Hurricanes can cause a tremendous amount of death and destruction. Longtime residents of coastal Florida, the Carolinas, Texas, Mississippi, Alabama and Louisiana are familiar with the drill - but there are always procrastinators. 

Hurricane preparedness takes time. Don't leave it to the last minute. Here are some things to keep in mind when a storm is coming:

• Maintain situational awareness. Keep an eye on national and local media and monitor developing weather systems.
• Track the projected path of storms, using websites like National Hurricane Center (www.nhc.noaa.gov) and follow news reports.
• Do a risk assessment for your home. Assess vulnerability to storm surge, wind damage, and flooding. 
• Plan on at least a three-day wait before substantial government assistance is in place after a hurricane. FEMA can't put its trucks and trailers in the direct path of the storm. It takes at least time for state and FEMA resources to be put in place.
• Cut down any large trees overhanging your house and garage. The tree could fall, taking out part of your house.
• Expect a run on hurricane supplies in the last 48 hours before the storm. Buy your batteries, bottled water, fuel cans, generators and other supplies before you need them.
• Invest in hardened windows, shutters and doors.
• Failing that, buy your plywood well ahead of time, along with a drill and screws to board up your windows.
• Obey evacuation orders. If you receive an evacuation order, you are getting it because the authorities know they will not be able to reach you in an emergency. Leave early if you can to avoid gridlock on the roads leaving town. Remember: Many people in coastal communities are killed by hurricanes when they ignore orders to evacuate.
• Keep your homeowner's or renter's coverage updated with the current replacement value of your home and belongings.
• Inventory your belongings. You can apps like: Sortly (available for iOS and Android phones), Memento Database (available for iOS and Android phones) and Nest Egg (for iOS only). These resources are free or very low cost and will facilitate compensation from your insurance company if your home is damaged or destroyed by a weather event.
• Keep fuel in your car. Many times, gas stations run out of fuel in the day or so before a storm. If you can't fuel your vehicle, you can't evacuate. And you may not be able to function.
• Get a functional battery-operated radio. Don't count on cell phones working for a number of days after a storm.
• You may be without power for as long as two weeks and sometimes longer. Keep nonperishables, batteries and flashlights.
• Keep your generator outdoors. Every year, people die from carbon monoxide poisoning because they moved their generator indoors to keep it from being stolen.
• Understand your generator's capacity. Generators have a limited load. This is especially important to know when you start up electrical items connected to the generator, because startups cause a spike in electrical demand.
• Know your neighbors. Your neighbors may have a harder time preparing or evacuating from storms than you do, because of frailty, disability, young children, poverty or lack of reliable transportation.
• Know your community emergency management contacts.
• Don't underestimate tropical storms. Just because it's not a hurricane doesn't mean it can't do a lot of damage locally. Tropical storms can dump as much rain as a hurricane.

 
By understanding these guidelines, you can protect your home as well as you can and keep your family safe. 

You will also have an easier time getting reimbursed by your insurance company for any damage.

As lawsuits against employers continue rising amid the coronavirus pandemic, some businesses are requiring workers to sign waivers absolving them of liability and responsibility should they contract the virus.

Eight percent of executives surveyed by law firm Blank Rome said they would require that their workers sign waivers of liability before returning to the workplace.
While employers are trying to protect themselves from a liability that didn't even exist a year ago, some human resources legal experts have expressed concerns that they may not be necessary and may be unenforceable.

The moves come as employers are wrestling with numerous risks that the pandemic has wrought, and with the U.S. Senate having proposed legislation that would limit the liability of employers for workers who become sick during the pandemic. A number of states have also enacted laws or emergency regulations that make it harder for employees to sue employers for negligence over COVID-19.

COVID-19-spurred employee lawsuits have mostly centered on employers not providing the proper protections for workers, discrimination or for being laid off for refusing to come to work.

Legal experts caution that employers cannot require workers to waive rights they may have, such as access to workers' compensation benefits or the right to file a complaint with OSHA.

They also say that some employers may consider waivers as a green light to not take precautions against COVID-19, but in such cases the waivers would likely not be legal.

If a worker claims they caught COVID-19 at work and the facts back that up, they would likely have access to workers' compensation benefits (some states even require it). But if the employer was negligent, the employee could have further legal avenues to pursue besides workers' compensation, rights that cannot legally be waived, lawyers say.

So even if an employee were to sign a document waiving their right to file a complaint if they feel their employer is being negligent, they may still have recourse.

Requiring workers to sign waivers could present a number of legal issues, according to the law website nolo.com, including:

• Courts in some states are reluctant to enforce liability waivers in the workplace because of the superior bargaining power of employers over their staff.
• Workplace morale could suffer if your employees think you are placing your own economic interests above workplace safety.
• Any waiver employees sign would not protect your firm from lawsuits filed by their families should they contract COVID-19 if staff are infected at work.
• A waiver might be unnecessary in states that have passed laws granting immunity to employers for claims made by workers infected with the virus.

 
Another option

While employees who refuse to sign a waiver of their company's liability may have grounds to challenge their employer, some liability lawyers say that employers instead of a waiver can ask their staff to sign a social contract that requires:

• The employer to follow Centers for Disease Control and Prevention guidelines and take all necessary precautions to prevent the spread of COVID-19 at work, and
• The workers to comply with their employer's requirements on mandates on wearing masks, social distancing and not coming to work if they have symptoms or of they think they have been exposed to someone with COVID-19. 

 
This type of agreement won't protect an employer from a lawsuit, but it does spell out that they are following authorities' recommendation for protecting employees.

While employees who refuse to sign a waiver of their company's liability could have grounds to sue, those who sign this type of acknowledgement of new workplace rules and government guidance are less likely to be successful if they are fired for not signing. This is because the acknowledgement is not forcing them to give up any of their rights and is rather for their and their co-workers' protection. 

These social contracts also would provide workers with a list of their responsibilities when working during the COVID-19 pandemic, and outline what their employer is doing to protect them.

President Trump has issued executive orders aimed at reducing the cost of medications by tying Medicare payment for outpatient drugs to international prices, passing drug-maker rebates to patients and not middlemen, and allowing individuals to import prescription medications.

Another executive order aims to force community health centers that receive 340B drug discounts to pass discounts for insulin and injectable epinephrine on to patients.
Here's a run-down of the orders:
 
Drug importation

The Executive Order on Increasing Drug Importation to Lower Prices for American Patients calls for new regulations that would:

• Allow individual state health plans to import certain drugs.
• Authorize the reimportation of insulin products that were made in the United States and later exported, and
• Set up a system to grant drug importation waivers for individuals to use at authorized pharmacies.

 
The system that Trump is proposing is reportedly modeled after new laws that took effect in Vermont in 2018, Florida in 2019 and then Colorado and Maine last year, allowing for the importation of certain prescription drugs from Canada. 

Florida's bill directed the state's Agency for Health Care Administration to establish a Canadian Prescription Drug Importation Program and an International Prescription Drug Importation Program.

Vermont and Florida have already submitted proposals to the U.S. Department of Health and Human Services to import prescription drugs from Canada, as the president in recent weeks has reiterated his intention to allow states to do so.

Federal law already grants HHS the authority to allow drug imports, as long as the department's secretary certifies the imported drugs are safe and effective and would lower costs to U.S. consumers.

HHS and the Food and Drug Administration in early August unveiled two pathways that entities could use to import drugs.

Under one pathway, HHS and the FDA would use existing rulemaking authority to allow states, pharmaceutical manufacturers and pharmacists to develop pilot programs to import drugs from Canada "that are versions of FDA-approved drugs that are manufactured consistent with the FDA approval."
 
Eliminating secret deals

Another order would prohibit secret deals between drug makers and pharmacy benefit manager (PBM) middlemen, ensuring patients directly benefit from available discounts at the pharmacy counter.

The Executive Order on Lowering Prices for Patients by Eliminating Kickbacks to Middlemen would pass drug-maker rebates to patients  and allow them to apply the rebate to their cost-sharing, such as deductibles in Medicare Part D plans.

The order states that the any rebate rule could not be advanced unless the HHS secretary gave public confirmation that it would not raise premiums, taxpayer spending or out-of-pocket costs. 

In particular, the proposed rule would exclude from safe-harbor protections under the anti-kickback statute price reductions that are not applied at the point-of-sale or other remuneration that drug manufacturers provide to health plan sponsors, pharmacies or PBMs in operating the Medicare Part D program.

It would also establish new safe harbors that would allow health plan sponsors, pharmacies and PBMs to apply discounts at the patient's point-of-sale in order to lower the patient's out-of-pocket costs.

This would be a significant step in getting drug-maker discounts to patients instead of the PBMs. One of the reasons pharmaceutical prices are so high is the complex mix of payers and negotiators that often separates the consumer from the manufacturer in the drug-purchasing process. 

The result is that the prices patients see at the point of sale do not reflect the prices that their insurance companies, and PBMs hired by those companies, actually pay for medicines. Instead, PBMs negotiate significant discounts off of the list prices, sometimes up to 50% of the cost of the drug, and often the Medicare patient can never enjoy that discount.
 
International reference pricing

Another executive order, which hasn't yet been published publicly, would establish an international pricing index that would set the price Medicare Part B pays for the costliest medications covered under the program to the lowest price in other economically advanced countries. 

However, Trump said his administration will hold the order until Aug. 24 because he may not implement it. He said he needs to meet with pharmaceutical executives first.
 
Epinephrine and insulin discounts

The Executive Order on Access to Affordable Life-saving Medications would require federally qualified health centers to pass along discounts on insulin and injectable epinephrine received from drug companies to certain low-income Americans.

Only patients with low incomes; those with high cost-sharing requirements for insulin or epinephrine; those with high, unmet deductibles; and/or those without health insurance would be eligible for the discount.
 
What's next

In all, Trump issued four executive orders that will require the Centers for Medicaid and Medicare Services to draft new regulations, which would likely not be completed by the end of the year. Regulations often take months to draft and then have to be sent out for public comment before final regs are written. 

The regulations will likely only come to fruition if Trump wins the presidency for a second term, as any regulatory initiatives in mid-stream would probably otherwise be abandoned.