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OMAHA Neb (AP) -- A major Nebraska health insurer has been unable to come to terms with one of the states biggest medical networks so thousands of people are either facing significantly higher costs or changing doctors. No talks have been held since the contract between Blue Cross Blue Shield of Nebraska and Catholic Health Initiatives expired Sept 1 So the facilities and doctors affiliated with Catholic Health Initiatives are no longer part of the Blue Cross network. Blue Cross has created a mess for people all across the state of Nebraska said Dr Cliff Robertson CEO of CHI Health. The expired contract covered all CHI Health hospitals in Omaha Schuyler and Plainview. It also includes hospitals in Lincoln Grand Island Kearney and Nebraska City affiliated with Catholic Health Initiatives. A network of doctors in the Omaha area is also affected by the contract. Blue Cross said about 530 of those roughly 1400 doctors have changed their affiliation so they could remain in network. The two sides negotiated all summer but remain far apart on costs. Robertson said CHI Health is prepared to remain out of network for an extended period. Blue Cross said CHI Health which used to be Alegent Creighton Health routinely charges 10 to 30 percent more than other Omaha hospitals. CHI Health says those figures are misleading and its total cost of treatment is lower even if certain services cost more. We do want them to be in the network said Lee Handke a senior vice president with Blue Cross. To that end Blue Cross is drafting a proposed contract that it will submit to CHI Health with the next week or so but that proposal will be less generous than what the insurer offered during summer talks. Robertson said he thinks the key disagreement has been over the payment model. CHI Health wants to continue moving away from a traditional system that promises payment for certain services to one that focuses more on the overall well being of patients and the total cost of treatment. The next couple of months may play a key role in the negotiations because Nebraska companies and individuals will be deciding whether to sign up with Blue Cross for 2015 or choose a competitor whose insurance network includes CHI Health doctors. Blue Cross said about 110000 of its policyholders were treated at a CHI Health facility or by a doctor affiliated with that network in the past 18 months. Both sides say many people are confused about how the dispute affects them. Blue Cross is holding online town hall meetings this week and CHI Health has fielded more than 2600 calls to a hotline it set up in late August. Sept 17 (Reuters) - The U.S. Department of Agriculture on Wednesday gave final approval to new genetically modified corn and soybeans developed by Dow AgroSciences that while heavily criticized by environmentalists and some farmers are portrayed by Dow as an answer to weed resistance problems that limit crop production. Approval of the specialty corn and soybeans to be sold as part of a branded Enlist Weed Control System means the traits could be on the market for the 2015 U.S. planting season according to Dow AgroSciences a unit of Dow Chemical. Dow is still awaiting approval from the Environmental Protection Agency for Enlist herbicide which the genetically altered Enlist corn and beans are designed to tolerate. Like the popular Roundup Ready system developed by rival Monsanto Co farmers who plant Enlist crops can spray their fields with Enlist herbicide and kill weeds but not the crops. Corn and soybeans containing Monsantos Roundup Ready trait which can tolerate sprayings of Roundup herbicide make up roughly 90 percent of U.S. corn and soybean plantings every spring. But heavy use of Roundup has triggered an explosion of herbicide-resistant super weeds that are hard for farmers to fight and which can choke off crop yields. The prevalence of resistant weeds has more than doubled since 2009 and so-called super weeds now infest roughly 70 million acres of U.S. farmland according to Dow. Because weeds have not yet developed resistance to Enlist the system addresses the problem. Enlist will help farmers increase their productivity to meet the growing demand for a safe and affordable food supply Tim Hassinger president of Dow AgroSciences said in a statement. Dow pegs the market opportunity for Enlist at about $1 billion. Monsanto is also developing a new biotech cropping system. Enlist combines a 60-year-old herbicide component known as 24-D with glyphosate the chief ingredient in long-used Roundup. Opponents say the use of 24-D can cause potential health and environmental problems including increasing weed resistance. And they fear the chemical will damage neighboring farm fields. Fruit and vegetable farmers are particularly concerned that 24-D drift will lead to crop damage. But Dow has said the Enlist system is safe if properly used. The USDA approval of Enlist after such a fundamentally flawed review process is a slap in the face to farmers said Marcia Ishii-Eiteman senior scientist with Pesticide Action Network (PAN). Thousands of farmers have warned USDA of the crop damage economic losses and health risks they will face from pesticide drift if these 24-D resistant seeds hit the market. Ishii-Eiteman hinted at a lawsuit saying PAN would pursue legal options to protect farmers. A little goldfish just underwent a big operation. The pipsqueak named George had a life-threatening tumor removed from his head last week at the Lort Smith Animal Hospital in Melbourne Australia. George is currently recovering at home in his pond in Melbourne after the tricky one-hour surgery which went swimmingly according to the hospitals Facebook page. The tumor had been slowly developing over the past year something that seemed to affect 10-year-old Georges behavior. Georges owners decided to do the surgery as he was a much-loved pet who was suffering with the tumor Lort Smith told Live Science. It was not a brain tumor but it was a tumor growing from his head. Apparently the fish was having trouble eating and moving around, even getting bullied by other fish Dr. Tristan Rich head of the hospitals exotic and wildlife vet team To knock out the fish during surgery Rich set up three buckets one with the initial dose of anesthetic another with the anesthetic given to keep the fish asleep throughout the surgery and one with clean water where the fish would recover according to Lort Smiths Facebook page. During surgery a tube ran from the maintenance bucket (where anesthetic was being oxygenated) into the goldfishs mouth. That anesthetic-filled water ran over Georges gills while Rich removed the tumor. The tumor was relatively large and Rich had to use a gelatin sponge to control the bleeding during surgery. With such a big tumor the surgical cut was also large and as stated in the Facebook statement was difficult to seal. So Dr. Tristan put in four sutures then sealed the rest of the wound with tissue glue the statement read. After being placed into the recovery bucket George received injections of pain medicine and antibiotics. KANSAS CITY Mo. (Reuters) - Police on Sunday were investigating an accident that killed five people including three toddlers when their car stopped on a Kansas City freeway and was struck from behind by a semi-truck. Two women and three children under the age of 3 died in the Saturday wreck on Interstate 435 several miles east of downtown Kansas City Missouri police said in a statement and interviews. The car had stopped in the outermost southbound lane of the freeway when it was struck at about 5 p.m. police said. It was not immediately clear if the car had become disabled in the roadway or possibly run out of gas police said in the statement. Two of the victims died at the scene and three died at area hospitals police said. Their names and how they may have been related was not disclosed pending further investigation. The driver of the truck unhurt tested negative for alcohol and was released pending further investigation said Darin Snapp a spokesman for Kansas City police. He was not charged Snapp said. The accident shut down southbound traffic on the interstate for about four hours police said.