risk Assessment Committee adopted the Opinion that it meets the criteria for a category 1B substance toxic for reproduction. The report also says PFNA meets the criteria for classification as a PBT substance.

    Another reason for adding it to the REACH candidate list, says Kemi, is it is a possible replacement for PFOA. If it is added to the list, the restriction of a group of long-chain PFCAs (perfluorocarboxylic acids) and their precursors might be considered as the next step (CW 12 May 2015).

    Nitrobenzene: classified as a category 1B reprotoxicant. Nitrobenzene is mainly used as an intermediate under strictly controlled conditions. But it is also used to prepare formulations, as processing aid and as a solvent.

    UV-327 and UV-350: both of these substances are used as UV stabilisers in transparent plastics. Although neither has yet been registered, the proposing member state, Germany, says they are believed to be on the EU market. Both are proposed on the grounds that they are very persistent, very bioaccumulative substances (vPvBs).

    The dossiers were originally submitted more than two years ago (CW 13 February 2013), but Echa’s Member State Committee decided further consideration of documents provided by Germany was needed. Having worked further on the cases, Germany has now resubmitted them, and they will be treated as “new” cases and all process steps for identification as SVHC will be conducted.

    1,3-propanesultone: Proposed by Echa, this substance is a category 1B carcinogen. Uses which appear to be in the scope of authorisation include formulation and use in the electrolyte fluid in the production of lithium ion batteries at industrial sites.

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  4. California Agency Amends Prop 65 Website Proposal

    Sep 7, 2015 | Chemical Watch

    California's Office of Environmental Health Hazard Assessment (Oehha) has published changes to its proposal to develop a Proposition 65 warning website (CW 25 June 2015).

    The changes address comments received earlier this summer on the agency's proposal to establish a website that provides the public with information on exposure to substances required to be labelled under Prop 65.

    Specific amendments include:clarification on the anticipated functions of the agency's site;the addition of a process by which entities may request correction of inaccurate information;modification of the agency's disclaimer regarding information received from third parties;specification that businesses must respond to a request for information within 90 days;a new subsection allowing businesses to respond to information requests via trade groups; andthe addition of text explicitly stipulating that businesses do not need to provide information to the agency that is subject to legal privilege.

    Comments on the latest draft of the proposed regulation will be accepted until 21 September.

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  5. Chemical Security News

  6. CSB Sets Houston Meeting on DuPont La Porte Release

    Sep 7, 2015 | Occupational Health & Safety

    The U.S. Chemical Safety Board will hold a public meeting Sept. 30 in Houston to consider recommendations following the methyl mercaptan gas release that killed four workers at the DuPont La Porte facility on Nov. 15, 2014, ultimately causing OSHA to place the company in its Severe Violator Enforcement Program. Three other workers were injured.

    "The meeting in Houston will be my first public meeting since commencing my tenure in August as chairperson. I believe it will be an extremely informative and productive evening. I am eager to meet with and hear from members of the community," CSB Chairperson Vanessa Allen Sutherland said. "It is important that the CSB's recommendations are made public, as their intent is to prevent a similar accident from occurring at the DuPont facility and at other sites across the country."


    CSB investigators will present their findings and suggested recommendations and will include an animation depicting the events that led to the deaths. The meeting will begin at 6 p.m. at a downtown Houston hotel yet to be determined and is expected to end around 9 p.m. Pre-registration is not required, but to ensure adequate seating, attendees are asked to pre-register by emailing their names and affiliations to meeting@csb.gov.

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  7. EPA Faces Grilling over Toxic Mine Spill

    Sep 7, 2015 | The Hill - E2 Wire

    By Timothy Cama

    The Environmental Protection Agency (EPA) will face tough questions as lawmakers return and examine the mine waste spill it caused in Colorado.

    Four congressional committees have planned hearings on the Aug. 5 spill of heavy metal sludge into a tributary of the Animas River near Silverton, Colo.

    The incident at the long-closed Gold King Mine turned the river bright orange and brought a wave of unwanted attention on the EPA as Republicans, the agency’s opponents and local residents criticized officials for what they saw as hypocrisy and a lack of transparency.

    Those criticisms are likely to intensify over the next two weeks as congressional Republicans try to assign blame for the high-profile disaster.

    The spill came at an extremely important time for the administration, a mere two days after President Obama rolled out the first carbon dioxide limits for power plants, the key piece of his second-term push against climate change.

    The timing has not been lost on Republicans, who are using the incident to embarrass the EPA and prove their long-held belief that the agency is not equipped to take on the wide-ranging regulatory agenda it set out.

    The House Science Committee will get the first crack with a hearing Sept. 9, only a day after Congress returns from its August recess.

    “After spilling millions of gallons of toxic chemicals into the Animas River, the EPA has an obligation to be forthcoming about what went wrong and potential long-term impacts on local communities,” Rep. Lamar Smith (R-Texas), the committee’s chairman, said in a statement.

    Mathy Stanislaus, head of the EPA’s solid waste and emergency response office, will represent the agency.

    The other witnesses at the event will represent Environmental Restoration, the EPA contractor responsible for the spill; the Navajo Nation, whose reservation is downstream from the spill; and the town of Durango, Colo., which is also downstream.

    Smith is an outspoken opponent of the EPA’s agenda, repeatedly questioning the science behind its regulations on climate change and pollution.

    The EPA already angered Smith when it missed a deadline he set in August for certain documents related to the attempted cleanup at the Gold King Mine.

    The Senate Environment and Public Works Committee will hold its own hearing on the spill Sept. 16, followed the next day by a joint hearing of the House Oversight Committee and House Natural Resources Committee.

    “It is important for this committee, the agency, and the public to know what exactly went wrong leading up to Aug. 5 and in the days that followed,” Sen. Jim Inhofe (R-Okla.), another strong opponent of Obama’s environmental agenda and chairman of the environment panel, said in a statement.

    “The hearing will examine the immediate and long-term environmental and economic impacts to the states, local communities, and Indian tribes as a result of the spill.”

    EPA head Gina McCarthy is the sole witness scheduled so far to speak to the Senate panel.

    She will be joined by Interior Secretary Sally Jewell the following day for the hearing in front of the House committees. Jewell’s responsibilities include the Bureau of Indian Affairs and the Bureau of Reclamation, which is conducting an investigation into the spill.

    “Despite knowing that the spill of mine waste was an imminent possibility for more than one year, EPA has struggled to respond to the disaster,” Oversight Chairman Jason Chaffetz (R-Utah) and Natural Resources Chairman Rob Bishop (R-Utah), wrote in an Aug. 31 letter.

    The hearings fit Republican efforts to undermine the EPA, said Joel Mintz, a professor at Nova Southeastern University Law Center and scholar at the liberal Center for Progressive Reform.

    “This will probably be something that they’ll use as ammunition to embarrass the agency,” he said.

    “Their point of view is always essentially that the agency is doing unnecessary work, that they’re harming the economy, that costs jobs, and they’ll try and use this set of hearings as a vehicle for spotlighting their views and just generally embarrassing EPA,” Mintz continued.

    “Trying to prove they’re incompetent, anything they can do to tarnish the agency in the public eye, that’s their goal.”

    Congressional Democrats have been less vocal than Republicans since the spill, but have also indicated they want to get to the bottom of what happened.

    The hearings could give Democrats a chance to shine a light on the thousands of abandoned mines in the west that could pose similar dangers of blowouts and leaks into waterways, among other risks.

    “The Gold King mine that polluted the Animas is one of some 500,000 abandoned mines pocking the landscape of the American West, some 23,000 in Colorado alone,” NRDC President Rhea Suh wrote in a recent blog post.

    “Many thousands of these mines were shuttered and left behind decades before the Clean Water Act and other national safeguards were put in place to protect our rivers and streams.”

    A likely focus of the hearings will be an initial report from the EPA’s internal investigation. That report blamed the blowout event on the fact that federal and state workers did not know the correct pressure of the fluid behind the backfill they were moving, despite multiple tests that show the pressure was low.

    “Despite the available information suggesting low water pressure behind the debris at the Adit entrance, there was, in fact, sufficiently high pressure to cause the blowout,” the internal report stated. An adit is an opening to an underground mine.

    “Because the pressure of the water in the Adit was higher than anticipated, the precautions that were part of the work plan turned out to be insufficient.”

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  8. Energy and Environment News

  9. Nine Obama Regulations to Watch

    Sep 7, 2015 | The Hill - Regulation

    By Lydia Wheeler

    The window is already closing on President Obama’s regulatory agenda, and agencies across the federal government are moving to crank out a slew of new rules before election year politics bring business in Washington to a virtual standstill. 
     
    Obama has made no bones about using the power of his office to accomplish his policy goals in lieu of congressional action, presiding over numerous controversial regulations in the energy, healthcare and financial sectors, among many others. 
     
    With more than a year left, the administration will continue to promulgate regulations until the clock runs out.
     
    However, controversial rules in any administration tend to stall in election years. And proponents of stronger heath and safety protections fear that a GOP-controlled Congress could overturn rules issued at the tail end of the Obama administration, in the event that a Republican wins the White House next year. 
     
    They are instead hoping for a flurry of action this fall on regulations, many of which they see as long overdue. 
     
    Here are ten of the most highly anticipated rules likely to come down the pipeline in the remainder of 2015: 
     
    Tobacco: The Food and Drug Administration (FDA) is expected to finalize its tobacco “deeming rule” to regulate all tobacco products under the Tobacco Control Act, including electronic cigarettes and cigars. 
     
    Industry and advocacy groups have been pushing FDA to finalize the rule by the end of the summer, but with two weeks left in August all bets are now on September. 
     
    The agency has been slow from the start on issuing the rule, which would expand the FDA’s reach to a host of new products over which it has not previously asserted authority. 
     
    Congress gave FDA the power to regulate more tobacco products in the 2009 Family Smoking Prevention Act, but it took the agency until April 2014 to propose the rule.
     
    Ozone:  The Environmental Protection Agency’s (EPA) final ozone standards were expected to go to the White House Office of Management and Budget this month for review.  
     
    In November, EPA proposed strengthening the acceptable concentration of smog from 75 parts per billion set in 2008 to a standard between 65 and 70 parts per billion. The agency is under court order to finalize the rule by Oct. 1. 
     
    Payday lending: In March, the Consumer Financial Protection Bureau (CFPB) gave a sneak peak at its plan to begin regulating the payday lending industry, outlining a framework for the rules.
     
    The rules expected to be proposed this fall will likely force lenders to verify a consumer’s income, debt and borrowing history when determining their ability to repay a loan in full and still cover basic living expenses.
     
    As part of the rule-making process, the CFPB must convene a review panel to assess the impact of the regulation on small businesses. 
     
    Chemical plants: The EPA could come through with its proposed revisions to the risk management plans at chemical facilities. 
     
    The rule was a recommendation from the federal task force President Obama created through executive order to shore up safety at the nation’s chemical plants following the deadly blast at a Texas fertilizer plant in 2013.

    Food safety: The Food and Drug Administration has signed off on final rules to protect people and animals from foodborne illnesses. 

    In late August, the FDA sent for publication in the Federal Register a set of rules that would force manufacturers of food — for both people and animals — to implement preventive controls to minimize the risk of contaminating food when it’s manufactured, processed, packed or held by a facility.

    The agency said last week that the documents could take several days to publish. 

    The agency has by court order until Oct. 31 to finalize safety standards for produce and a rule to create a foreign supplier verification program for imported food. 
     
    Clean water: EPA is expected to finalize its “Waters of the U.S.” rule, which gives the agency the authority to regulate the nation's streams, wetlands and other smaller waterways, despite legal challenges from across the country.
     
    States argue the rule is overly costly and will force them to regulate roadside ditches, small ponds and even water features on golf courses — a contention that the EPA denies. 
     
    Agriculture: OIRA completed its review of EPA’s proposed revisions to its standards for pesticide applicators earlier this month. The final standards aim to improve the training and awareness of the potential harm that comes from exposure to pesticides. The agency could release its final rule at anytime. 
     
    Arbitration: In March the CFPB released a study finding that pre-dispute arbitration clauses in contractual financial agreements bar victims of illegal activity from seeking relief, particularly through class action lawsuits.
     
    The report, which was a mandate of the Dodd-Frank Wall Street Reform and Consumer Protection Act, could signal that a rule is forthcoming. 
     
    Advocates for financial reform argue that a rule banning forced arbitration is needed to protect consumers from bad corporate actors. 
     
    Electronic records: Final rules from the Centers for Medicare and Medicaid Services (CMS) to simplify requirements for its new electronic health record system could come this fall.   
     
    The rules reduce the number of ways doctors must demonstrate how they are meeting the guidelines for the “meaningful use” of e-records and give healthcare providers more time to submit their data. 
     
    CMS gives financial incentives to providers that show they are using electronic health records to improve patient care. To receive the incentive and avoid Medicare payment adjustments, the agency said a provider must attest to demonstrating meaningful use every year. 

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