Présentation du dossier

Directory of Open Access Journals (Sweden)

2007-02-01

Full Text Available Les textes rassemblés dans ce dossier proviennent de la première Journée d’étude organisée par le groupe COnTEXTES, le 28 mars 2006 à l’Université de Liège. Le choix d’aborder une telle problématique a été guidé par le constat d’un décalage générationnel : tandis que la critique idéologique a mobilisé la plupart des consciences théoriques attentives aux forces sociales qui traversent le littéraire (Louis Althusser, Marc Angenot, Philippe Hamon, parmi d’autres, le concept d’idéologie semble a...

From pralines to multinationals: The economic history of Belgian chocolate

OpenAIRE

Garrone, Maria; Pieters, Hannah; Swinnen, Johan F. M.

2016-01-01

Belgium is associated with high-quality chocolate products and Belgian companies play an important role in cocoa processing. However, in historical perspective the global success and reputation of Belgian chocolate is a relatively recent phenomenon. Especially since the 1980s exports of "Belgian chocolates" have grown exponentially. We document the growth of the sector and discuss its determinants. Today, the very concept of "Belgian chocolate" faces challenges, as successful companies have b...

Teaching Dossier Documents: A Comparison of Importance by Major Stakeholders

Science.gov (United States)

Burnap, Charles A.; Kohut, Gary F.; Yon, Maria G.

2010-01-01

Most institutions of higher education require evidence of effective teaching as part of the review process for reappointment and for tenure/promotion. This study examines the relative importance of various documents placed in the teaching section of the dossier as rated by pre-tenured faculty members and review committee members. Results indicate…

Lutte contre le changement climatique et maîtrise de la demande d’énergie : introduction au dossier thématique

OpenAIRE

Aubrée, Loïc; Calvo-Mendieta, Iratxe

2017-01-01

Cet article constitue l’introduction du dossier thématique consacré à la lutte contre le changement climatique et la maîtrise de la demande d’énergie. Après un dossier de la Revue Développement Durable et Territoires, paru en décembre 2015 et en juillet 2016, abordant la question du climat sous l’angle de l’adaptation, les articles de ce dossier s’intéressent aux politiques, aux programmes et aux instruments qui contribuent à l’atténuation du changement climatique. L’objectif est la diminutio...

Security and Privacy Improvements for the Belgian eID Technology

Science.gov (United States)

Verhaeghe, Pieter; Lapon, Jorn; de Decker, Bart; Naessens, Vincent; Verslype, Kristof

The Belgian Electronic Identity Card enables Belgian citizens to prove their identity digitally and to sign electronic documents. At the end of 2009, every Belgian citizen older than 12 years will have such an eID card. In the future, usage of the eID card may be mandatory. However, irresponsible use of the card may cause harm to individuals.

Dossier: management of nuclear wastes. Research, results

International Nuclear Information System (INIS)

Anon.

2001-01-01

The researches carried out since many years on nuclear wastes have led to two main ways of management: the long-term conditioning of radio-elements and their advanced separation. The French atomic energy commission (CEA) has chosen to take up also the transmutation challenge, a way to transform long-living radioactive wastes into short-living radioactive wastes or stable compounds. The transmutation programs are based both on simulation and experiments with a huge international collaboration. This dossier presents in a digest way the research activity carried out on nuclear wastes processing and management at the CEA. (J.S.)

Nagra technical report 14-02, geological basics - Dossier V - Hydro-geological conditions; SGT Etappe 2: Vorschlag weiter zu untersuchender geologischer Standortgebiete mit zugehörigen Standortarealen für die Oberflächenanlage -- Geologische Grundlagen -- Dossier V -- Hydrogeologische Verhältnisse

Energy Technology Data Exchange (ETDEWEB)

Traber, D.; Gautschi, A.; Marschall, P.; Becker, J. [National Cooperative for the Disposal of Radioactive Waste (NAGRA), Wettingen (Switzerland); Waber, N. [Institut of Geological Sciences, University of Berne, Berne (Switzerland)

2014-12-15

This dossier is the fifth of a series of eight reports concerning the safety and technical aspects of locations for the disposal of radioactive wastes in Switzerland. Dossier V looks at hydro-geological considerations in North-Western Switzerland. Rock layers in the region and their hydrological properties are examined. Ground-water and deeper lying aquifers in the various rock formations are discussed. The specific hydrology in the proposed areas for nuclear waste depositories is looked at, including infiltration and exfiltration zones and gradients.

The history of Belgian assisted reproduction technology cycle registration and control: a case study in reducing the incidence of multiple pregnancy.

Science.gov (United States)

De Neubourg, D; Bogaerts, K; Wyns, C; Albert, A; Camus, M; Candeur, M; Degueldre, M; Delbaere, A; Delvigne, A; De Sutter, P; Dhont, M; Dubois, M; Englert, Y; Gillain, N; Gordts, S; Hautecoeur, W; Lesaffre, E; Lejeune, B; Leroy, F; Ombelet, W; Perrier D'Hauterive, S; Vandekerckhove, F; Van der Elst, J; D'Hooghe, T

2013-10-01

What is the effect of a legal limitation of the number of embryos that can be transferred in an assisted reproductive technology (ART) cycle on the multiple delivery rate? The Belgian national register shows that the introduction of reimbursement of ART laboratory costs in July 2003, and the imposition of a legal limitation of the number of embryos transferred in the same year, were associated with a >50% reduction of the multiple pregnancy rate from 27 to 11% between 2003 and the last assessment in 2010, without any reduction of the pregnancy rate per cycle. Individual Belgian IVF centres have published their results since the implementation of the law, and these show a decrease in the multiple pregnancy rate on a centre by centre basis. However, the overall national picture remains unpublished. Cohort study from 1990 to 2010 of all ART cycles in Belgium (2685 cycles in 1990 evolving to 19 110 cycles in 2010), with a retrospective analysis from 1990 to 2000 and prospective online data collection since 2001. Registration evolved from paper written reports per centre to a compulsory online registration of all ART cycles. From 2001 up to mid-2009, data were collected from Excel spread sheets or MS Access files into an MS Access database. Since mid-2009, data collection is done via a remote and secured web-based system (www.belrap.be) where centres can upload their data and get immediate feedback about missing data, errors and inconsistencies. National Belgian registration data show that reimbursement of IVF laboratory costs in July 2003, coupled to a legal limitation in the number of embryos transferred in utero, were associated with a 50% reduction of the multiple pregnancy rate from 27 to 11% without reduction of the pregnancy rate per cycle, and with an increase in the number of fresh and frozen ART cycles due to improved access to treatment. There is potential underreporting of complications of ART treatment, pregnancy outcome and neonatal health. Over the 20

Pressure Vessel Steel Research: Belgian Activities

International Nuclear Information System (INIS)

Van Walle, E.; Fabry, A.; Ait Abderrahim, H.; Chaouadi, R.; D'hondt, P.; Puzzolante, J.L.; Van de Velde, J.; Van Ransbeeck, T.; Gerard, R.

1994-03-01

A review of the Belgian research activities on Nuclear Reactor Pressure Vessel Steels (RPVS) and on related Neutron Dosimetry Aspects is presented. Born out of the surveillance programmes of the Belgian nuclear power plants, this research has lead to the development of material saving techniques, like reconstitution and miniaturization, and to improved neutron dosimetry techniques. A physically- justified RPVS fracture toughness indexation methodology, supported by micro-mechanistic modelling, is based on the elaborate use of the instrumented Charpy impact signal. Computational tools for neutron dosimetry allow to reduce the uncertainties on surveillance capsule fluences significantly

Pressure Vessel Steel Research: Belgian Activities

Energy Technology Data Exchange (ETDEWEB)

Van Walle, E; Fabry, A; Ait Abderrahim, H; Chaouadi, R; D` hondt, P; Puzzolante, J L; Van de Velde, J; Van Ransbeeck, T [Centre d` Etude de l` Energie Nucleaire, Mol (Belgium); Gerard, R [TRACTEBEL, Brussels (Belgium)

1994-03-01

A review of the Belgian research activities on Nuclear Reactor Pressure Vessel Steels (RPVS) and on related Neutron Dosimetry Aspects is presented. Born out of the surveillance programmes of the Belgian nuclear power plants, this research has lead to the development of material saving techniques, like reconstitution and miniaturization, and to improved neutron dosimetry techniques. A physically- justified RPVS fracture toughness indexation methodology, supported by micro-mechanistic modelling, is based on the elaborate use of the instrumented Charpy impact signal. Computational tools for neutron dosimetry allow to reduce the uncertainties on surveillance capsule fluences significantly.

Measurement of the natural radiation of the Belgian territory

International Nuclear Information System (INIS)

Gillard, J.; Flemal, J.M.; Deworm, J.P.; Slegers, W.

1989-01-01

A measurement campaign of natural occuring radionuclides was set up on the Belgian territory in order to assess the doses received by the Belgian population. The results of the measurements are published together with a map of natural occuring radionuclides and exposure rates. (L.D.C.)

The Health Risks of Belgian Illicit Indoor Cannabis Plantations.

Science.gov (United States)

Vanhove, Wouter; Cuypers, Eva; Bonneure, Arne-Jan; Gotink, Joachim; Stassen, Mirna; Tytgat, Jan; Van Damme, Patrick

2018-04-10

We assessed the prevalence of potential health hazards to intervention staff and cannabis growers in Belgian indoor cannabis plantations. Surface mold swab samples were taken at 16 Belgian indoor plantations contained mostly Penicillium sp. and Aspergillus sp. However, their precise health impact on intervention staff and illicit growers is unclear as no molds spore concentrations were measured. Atmospheric gas monitoring in the studied cannabis plantations did not reveal dangerous toxic substances. Health symptoms were reported by 60% of 221 surveyed police, but could not be linked to specific plantation characteristics. We conclude that Belgian indoor cannabis plantations pose a potential health threat to growers and intervention staff. AS there are currently no clear safety guidelines for seizure and dismantling of Belgian indoor cannabis plantations, we recommend first responders to follow strict safety rules when entering the growth rooms, which include wearing appropriate personal protective equipment. © 2018 American Academy of Forensic Sciences.

A Critical Analysis of the Environmental Dossiers from the OECD Sponsorship Programme for the Testing of Manufactured Nanomaterials

DEFF Research Database (Denmark)

Hansen, Steffen Foss; Hjorth, Rune; Skjolding, Lars Michael

2017-01-01

In 2015, the OECD finally published the findings of its seven year testing programme for manufactured nanomaterials. Here, we present the first in-depth analysis of the published OECD dossiers with regards to data on physical and chemical properties, environmental fate and ecotoxicology. Each...... prior, during and/or at the end of the study. We find that the information in the dossiers present an incomplete portfolio of nanomaterial ecotoxicological evaluations that are difficult to draw substantive conclusions from and that most of the studies were not designed to investigate the validity...

Dossier: transport of radioactive materials

International Nuclear Information System (INIS)

Mignon, H.; Brachet, Y.; Turquet de Beauregard, G.; Mauny, G.; Robine, F.; Plantet, F.; Pestel Lefevre, O.; Hennenhofer, G.; Bonnemains, J.

1997-01-01

This dossier is entirely devoted to the transportation of radioactive and fissile materials of civil use. It comprises 9 papers dealing with: the organization of the control of the radioactive materials transport safety (safety and security aspects, safety regulations, safety analysis and inspection, emergency plans, public information), the technical aspects of the regulation concerning the transport of radioactive materials (elaboration of regulations and IAEA recommendations, risk assessments, defense in depth philosophy and containers, future IAEA recommendations, expertise-research interaction), the qualification of containers (regulations, test facilities), the Transnucleaire company (presentation, activity, containers for spent fuels), the packages of radioactive sources for medical use (flux, qualification, safety and transport), an example of accident during radioactive materials transportation: the Apach train derailment (February 4, 1997), the sea transport of radioactive materials (international maritime organization (OMI), international maritime dangerous goods (IMDG) code, irradiated nuclear fuel (INF) safety rules), the transport of radioactive materials in Germany, and the point of view from an external observer. (J.S.)

78 FR 51061 - TRICARE; Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical...

Science.gov (United States)

2013-08-20

... DEPARTMENT OF DEFENSE 32 CFR Part 199 [DoD-2010-HA-0072] RIN 0720-AB41 TRICARE; Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical Access Hospitals; Correction... TRICARE; Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical Access...

The Belgian Nuclear Higher Education Network

International Nuclear Information System (INIS)

Moons, F.; D'Haeseleer, W.; Giot, M.

2004-01-01

Full text: BNEN, the Belgian Nuclear Higher Education Network has been created in 2001 by five Belgian universities and the Belgian Nuclear Research Centre (SCK-CEN) as a joint effort to maintain and further develop a high quality programme in nuclear engineering in Belgium. In a country where a substantial part of electricity generation will remain of nuclear origin for a number of years, there is a need for well educated and well trained engineers in this area. Public authorities, regulators and industry brought their support to this initiative. In the framework of the new architecture of higher education in Europe, the English name for this 60 ECTS programme is 'Master of Science in Nuclear Engineering'. To be admitted to this programme, students must already hold a university degree in engineering or equivalent. Linked with university research, benefiting from the human resources and infrastructure of SCK-CEN, encouraged and supported by the partners of the nuclear sector, this programme should be offered not only to Belgian students, but also more widely throughout Europe and the world. The master programme is a demanding programme where students with different high level backgrounds in engineering have to go through highly theoretical subjects like neutron physics, fluid flow and heat transfer modelling, and apply them to reactor design, nuclear safety and plant operation and control. At a more interdisciplinary level, the programme includes some important chapters of material science, with a particular interest for the fuel cycle. Radiation protection belongs also to the backbone of the programme. All the subjects are taught by academics appointed by the partner universities, whereas the practical exercises and laboratory sessions are supervised by researchers of SCK-CEN. The final thesis offers an opportunity for internship in industry or in a research laboratory. More information: http://www.sckcen.be/BNEN. (author)

Nagra technical report 14-02, geological basics - Dossier IV - Information on geo-mechanics; SGT Etappe 2: Vorschlag weiter zu untersuchender geologischer Standortgebiete mit zugehörigen Standortarealen für die Oberflächenanlage -- Geologische Grundlagen -- Dossier IV -- Geomechanische Unterlagen

Energy Technology Data Exchange (ETDEWEB)

Marschall, P.; Giger, S.

2014-12-15

This dossier is the fourth of a series of eight reports concerning the safety and technical aspects of locations for the disposal of radioactive wastes in Switzerland. This Dossier IV considers the documentation on geo-mechanical aspects that is available. Rock-stress conditions are looked at as are the methods and instrumentation used to establish them. The results of local analyses are presented and discussed, as are the magnitudes and long-term stability of such stress conditions. The geo-mechanical properties of Opalinus Clay as a host rock for a repository are discussed. Mountain-building models and coupled hydro-mechanical processes are also discussed.

Tips for Constructing a Promotion and Tenure Dossier that Documents Engaged Scholarship Endeavors

Science.gov (United States)

Franz, Nancy K.

2011-01-01

The growth of the community engagement movement in higher education over the past 2 decades has resulted in more faculty member interest and practice in engaged scholarship. As more institutions value this work, faculty members are looking for ways to enhance the effectiveness of their engaged scholarship dossiers for promotion and tenure. This…

44 CFR 208.52 - Reimbursement procedures.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement procedures. 208... Reimbursement Claims and Appeals § 208.52 Reimbursement procedures. (a) General. A Sponsoring Agency must present a claim for reimbursement to DHS in such manner as the Assistant Administrator specifies . (b...

Implementation of the 2011 Reimbursement Act in Poland: Desired and undesired effects of the changes in reimbursement policy.

Science.gov (United States)

Kawalec, Paweł; Sagan, Anna; Stawowczyk, Ewa; Kowalska-Bobko, Iwona; Mokrzycka, Anna

2016-04-01

The Act of 12 May 2011 on the Reimbursement of Medicines, Foodstuffs Intended for Particular Nutritional Uses and Medical Devices constitutes a major change of the reimbursement policy in Poland. The main aims of this Act were to rationalize the reimbursement policy and to reduce spending on reimbursed drugs. The Act seems to have met these goals: reimbursement policy (including pricing of reimbursed drugs) was overhauled and the expenditure of the National Health Fund on reimbursed drugs saw a significant decrease in the year following the Act's introduction. The annual savings achieved since then (mainly due to the introduction of risk sharing schemes), have made it possible to include new drugs into the reimbursement list and improve access to innovative drugs. However, at the same time, the decrease in prices of reimbursed drugs, that the Act brought about, led to an uncontrolled outflow of some of these drugs abroad and shortages in Poland. This paper analyses the main changes introduced by the Reimbursement Act and their implications. Since the Act came into force relatively recently, its full impact on the reimbursement policy is not yet possible to assess. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

44 CFR 352.28 - Reimbursement.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement. 352.28 Section... Participation § 352.28 Reimbursement. In accordance with Executive Order 12657, Section 6(d), and to the extent permitted by law, FEMA will coordinate full reimbursement, either jointly or severally, to the agencies...

The Belgian Nuclear Higher Education Network: Your way to the European Master in Nuclear Engineering

International Nuclear Information System (INIS)

Moons, F.; D'haeseleer, W.; Giot, M.

2004-01-01

BNEN, the Belgian Nuclear Higher Education Network has been created in 2001 by five Belgian universities and the Belgian Nuclear Research Centre (SCK CEN) as a joint effort to maintain and further develop a high quality programme in nuclear engineering in Belgium. More information: http://www.sckcen.be/BNEN. (author)

A quality control exercise of radionuclide calibrators among Belgian hospitals

International Nuclear Information System (INIS)

Reher, D.F.G.; Merlo, P.

1990-01-01

On the initiative of the Belgian Association of Hospital Physicists, eleven Belgian hospitals participated in a quality control of radionuclide calibrators conducted in collaboration with the Central Bureau for Nuclear Measurements of the Commission of the European Communities. For practical reasons the nuclide 57 Co was chosen. The results from 20 different radionuclide calibrators show a fair agreement with a similar comparison carried out in 1980 in the UK. (orig.)

Het digitale sport medisch dossier: zucht of zegen? [Digital Sport Medical Record: Sigh or a blessing?

NARCIS (Netherlands)

Stege, J.P.; Fleuren, M.A.H.; Knaap, E.T.W. van der; Stubbe, J.H.

2013-01-01

Sinds 2004 zijn er verschillende initiatieven ontplooid rondom de ontwikkeling van een digitaal Sport Medisch Dossier (SMD). Uit gesprekken met de Vereniging voor Sportgeneeskunde (VSG) blijkt dat er vooral problemen worden gesignaleerd met de ingebruikname van het digitale SMD. In het voorjaar van

Dossier: renewable energies for heat production; Dossier: energies renouvelables pour la production de chaleur

Energy Technology Data Exchange (ETDEWEB)

Anon.

2002-09-01

This dossier makes a state-of-the-art of today's applications of renewable energy sources in the residential, collective and tertiary sectors for the space heating and the hot water production. In France, three energy sources profit by a particularly favorable evolution: the solar thermal, the wood fuel and the geothermal energies. In these sectors, the offer of reliable and technically achieved appliances has been considerably widen thanks to the impulse of some French and German manufacturers. Part 1 - solar thermal: individual solar water heaters (monobloc, thermosyphon with separate tank, forced circulation systems, auxiliary heating systems); combined solar systems (direct heating floor, system with storage); collective solar systems for hot water production (receivers, efficiency, heat storage and transfer, auxiliary heating, decentralized systems); heating of open-air swimming pools; some attempts in air-conditioning; the warranty of results. Part 2 - wood fuels: domestic space heating (log boilers, installation rules, hydro-accumulation, automatic boilers); collective and tertiary wood-fueled heating plants (design of boiler plants, fuel supply, combustion chamber, smoke purification systems, ash removal, regulation system), fuels for automatic collective plants, design and installation rules. Part 3 - geothermal energy: different types (water-source and ground-source heat pumps, financial incentive). (J.S.)

Les dossiers de pensions des troupes coloniales et indigènes. La sous-série GR 13 Yf 

OpenAIRE

HEISER, Sandrine; Guillot, Hélène

2013-01-01

En avril 2011, le Service historique de la Défense (SHD) a débuté le classement des dossiers de pensions des troupes coloniales et des troupes indigènes pour la période 1850-1950. 14 000 premiers dossiers ont été inventoriés, sur un total de 24 000, l’objectif étant d’achevé le classement pour le centenaire de la Grande Guerre. L’opération comporte également une phase importante de reconditionnement permettant une communication immédiate et idéale aux lecteurs au gré des mises à jour régulièr...

45 CFR 149.300 - General reimbursement rules.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false General reimbursement rules. 149.300 Section 149... REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.300 General reimbursement rules. Reimbursement under this program is conditioned on provision of accurate information by the...

Open Access to the Belgian Nuclear higher Education Network

International Nuclear Information System (INIS)

Simons, S.

2005-01-01

Under the name of the Belgian Nuclear higher Education Network, five Belgian universities, Universite Catholique de Louvain, Universiteit Gent, Universite de Liege, Vrije Universiteit Brussel have established in 2002, in collaboration with the Belgian Nuclear Research Centre SCK-CEN, a common Belgian Interuniversity Programme of the third cycle leading to the academic degree of Master of Science in Nuclear Engineering. Under the lead of the SCK-CEN a project to use and share the acquired experience of the Consortium BNEN - in order to support the realization of a common European Education Programme in Nuclear Engineering - has been accepted by the European Commission for funding under the EU's Sixth Research Framework Programme.The project wants to contribute actively to the development of a more harmonised approach for education in nuclear sciences and engineering in Europe. It brings the European higher Education Area closer to realization and helps to safeguard the necessary competence and expertise for the continued safe use of nuclear energy and other uses of radiation in industry and medicine in Europe. The project foresees input and participation from stakeholders from different countries of the enlarged European Union (EU-25) and will therefore contribute to the integration of the new member states into the European Research Area and thus to the enlargement of Europe. The set-up of the project foresees an active role for female experts with the intention to reinforce the place and role of women in science

Different compositions of pharmaceuticals in Dutch and Belgian rivers explained by consumption patterns and treatment efficiency

NARCIS (Netherlands)

Laak, ter T.L.; Kooij, P.J.F.; Tolkamp, H.; Hofman, J.

2014-01-01

In the current study, 43 pharmaceuticals and 18 transformation products were studied in the river Meuse at the Belgian-Dutch border and four tributaries of the river Meuse in the southern part of the Netherlands. The tributaries originate from Belgian, Dutch and mixed Dutch and Belgian catchments.

The usefulness of Belgian formulae in third molar-based age assessment of Indians.

Science.gov (United States)

Bhowmik, Biyas; Acharya, Ashith B; Naikmasur, Venkatesh G

2013-03-10

The third molars are one of few useful predictors for assessing the degree of maturity in adolescence and young adulthood. It has application in age estimation in the age group of 14-23 years, in general, and in juvenile/adult status prediction, in particular. Using a 10-stage grading of third molars, Gunst et al. developed regression formulae on a large sample of Belgians (n=2513) for estimating age. Their research has been recommended as a 'reference study' in age estimation guidelines. The present study has ventured to determine if estimating age in Indians using the Belgian formulae produced results comparable to those reported in the Belgian study; in addition, this study attempts to determine if the same formulae predicted juvenile/adult status (age aged between 14 and 23 years. The OPGs included a mix of one, two, three and four third molars. In total, 916 teeth were assessed using the same 10-stage grading. Age in each OPG was estimated by applying the relevant Belgian regression formulae (regression formulae are available for one, two, three and four third molars). To determine if the formulae produced age estimates comparable to those in the Belgian study, the percentage of Indian subjects whose actual age fell within the 68% confidence interval (CI) (calculated from the ± 1 S.D. value available for each Belgian formula) was ascertained. If ≥ 68% of Indian subjects' age fell inside this interval, it indicates that the Belgian formulae are applicable in Indians. To assess the suitability of the Belgian formulae in predicting juvenile/adult status in Indians, the accuracy of the age estimation per se was not considered, rather, the number of correct age predictions only was noted. Overall, ≈ 74% of Indian subjects' actual age fell within the 68% CI; with regards to the Belgian formulae being able to correctly predict juvenile/adult status, 78% of all subjects were categorized to the correct age group (age estimation per se of Indians; however, the

Dossiê do Barreado / Barreado Dossier

Directory of Open Access Journals (Sweden)

Joana Pellerano

2015-04-01

Full Text Available A presente resenha apresenta o livro Cozinhando a tradição: Festa, cultura, história e turismo no litoral paranaense, de Maria Henriqueta Sperandio Garcia Gimenes-Minasse, publicado em 2013 pela Editora UFPR. A obra apresenta a história do Barreado, prato tradicional do litoral do Paraná, as transformações que aconteceram no preparo e no consumo e sua relação com o desenvolvimento econômico e turístico da região, que se vê representada na sua preparação culinária. Barreado Dossier - This review presents the book Cooking tradition: Party, culture, history and tourism in the coast of Paraná, of Henrietta Maria Garcia Sperandio Gimenes-Minasse, published in 2013 by UFPR Press. The book presents the history of Barreado, traditional dish of the coast of Paraná, the changes in its preparation and consumption and its relation to economic development and tourism in the region represented in its culinary preparation. 

Information dossier. Return of vitrified wastes from France to Belgium; Dossier d'information. Retour de dechets vitrifies depuis la France vers la Belgique

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-02-01

Synatom, a daughter company of Electrabel and Tractebel, is in charge of the fuel management of Belgium nuclear power plants. Contracts were signed with Cogema (France) in the 70's for the reprocessing/recycling of spent fuels. The ultimate residual wastes are vitrified at Cogema-La Hague and sent back to Belgium by rail and road transports. This information dossier presents: the power production in Belgium, the management of the fuel cycle in Belgium (recycling, interim storage of spent fuels at Tihange and Doel sites, political choices, financing), the vitrification process (quality assurance, safety), the transport of vitrified wastes from France to Belgium (handling, packaging, TN 28 VT container, regulations, safety evaluation), interim storage, long-term disposal. (J.S.)

Maintenance Energy Requirements of Double-Muscled Belgian Blue Beef Cows

OpenAIRE

Fiems, Leo O.; De Boever, Johan L.; Vanacker, José M.; De Campeneere, Sam

2015-01-01

Simple Summary Double-muscled Belgian Blue animals are extremely lean, characterized by a deviant muscle fiber type with more fast-glycolytic fibers, compared to non-double-muscled animals. This fiber type may result in lower maintenance energy requirements. On the other hand, lean meat animals mostly have a higher rate of protein turnover, which requires more energy for maintenance. Therefore, maintenance requirements of Belgian Blue cows were investigated based on a zero body weight gain. T...

47 CFR 27.1239 - Reimbursement obligation.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement obligation. 27.1239 Section 27... Policies Governing the Transition of the 2500-2690 Mhz Band for Brs and Ebs § 27.1239 Reimbursement obligation. (a) A proponent may request reimbursement from BRS licensees and lessees, EBS lessees, and...

Dossier 'thermal regulation 2000'. Reconciling building and environment; Dossier RT 2000. Reconcilier batiment et environnement

Energy Technology Data Exchange (ETDEWEB)

Grumel, N.

2001-04-01

The works that led to the setup of the new French thermal regulation (TR 2000) for buildings started in 1997 and were carried out by the general direction of urbanism, accommodation and construction (DGUHC) of the ministry of equipment, transport and accommodation, by the agency of environment and energy mastery (Ademe) and by the scientific and technical committee of building trade. The different steps of buildings construction have been reviewed with specialists, industrialists, energy suppliers, design offices, federation of companies and other professional organisms, in order to reduce the energy consumption of buildings and their impact on the environment. The new regulation is based on the determination of the 'C coefficient', the conventional energy consumption coefficient, and of reference values for the six steps of the elaboration of a construction project. The TR 2000 will be enforced in June 1, 2001. Today, the air conditioning is not concerned by the TR 2000, but will be included in 2003. This dossier presents the different aspects of the new thermal regulation. (J.S.)

Performance communication of the Belgian railway

NARCIS (Netherlands)

Gelders, Dave; Verckens, Jan Pieter; Galetzka, Mirjam; Seydel, E.R.

2007-01-01

Purpose – The purpose of this paper is to provide an insight into performance communication from an important public service, i.e. the Belgian Railway, towards its employees (internal) and stakeholders (external). Design/methodology/approach – A qualitative research approach was taken in the form of

50 CFR 37.46 - Cost reimbursement.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Cost reimbursement. 37.46 Section 37.46... NATIONAL WILDLIFE REFUGE, ALASKA General Administration § 37.46 Cost reimbursement. (a) Each applicant for or holder of a special use permit issued under this part shall reimburse the Department for its...

14 CFR 1214.803 - Reimbursement policy.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Reimbursement policy. 1214.803 Section 1214... Spacelab Services § 1214.803 Reimbursement policy. (a) Reimbursement basis. (1) This policy is established...) Standard flight price. During this phase, customers covered by subpart 1214.1 or subpart 1214.2 shall...

23 CFR 140.807 - Reimbursable costs.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Reimbursable costs. 140.807 Section 140.807 Highways... Highway Agency Audit Expense § 140.807 Reimbursable costs. (a) Federal funds may be used to reimburse an SHA for the following types of project related audit costs: (1) Salaries, wages, and related costs...

A CO2-strategy for BTC [Belgian Development Agency

Energy Technology Data Exchange (ETDEWEB)

Bailly, J. [Prospect C and S, Brussels (Belgium); Hanekamp, E. [Partners for Innovation, Amsterdam (Netherlands)

2008-09-15

The CO2 footprint is determined the CO2 strategy is developed for the Belgian Technical Cooperation (BTC). BTC is the Belgian agency for development cooperation, and finances development projects in 23 partner countries. The CO2 footprint covered BTC's activities in 2007 in all their offices worldwide. Footprint and strategy were finalised and adopted by the Executive Board at the end of 2008. Meanwhile, the BTC began with the introduction of the proposed strategy. Partners for Innovation and Prospect were asked to support the introduction of the strategy and to determine the CO2 footprint of 2008.

Manx Gaelic: The Manx Gaelic Language in Education in the Isle of Man. Regional Dossiers Series

Science.gov (United States)

McArdle, Fiona, Comp.; Teare, Robert, Comp.

2016-01-01

This regional dossier aims at providing a concise description of and basic statistics on minority language education in a specific region of Europe--the Isle of Man. Aspects that are addressed include features of the education system, recent educational policies, main actors, legal arrangements, and support structures, as well as quantitative…

North Frisian: The North Frisian Language in Education in Germany, 3rd Edition. Regional Dossiers Series

Science.gov (United States)

Walker, Alastair G. H., Comp.

2015-01-01

This regional dossier aims to provide a concise, description and basic statistics about minority language education in a specific region of Europe. Aspects that are addressed include features of the education system, recent educational policies, main actors, legal arrangements, and support structures, as well as quantitative aspects, such as the…

BNAIC 2008 : Proceedings of BNAIC 2008, the twentieth Belgian-Dutch Artificial Intelligence Conference

NARCIS (Netherlands)

Nijholt, Anton; Pantic, Maja; Poel, Mannes; Hondorp, Hendri

2008-01-01

This book contains the proceedings of the 20th edition of the Belgian-Netherlands Conference on Artificial Intelligence. The conference was organized by the Human Media Interaction group of the University of Twente. As usual, the conference was under the auspices of the Belgian-Dutch Association for

Presentación al Dossier de Historia Pública

Directory of Open Access Journals (Sweden)

Diana González Rey

2014-12-01

Full Text Available Con este número cumplimos ocho ediciones de la revista Historia 2.0: Conocimiento Histórico en Clave Digital. Con una política editorial abierta, la revista ha logrado mantener su espacio en la red y su carácter de edición para jóvenes historiadores. La siguiente edición que gratamente les presentamos a nuestros lectores es resultado de un proceso de evaluación variopinto, una continuación del dossier iniciado en la edición número siete dedicado a la historia ambiental. Como complemento se presenta un interesante apartado que pretende abrir el debate en torno a la historia pública, un campo que aunque ha ganado un espacio de especialización en Estados Unidos y Europa es prácticamente desconocido en América Latina.

7 CFR 1205.520 - Procedure for obtaining reimbursement.

Science.gov (United States)

2010-01-01

... application forms may be filed. In any such case, the reimbursement application shall show the names... Cotton Board shall make reimbursement to the importer. For joint applications, the reimbursement shall be... procedures prescribed in this section. (a) Application form. An importer shall obtain a reimbursement...

47 CFR 27.1168 - Triggering a Reimbursement Obligation.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Triggering a Reimbursement Obligation. 27.1168... a Reimbursement Obligation. (a) The clearinghouse will apply the following test to determine when an... reimbursement obligation exists, the clearinghouse will calculate the reimbursement amount in accordance with...

44 CFR 295.31 - Reimbursement of claim expenses.

Science.gov (United States)

2010-10-01

... § 295.31 Reimbursement of claim expenses. (a) FEMA will reimburse Claimants for the reasonable costs they incur in copying documentation requested by OCGFC. FEMA will also reimburse Claimants for the... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement of claim...

The Odd One Out? Revisiting the Belgian Welfare State

Directory of Open Access Journals (Sweden)

Cor Wagenaar

2014-08-01

Full Text Available Michael Ryckewaert publication Building the Economic Backbone of the Belgian Welfare State. Infrastructure, planning and architecture 1945-1973 describes the evolution of the welfare state and Belgium, more specifically its spatial characteristics. This by now historical socio-political model had decidedly collectivist traits, culminating in the provision of social security networks and a vast expansion of the public domain. If collectivism was one of the key elements of the welfare state, the absence of centralized planning appears to make the Belgian variant somewhat problematic.Whereas in countries like the Netherlands, Germany and France, modernism became the house style of the welfare state, thanks to the massive investments in public housing, this did not happen in Belgium. Here, the De Taeye Act of 1948 sponsored the construction of individual, detached houses; not surprisingly, most clients preferred traditional architecture and refrained from modern experiments. Industrial parks, office buildings and shops, on the other hand, developed into the cornerstones of Belgian modern architecture after 1945. Both the low-density sprawl and the industrial parks depend heavily on the use of the car, which was accommodated by the construction of a network of highways.

Introduction of mixed oxide fuel elements in the belgian cores

International Nuclear Information System (INIS)

Charlier, A.F.; Hollasky, N.A.

1994-01-01

The important amount of plutonium recovered from the reprocessing of spent fuel on the one hand, the national and international experience of the use of mixed oxide UO 2 -PuO 2 fuel in power reactors on the other hand, have led Belgian utilities to decide the introduction of Mixed-Oxide fuel in Doel unit 3 and Tihange unit 2 cores. The 'MOX' project has shown that it was possible without reducing safety or requiring modifications of the plant equipment. It has been approved by the Belgian 'Nuclear Safety Commission'. (authors). 1 tab., 2 figs

Evaluation de la qualité de la tenue des dossiers médicaux des ...

African Journals Online (AJOL)

Evaluation de la qualité de la tenue des dossiers médicaux des patientes en gynécologie et en obstétrique dans un Centre hospitalier universitaire de référence, Burkina Faso. H. Zamané, S. Kiemtoré, I. Ouédraogo, P.D. Kaïn, Y.A. Sawadogo, S.D. Sanou, A. Ouattara, A. Dembélé, J. Lankoandé ...

Equity in Medicaid Reimbursement for Otolaryngologists.

Science.gov (United States)

Conduff, Joseph H; Coelho, Daniel H

2017-12-01

Objective To study state Medicaid reimbursement rates for inpatient and outpatient otolaryngology services and to compare with federal Medicare benchmarks. Study Design State and federal database query. Setting Not applicable. Methods Based on Medicare claims data, 26 of the most common Current Procedural Terminology codes reimbursed to otolaryngologists were selected and the payments recorded. These were further divided into outpatient and operative services. Medicaid payment schemes were queried for the same services in 49 states and Washington, DC. The difference in Medicaid and Medicare payment in dollars and percentage was determined and the reimbursement per relative value unit calculated. Medicaid reimbursement differences (by dollar amount and by percentage) were qualified as a shortfall or excess as compared with the Medicare benchmark. Results Marked differences in Medicaid and Medicare reimbursement exist for all services provided by otolaryngologists, most commonly as a substantial shortfall. The Medicaid shortfall varied in amount among states, and great variability in reimbursement exists within and between operative and outpatient services. Operative services were more likely than outpatient services to have a greater Medicaid shortfall. Shortfalls and excesses were not consistent among procedures or states. Conclusions The variation in Medicaid payment models reflects marked differences in the value of the same work provided by otolaryngologists-in many cases, far less than federal benchmarks. These results question the fairness of the Medicaid reimbursement scheme in otolaryngology, with potential serious implications on access to care for this underserved patient population.

Reimbursement of analgesics for chronic pain.

Science.gov (United States)

Pedersen, Line; Hansen, Anneli Borge; Svendsen, Kristian; Skurtveit, Svetlana; Borchgrevink, Petter C; Fredheim, Olav Magnus S

2012-11-27

The prevalence of chronic non-malignant pain in Norway is between 24% and 30%. The proportion of the population using opioids for non-malignant pain on a long-term basis is around 1%. The purpose of our study was to investigate how many were prescribed analgesics on reimbursable prescription under reimbursement code -71 (chronic non-malignant pain) in 2009 and 2010, which analgesics were prescribed and whether prescribing practices were in accordance with national guidelines. We retrieved pseudonymised data from the National Prescription Database on all those who received drugs with reimbursement code -71 in 2009 and 2010. The data contain information on drug, dosage, formulation, reimbursement code and date of issue. 90,731 patients received reimbursement for drugs indicated for chronic non-malignant pain in 2010. Of these, 6,875 were given opioids, 33,242 received paracetamol, 25,865 non-steroid inflammatory drugs (NSAIDs), 20,654 amitryptiline and 16,507 gabapentin. Oxycodone was the most frequently prescribed opioid, followed by buprenorphine, tramadol and codeine/paracetamol. Of those who were prescribed opioids, 4,047 (59%) received mainly slow-release opioids, 2,631 (38%) also received benzodiazepines and 2,418 (35%) received benzodiazepine-like sleep medications. The number of patients who received analgesics and opioids on reimbursable prescriptions was low compared to the proportion of the population with chronic pain and the proportion using opioids long-term. 38% of those reimbursed for opioids also used benzodiazepines, which is contrary to official Norwegian guidelines.

44 CFR 208.35 - Reimbursement for Advisory.

Science.gov (United States)

2010-10-01

... Cooperative Agreements § 208.35 Reimbursement for Advisory. DHS will not reimburse costs incurred during an... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for Advisory. 208.35 Section 208.35 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY...

47 CFR 97.527 - Reimbursement for expenses.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Reimbursement for expenses. 97.527 Section 97... AMATEUR RADIO SERVICE Qualifying Examination Systems § 97.527 Reimbursement for expenses. VEs and VECs may be reimbursed by examinees for out-of-pocket expenses incurred in preparing, processing...

Dossier for marketing authorization in the European union

Directory of Open Access Journals (Sweden)

Maida Todić

2003-02-01

Full Text Available Extensive and complete documentation must be presented for marketing authorization of a medicinal product in the EU. Presented documentation should prove quality, safety and efficacy of the medicinal product. It is ensured that the applicant supplies the authorities with complete information. The legislation in Federation of Bosnia and Herzegovina has also taken more steps towards those European directions.The presentation and content of the dossier in the European Union has been redefined. The “old” EU format will be replaced with the Common Technical Document (EU CTD format agreed in 2000, within the International Conference on Harmonization framework. These two formats are intended to coexist during the transition period until July 2003. The CTD is an internationally agreed upon format for the preparation of a well structured presentation for applications to be submitted to regulatory authorities in the three ICH regions of Europe, US and Japan.

45 CFR 149.200 - Use of reimbursements.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Use of reimbursements. 149.200 Section 149.200 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Use of Reimbursements § 149.200 Use of reimbursements...

Cooking up a culinary identity for Belgium. Gastrolinguistics in two Belgian cookbooks (19th century).

Science.gov (United States)

Parys, Nathalie

2013-12-01

The notion of cookbooks as socio-historic markers in a society is generally accepted within food studies. As both representations and prescriptions of food practices, perceived habits and attitudes towards food, they represent a certain identity for their readers. This paper investigates the nature of the identity that Belgian cookbooks constructed through their rhetoric. An important part of this study is to explore how and to what extent explicit reference to Belgium was made. To this end recipe titles/labels and recipe comments used in two leading bourgeois cookbooks from nineteenth-century Belgium were subjected to a quantitative and qualitative content analysis. The analysis showed that clear attention was paid to national culinary preferences. In terms of a domestic culinary corpus, it became apparent that both the Dutch and French editions of these cookbooks promoted dishes that were ascribed a Belgian origin. Internationality, however, was also an important building block of Belgian culinary identity. It was part of the desire of Belgian bourgeoisie to connect with an international elite. It fit into the 'search for sophistication', which was also expressed through the high representation of the more costly meats and sweet dishes. In addition, other references associated with bourgeois norms and values, such as family, convenience and frugality, were additional building blocks of Belgian culinary identity. Other issues such as tradition, innovation and health, were also matters of concerns to these Belgian cookbooks. Copyright © 2013 Elsevier Ltd. All rights reserved.

45 CFR 149.100 - Amount of reimbursement.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Amount of reimbursement. 149.100 Section 149.100... REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reinsurance Amounts § 149.100 Amount of reimbursement... reimbursement in the amount of 80 percent of the costs for health benefits (net of negotiated price concessions...

45 CFR 703.9 - Reimbursement of members.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Reimbursement of members. 703.9 Section 703.9... AND FUNCTIONS OF STATE ADVISORY COMMITTEES § 703.9 Reimbursement of members. (a) Advisory Committee members may be reimbursed by the Commission by a per diem subsistence allowance and for travel expenses at...

State Medicaid reimbursement for nursing homes, 1978-86

Science.gov (United States)

Swan, James H.; Harrington, Charlene; Grant, Leslie A.

1988-01-01

State Medicaid reimbursement methods and rates are reported for the period 1978-86 for skilled nursing and intermediate care facilities. A cross-sectional time series regression analysis of Medicaid reimbursement rates on methods showed that States using prospective class reimbursement had significantly lower rates for the period 1982-86. States using prospective facility-specific reimbursement methods had lower rates than retrospective methods in 1983-84. PMID:10312516

Cultural differences in complex addition: efficient Chinese versus adaptive Belgians and Canadians.

Science.gov (United States)

Imbo, Ineke; LeFevre, Jo-Anne

2009-11-01

In the present study, the authors tested the effects of working-memory load on math problem solving in 3 different cultures: Flemish-speaking Belgians, English-speaking Canadians, and Chinese-speaking Chinese currently living in Canada. Participants solved complex addition problems (e.g., 58 + 76) in no-load and working-memory load conditions, in which either the central executive or the phonological loop was loaded. The authors used the choice/no-choice method to obtain unbiased measures of strategy selection and strategy efficiency. The Chinese participants were faster than the Belgians, who were faster and more accurate than the Canadians. The Chinese also required fewer working-memory resources than did the Belgians and Canadians. However, the Chinese chose less adaptively from the available strategies than did the Belgians and Canadians. These cultural differences in math problem solving are likely the result of different instructional approaches during elementary school (practice and training in Asian countries vs. exploration and flexibility in non-Asian countries), differences in the number language, and informal cultural norms and standards. The relevance of being adaptive is discussed as well as the implications of the results in regards to the strategy choice and discovery simulation model of strategy selection (J. Shrager & R. S. Siegler, 1998).

CLAIMS FOR REIMBURSEMENT OF EDUCATION FEES

CERN Multimedia

Personnel Division

1999-01-01

REMINDERYou are reminded that, in accordance with Article R A 8.07 of the Staff Regulations 'the relevant bills shall be grouped so that not more than three claims in respect of each child are submitted in an academic year'.For this purpose:the academic year is defined as the period going from 1st September to 31st August, only paid bills can be subject to reimbursement, a claim for reimbursement of education fees may only include bills for expenses incurred during a given academic year for a given child, bills for one child may be grouped on a claim by periods of term, semester or academic year, the months of July and August should be included in the third term, or the second semester, or the academic year, for each dependent child, a maximum of 3 claims can be submitted for the reimbursement of expenses incurred during one academic year, therefore, any bill submitted for reimbursement after the third claim will not be reimbursed.Please make sure that you have received and paid all bills, including those for...

DOSSIER: Intelectuales y Editores

Directory of Open Access Journals (Sweden)

Gustavo Sorá

2009-04-01

Full Text Available El intelectual abre ideas, el editor las cierra. El escritor produce textos, el editor impresos. El intelectualescribe pero es el editor quien publica. No por nada, afirman algunos psicólogos, el pensamientoculmina con su publicación. Entre el escritor y el editor se moviliza una energía simbólica y socialsublimada bajo las líneas impresas que llegan al lector. Ese entre-lugar de producción de sentidos, decosmologías, de sociedad que marcó la formación de gran parte de las culturas desde la aparición de laexpresión gráfica de las ideas, permanece como un problema esquivo para la investigación, al menospara la antropología practicada en estas latitudes. Parece una cuestión obturada por el dominanteacúmulo de historias de las ideas, de la literatura, del pensamiento que reactualizan la oposición entreespíritu y materia, estética y sociedad, texto y contexto. Evidencia de ello es la clausura sufrida por lasociología de la literatura, una sub-disciplina tan incómoda para los guardianes del aura del genioliterario nacional.Este dossier busca iluminar esa relación con la certeza de que modela uno de los terrenos másfértiles para repensar el legado de la historia de la cultura en occidente y para generar un basto programade problemas de investigación escasamente explorados por las ciencias sociales y humanas en AméricaLatina, y aplicables al estudio de toda cultura, con o sin escritura.

49 CFR 22.27 - Eligible reimbursements to participating lenders.

Science.gov (United States)

2010-10-01

... reimbursement. Prior written approval from DOT OSDBU is required. Attorney fees will be reimbursed on a pro-rata... 49 Transportation 1 2010-10-01 2010-10-01 false Eligible reimbursements to participating lenders... PROGRAM (STLP) Participating Lenders § 22.27 Eligible reimbursements to participating lenders...

76 FR 63844 - Federal Travel Regulation (FTR); Lodging Reimbursement

Science.gov (United States)

2011-10-14

... lodging I select affect my reimbursement? (a) Your agency will reimburse you for different types of...; Docket Number 2011-0024, Sequence 1] RIN 3090-AJ22 Federal Travel Regulation (FTR); Lodging Reimbursement... (GSA) is amending the Federal Travel Regulation (FTR) regarding reimbursement of lodging per diem...

State Variation in Medicaid Reimbursements for Orthopaedic Surgery.

Science.gov (United States)

Lalezari, Ramin M; Pozen, Alexis; Dy, Christopher J

2018-02-07

Medicaid reimbursements are determined by each state and are subject to variability. We sought to quantify this variation for commonly performed inpatient orthopaedic procedures. The 10 most commonly performed inpatient orthopaedic procedures, as ranked by the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample, were identified for study. Medicaid reimbursement amounts for those procedures were benchmarked to state Medicare reimbursement amounts in 3 ways: (1) ratio, (2) dollar difference, and (3) dollar difference divided by the relative value unit (RVU) amount. Variability was quantified by determining the range and coefficient of variation for those reimbursement amounts. The range of variability of Medicaid reimbursements among states exceeded $1,500 for all 10 procedures. The coefficients of variation ranged from 0.32 (hip hemiarthroplasty) to 0.57 (posterior or posterolateral lumbar interbody arthrodesis) (a higher coefficient indicates greater variability), compared with 0.07 for Medicare reimbursements for all 10 procedures. Adjusted as a dollar difference between Medicaid and Medicare per RVU, the median values ranged from -$8/RVU (total knee arthroplasty) to -$17/RVU (open reduction and internal fixation of the femur). Variability of Medicaid reimbursement for inpatient orthopaedic procedures among states is substantial. This variation becomes especially remarkable given recent policy shifts toward focusing reimbursements on value.

Utilization of travel reimbursement in the Veterans Health Administration.

Science.gov (United States)

Nelson, Richard E; Hicken, Bret; Cai, Beilei; Dahal, Arati; West, Alan; Rupper, Randall

2014-01-01

To improve access to care, the Veterans Health Administration (VHA) increased its patient travel reimbursement rate from 11 to 28.5 cents per mile on February 1, 2008, and again to 41.5 cents per mile on November 17, 2008. We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit. We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases. Because of our data's longitudinal nature, we used multivariable generalized estimating equation models for analysis. Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Our cohort contained 214,376 veterans. During the study period, the average number of reimbursements per veteran was higher for rural patients compared to urban patients, and for those living 50-75 miles from the nearest VHA facility compared to those living closer. Higher reimbursement rates led to more veterans obtaining reimbursement regardless of urban-rural residence or distance traveled to the nearest VHA facility. However, after the rate increases, urban veterans and veterans living reimbursement utilization slightly more than other patients. Our findings suggest an inverted U-shaped relationship between veterans' utilization of the VHA travel reimbursement benefit and travel distance. Both urban and rural veterans responded in roughly equal manner to changes to this benefit. © 2013 National Rural Health Association.

Presentación Dossier Tema Libre

Directory of Open Access Journals (Sweden)

Diana González Rey

2015-12-01

Full Text Available Con el décimo número de la Revista Historia 2.0: Conocimiento Histórico en Clave Digital, los editores saludamos a los lectores. Durante estos cinco años la publicación ha pasado por diversas etapas de aprendizaje en las que destacamos el apoyo de los autores, estudiantes y de los profesionales de la historia que contribuyen a divulgar y sostener la edición. Hemos querido celebrar nuestros cinco años con un dossier de Tema Libre, tal como fue él de nuestra primera entrega, en ésta nueva edición número diez (10. Los artículos aquí publicados fueron al igual que en todas las ediciones convocados públicamente, en la página de Facebook de AHISAB, a través la distribución mediante listas de correos, de servidores gratuitos como H- México, quiénes nos han colaborado en el proceso de distribución de las convocatorias. Igualmente la evaluación por pares fue de manera anónima de acuerdo a todos los estándares internacionales, una labor que debemos agradecer notoriamente púes constituye la base fundamental y académica de nuestra publicación.

Maintenance Energy Requirements of Double-Muscled Belgian Blue Beef Cows

Science.gov (United States)

Fiems, Leo O.; De Boever, Johan L.; Vanacker, José M.; De Campeneere, Sam

2015-01-01

Simple Summary Double-muscled Belgian Blue animals are extremely lean, characterized by a deviant muscle fiber type with more fast-glycolytic fibers, compared to non-double-muscled animals. This fiber type may result in lower maintenance energy requirements. On the other hand, lean meat animals mostly have a higher rate of protein turnover, which requires more energy for maintenance. Therefore, maintenance requirements of Belgian Blue cows were investigated based on a zero body weight gain. This technique showed that maintenance energy requirements of double-muscled Belgian Blue beef cows were close to the mean requirements of cows of other beef genotypes. Abstract Sixty non-pregnant, non-lactating double-muscled Belgian Blue (DMBB) cows were used to estimate the energy required to maintain body weight (BW). They were fed one of three energy levels for 112 or 140 days, corresponding to approximately 100%, 80% or 70% of their total energy requirements. The relationship between daily energy intake and BW and daily BW change was developed using regression analysis. Maintenance energy requirements were estimated from the regression equation by setting BW gain to zero. Metabolizable and net energy for maintenance amounted to 0.569 ± 0.001 and 0.332 ± 0.001 MJ per kg BW0.75/d, respectively. Maintenance energy requirements were not dependent on energy level (p > 0.10). Parity affected maintenance energy requirements (p < 0.001), although the small numerical differences between parities may hardly be nutritionally relevant. Maintenance energy requirements of DMBB beef cows were close to the mean energy requirements of other beef genotypes reported in the literature. PMID:26479139

Reimbursement for critical care services in India

Science.gov (United States)

Jayaram, Raja; Ramakrishnan, Nagarajan

2013-01-01

There are significant variations in critical care practices, costs, and reimbursements in various countries. Of note, there is a paucity of reliable information on remuneration and reimbursement models for intensivists in India. This review article aims to analyze the existing reimbursement models in United States and United Kingdom and propose a frame-work model that may be applicable in India. PMID:23833469

Annual report for the steering committee of the association Euratom-Belgian State for fusion 1999

International Nuclear Information System (INIS)

Decreton, M.

1999-10-01

This report is prepared for the annual steering committee meting of the Association Euratom - Belgian State in the area of fusion reactor technology. The Belgian contribution focuses on the assessment of the first wall and blanket materials under radiation and coolant interaction and on developments for the remote handling in maintenance activities. The period October 1998 to September 1999 is reported on.The fusion technology work performed at the Belgian Nuclear Research Centre SCK/CEN, the Department of Metallurgy and Materials Engineering of the Louvain University (Belgium) and S.A. Gradel, a Luxemburg-based organisation, is described

Annual report for the steering committee of the association Euratom-Belgian State for fusion 1999

Energy Technology Data Exchange (ETDEWEB)

Decreton, M

1999-10-01

This report is prepared for the annual steering committee meting of the Association Euratom - Belgian State in the area of fusion reactor technology. The Belgian contribution focuses on the assessment of the first wall and blanket materials under radiation and coolant interaction and on developments for the remote handling in maintenance activities. The period October 1998 to September 1999 is reported on.The fusion technology work performed at the Belgian Nuclear Research Centre SCK/CEN, the Department of Metallurgy and Materials Engineering of the Louvain University (Belgium) and S.A. Gradel, a Luxemburg-based organisation, is described.

Annual report for the steering committee of the association Euratom-Belgian State for fusion 1998

Energy Technology Data Exchange (ETDEWEB)

Decreton, M

1998-10-01

This report is prepared for the annual steering committee meting of the Association Euratom - Belgian State in the area of fusion reactor technology. The Belgian contribution focuses on the assessment of the first wall and blanket materials under radiation and coolant interaction and on developments for the remote handling in maintenance activities. The period October 1997 to September 1998 is reported on.The fusion technology work performed at the Belgian Nuclear Research Centre SCK/CEN, the Department of Metallurgy and Materials Engineering of the Louvain University (Belgium) and S.A. Gradel, a Luxemburg-based organisation, is described.

Annual report for the steering committee of the association Euratom-Belgian State for fusion 1998

International Nuclear Information System (INIS)

Decreton, M.

1998-10-01

This report is prepared for the annual steering committee meting of the Association Euratom - Belgian State in the area of fusion reactor technology. The Belgian contribution focuses on the assessment of the first wall and blanket materials under radiation and coolant interaction and on developments for the remote handling in maintenance activities. The period October 1997 to September 1998 is reported on.The fusion technology work performed at the Belgian Nuclear Research Centre SCK/CEN, the Department of Metallurgy and Materials Engineering of the Louvain University (Belgium) and S.A. Gradel, a Luxemburg-based organisation, is described

Decomposing dynamic profit inefficiency of Belgian dairy farms

NARCIS (Netherlands)

Ang, Frederic; Lansink, Alfons Oude

2018-01-01

This paper introduces a nonparametric framework for analysing dynamic profit inefficiency and applies this to a sample of Belgian, specialised dairy farms from 1996 to 2008. Profit inefficiency is decomposed into technical and allocative inefficiency. The paper also decomposes profit inefficiency

48 CFR 16.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 16.405 Section 16.405 Federal Acquisition Regulations System FEDERAL ACQUISITION...-reimbursement incentive contracts. See 16.301 for requirements applicable to all cost-reimbursement contracts...

47 CFR 54.407 - Reimbursement for offering Lifeline.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Reimbursement for offering Lifeline. 54.407... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Low-Income Consumers § 54.407 Reimbursement for... carrier may receive universal service support reimbursement for each qualifying low-income consumer served...

47 CFR 24.247 - Triggering a reimbursement obligation.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Triggering a reimbursement obligation. 24.247... Mhz Band § 24.247 Triggering a reimbursement obligation. (a) Licensed PCS. The clearinghouse will... the Proximity Threshold test indicates that a reimbursement obligation exists, the clearinghouse will...

48 CFR 46.305 - Cost-reimbursement service contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement service... CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 46.305 Cost-reimbursement service contracts. The contracting officer shall insert the clause at 52.246-5, Inspection of Services—Cost Reimbursement, in...

48 CFR 46.303 - Cost-reimbursement supply contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement supply... CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 46.303 Cost-reimbursement supply contracts. The contracting officer shall insert the clause at 52.246-3, Inspection of Supplies—Cost-Reimbursement, in...

A DECADE OF HEALTH TECHNOLOGY ASSESSMENT IN POLAND.

Science.gov (United States)

Lipska, Iga; McAuslane, Neil; Leufkens, Hubert; Hövels, Anke

2017-01-01

The objective of this study is to illustrate and provide a better understanding of the role of health technology assessment (HTA) processes in decision making for drug reimbursement in Poland and how this approach could be considered by other countries of limited resources. We analyzed the evolution of the HTA system and processes in Poland over the past decade and current developments based on publicly available information. The role of HTA in drug-reimbursement process in Poland has increased substantially over the recent decade, starting in 2005 with the formation the Agency for Health Technology Assessment and Tariff System (AOTMiT). The key success factors in this development were effective capacity building based on the use of international expertise, the implementation of transparent criteria into the drug reimbursement processes, and the selective approach to the adoption of innovative medicines based on the cost-effectiveness threshold among other criteria. While Poland is regarded as a leader in Central and Eastern Europe, there is room for improvement, especially with regard to the quality of HTA processes and the consistency of HTA guidelines with reimbursement law. In the "pragmatic" HTA model use by AOTMiT, the pharmaceutical company is responsible for the preparation of a reimbursement dossier of good quality in line with HTA guidelines while the assessment team in AOTMiT is responsible for critical review of that dossier. Adoption of this model may be considered by other countries with limited resources to balance differing priorities and ensure transparent and objective access to medicines for patients who need them.

48 CFR 52.249-6 - Termination (Cost-Reimbursement).

Science.gov (United States)

2010-10-01

...-Reimbursement). 52.249-6 Section 52.249-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION....249-6 Termination (Cost-Reimbursement). As prescribed in 49.503(a)(1), insert the following clause: Termination (Cost-Reimbursement) (MAY 2004) (a) The Government may terminate performance of work under this...

Nagra technical report 14-02, geological basics - Dossier VII - Usage conflicts

International Nuclear Information System (INIS)

Gautschi, A.; Becker, J.; Traber, D.; Leu, W.

2014-01-01

This dossier is the seventh of a series of eight reports concerning the safety and technical aspects of locations for the disposal of radioactive wastes in Switzerland. It discusses possible conflicts with respect to the use of rock strata below or above the proposed host rock layers. Possible usage could include the extraction of salt, coal or other hydrocarbons. Other possible conflicting uses include the mining of stone, ores and minerals as well as the extraction of mineral water and thermal water. The construction of deep boreholes, for example for geothermal probes, could also cause conflicts with any nuclear waste depositories. The storage of natural gas or carbon sequestration, however, is not considered likely

The Mandate System for the Belgian Public Prosecution

Directory of Open Access Journals (Sweden)

Bruno BROUCKER

2009-12-01

Full Text Available The law of 22 December 1998 introduced the mandate system for the heads of the Public Prosecution offices, which were appointed permanent before that. Theoretically, such a system needs to enhance, within the organization, effectiveness, efficiency, responsabilisation, and goal-orientation. However, the mandate system within the Belgian Public Prosecution was introduced prematurely, for dubious reasons and in a precipitate manner. In the current situation, the position of the mandate holder is uncertain, with a bounded autonomy and a low wage increase. Moreover, it remains impossible to intervene in the policy of appointed heads of office (during their mandate, the efficiency and effectiveness is only increased in some prosecution offices and a contract containing actual management responsibilities is absent. In sum: there is a large gap between the theoretical principles of mandate systems and the way it is introduced in the Belgian Public Prosecution.

78 FR 46502 - Reimbursed Entertainment Expenses

Science.gov (United States)

2013-08-01

... is a reimbursement of travel expenses for food and beverages that Y pays in performing services as an... entertainment, amusement, recreation, or travel. * * * * * (f) * * * (2) * * * (iv) Reimbursed entertainment, food, or beverage expenses--(A) Introduction. In the case of any expenditure for entertainment...

Economic evaluation of reprocessing - Indicative Belgian position

International Nuclear Information System (INIS)

1979-05-01

This paper, which also appears as an Appendix to the final Working Group 4 report, forms part of the overall economic evaluation of reprocessing. The indicative national position and illustrative ''phase diagram'' for Belgium is presented. Other factors which influence the Belgian viewpoint and which are not included on the phase diagram are given

Variation in provider vaccine purchase prices and payer reimbursement.

Science.gov (United States)

Freed, Gary L; Cowan, Anne E; Gregory, Sashi; Clark, Sarah J

2009-12-01

The purpose of this work was to collect data regarding vaccine prices and reimbursements in private practices. Amid reports of physicians losing money on vaccines, there are limited supporting data to show how much private practices are paying for vaccines and how much they are being reimbursed by third-party payers. We conducted a cross-sectional survey of a convenience sample of private practices in 5 states (California, Georgia, Michigan, New York, and Texas) that purchase vaccines for administration to privately insured children/adolescents. Main outcome measures included prices paid to purchase vaccines recommended for children and adolescents and reimbursement from the 3 most common, non-Medicaid payers for vaccine purchase and administration. Detailed price and reimbursement data were provided by 76 practices. There was a considerable difference between the maximum and minimum prices paid by practices, ranging from $4 to more than $30 for specific vaccines. There was also significant variation in insurance reimbursement for vaccine purchase, with maximum and minimum reimbursements for a single vaccine differing from $8 to more than $80. Mean net yield per dose (reimbursement for vaccine purchase minus price paid per dose) varied across vaccines from a low of approximately $3 to more than $24. Reimbursement for the first dose of vaccine administered ranged from $0 to more than $26, with a mean of $16.62. There is a wide range of prices paid by practices for the same vaccine product and in the reimbursement for vaccines and administration fees by payers. This variation highlights the need for individual practices to understand their own costs and reimbursements and to seek opportunities to reduce costs and increase reimbursements.

47 CFR 27.1184 - Triggering a reimbursement obligation.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Triggering a reimbursement obligation. 27.1184... reimbursement obligation. (a) The clearinghouse will apply the following test to determine when an AWS entity... paragraphs (a)(3)(i) and (ii) of this section, indicates that a reimbursement obligation exists, the...

48 CFR 47.104-3 - Cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement... CONTRACT MANAGEMENT TRANSPORTATION General 47.104-3 Cost-reimbursement contracts. (a) 49 U.S.C. 10721 and... accrues to the Government, i.e., the Government shall pay the charges or directly and completely reimburse...

Stratified Medicine and Reimbursement Issues

Directory of Open Access Journals (Sweden)

Hans-Joerg eFugel

2012-10-01

Full Text Available Stratified Medicine (SM has the potential to target patient populations who will most benefit from a therapy while reducing unnecessary health interventions associated with side effects. The link between clinical biomarkers/diagnostics and therapies provides new opportunities for value creation to strengthen the value proposition to pricing and reimbursement (P&R authorities. However, the introduction of SM challenges current reimbursement schemes in many EU countries and the US as different P&R policies have been adopted for drugs and diagnostics. Also, there is a lack of a consistent process for value assessment of more complex diagnostics in these markets. New, innovative approaches and more flexible P&R systems are needed to reflect the added value of diagnostic tests and to stimulate investments in new technologies. Yet, the framework for access of diagnostic–based therapies still requires further development while setting the right incentives and appropriate align stakeholders interests when realizing long- term patient benefits. This article addresses the reimbursement challenges of SM approaches in several EU countries and the US outlining some options to overcome existing reimbursement barriers for stratified medicine.

48 CFR 52.243-2 - Changes-Cost-Reimbursement.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Changes-Cost-Reimbursement....243-2 Changes—Cost-Reimbursement. As prescribed in 43.205(b)(1), insert the following clause. The 30-day period may be varied according to agency procedures. Changes—Cost-Reimbursement (AUG 1987) (a) The...

44 CFR 208.44 - Reimbursement for other costs.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for other costs... Cooperative Agreements § 208.44 Reimbursement for other costs. (a) Except as allowed under paragraph (b) of this section, DHS will not reimburse other costs incurred preceding, during or upon the conclusion of...

Medicaid provider reimbursement policy for adult immunizations.

Science.gov (United States)

Stewart, Alexandra M; Lindley, Megan C; Cox, Marisa A

2015-10-26

State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Observational analysis using document review and a survey. Medicaid administrators in 50 states and the District of Columbia. Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Medicaid provider reimbursement policy for adult immunizations☆

Science.gov (United States)

Stewart, Alexandra M.; Lindley, Megan C.; Cox, Marisa A.

2015-01-01

Background State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Objective Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Design Observational analysis using document review and a survey. Setting and participants Medicaid administrators in 50 states and the District of Columbia. Measurements Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Results Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Limitations Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Conclusions Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. PMID:26403369

Os dossiês da REF: além das fronteiras entre academia e militância REF's dossiers: crossing the border between research and politics

Directory of Open Access Journals (Sweden)

Sônia Weidner Maluf

2004-12-01

Full Text Available Este artigo, apresentado originalmente no Encontro da REDEFEM em outubro de 2002, discute os Dossiês publicados desde o surgimento da Revista Estudos Feministas até o presente momento, fazendo um levantamento e uma breve descrição de cada um deles. Os Dossiês constituem uma seção da REF e se dedicam à abertura de um espaço de diálogo entre a produção acadêmica e intelectual e a militância, o ativismo e as políticas feministas. Os textos podem assumir diversos formatos além de artigos ou de ensaios acadêmicos. No final deste artigo, é feita uma breve análise do lugar dos dossiês nas fricções entre academia e militância, buscando ir além das dicotomias entre ação e reflexão ou teoria e prática.This article analyzes the Dossiers of Revista Estudos Feministas. This section is published since the appearance of the journal on 1992. We describe each one of the 24 dossiers published until now and analyze it main characteristics. The main objective of the Dossiers is to establish a dialogue between the feminist academic discussions and the feminist activism and politics. They are open to different styles of text beyond the academic paper. In the end of the article we analyze the place of the dossiers in the discussions about the tensions between academy and activism, trying to go beyond the dichotomies between action and reflection or between theory and practice.

Empty pledges: A content analysis comparing Belgian and Dutch child-targeting food websites

OpenAIRE

Neyens, Evy; Smits, Tim

2015-01-01

Background: In the EU Pledge, the food industry has vowed to retain from unhealthy food promotion to children under the age of twelve. Nonetheless, food brands increasingly lure children to branded websites packed with unhealthy food and beverage advertising. This study first explores the prevalence of online marketing strategies on 49 Belgian and Dutch child-targeting food websites. Second, it examines the nutrient content of the advertised foods. Third, it scrutinizes whether Belgian and Du...

23 CFR 140.505 - Reimbursable costs.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Reimbursable costs. 140.505 Section 140.505 Highways... Administrative Settlement Costs-Contract Claims § 140.505 Reimbursable costs. (a) Federal funds may participate in administrative settlement costs which are: (1) Incurred after notice of claim, (2) Properly...

HEALTH INSURANCE: CONTRIBUTIONS AND REIMBURSEMENT MAXIMAL

CERN Document Server

HR Division

2000-01-01

Affected by both the salary adjustment index on 1.1.2000 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maximal, has changed significantly. An adjustment of the amounts of the reimbursement maximal and the fixed contributions is therefore necessary, as from 1 January 2000.Reimbursement maximalThe revised reimbursement maximal will appear on the leaflet summarising the benefits for the year 2000, which will soon be available from the divisional secretariats and from the AUSTRIA office at CERN.Fixed contributionsThe fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions):voluntarily insured member of the personnel, with complete coverage:815,- (was 803,- in 1999)voluntarily insured member of the personnel, with reduced coverage:407,- (was 402,- in 1999)voluntarily insured no longer dependent child:326,- (was 321...

Clay 2001 dossier: progress report on feasibility studies and research into deep geological disposal of high-level, long-lived waste

International Nuclear Information System (INIS)

2001-12-01

A French Act of Parliament passed on 30 December 1991 set out the main areas of research required to prepare solutions for the long-term management of high-level, long-lived radioactive waste. The three avenues of research listed in the Act included a feasibility study of the deep geological disposal of these waste, with responsibility for steering the study given to ANDRA, France National Agency for Radioactive Waste Management. Following government decisions taken in 1998, the study focused on two types of geological medium, clay and granite. The clay formations study is essentially based on results from an underground laboratory sited at the border between the Meuse and Haute-Marne departments, where the Callovo-Oxfordian argillite beds are being investigated. No site has yet been chosen for an underground laboratory for the granite study, so for the time being this will draw on generic work and on research carried out in laboratories outside France. ANDRA has decided to present an initial report on the results of its research programme, publishing a dossier on the work on clay formations in 2001 with a second dossier covering the work on granite due for release in 2002. This dossier is thus a review of the work carried out by ANDRA on the feasibility study into a radioactive waste repository in a clay formation. It represents one step in a process of studies and research work leading up to the submission of a report due in 2005 containing ANDRA conclusions on the feasibility of a repository in the clay formation. (author)

How is intensive care reimbursed?

DEFF Research Database (Denmark)

Bittner, Martin-Immanuel; Donnelly, Maria; van Zanten, Arthur Rh

2013-01-01

Reimbursement schemes in intensive care are more complex than in other areas of healthcare, due to special procedures and high care needs. Knowledge regarding the principles of functioning in other countries can lead to increased understanding and awareness of potential for improvement. This can...... be achieved through mutual exchange of solutions found in other countries. In this review, experts from eight European countries explain their respective intensive care unit reimbursement schemes. Important conclusions include the apparent differences in the countries' reimbursement schemes---despite all...... of them originating from a DRG system, the high degree of complexity found, and the difficulties faced in several countries when collecting the data for this collaborative work. This review has been designed to help the intensivist clinician and researcher to understanding neighbouring countries...

Dossier: sirvientas, trabajadoras y activistas. El género en la historia social inglesa

OpenAIRE

Pita, Valeria Silvina; Andújar, Andrea Norma; Palermo, Silvana; Schettini, Cristiana

2015-01-01

Este trabajo es la introducción al dossier "?Sirvientas, trabajadoras y activistas. El género en la historia social inglesa?, el cual reúne artículos de Dorothy Thompson, Catherine Hall y Carolyn Steedman, tres historiadoras británicas pertenecientes a distintas generaciones e inscriptas en la tradición de la historia social marxista. Los textos que aquí se presentan abordan el estudio de diversas experiencias de trabajo y organización de la clase trabajadora en la Inglaterra de los albores ...

42 CFR 57.213a - Loan cancellation reimbursement.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Loan cancellation reimbursement. 57.213a Section 57... Professions Student Loans § 57.213a Loan cancellation reimbursement. (a) For loans made prior to October 22... credited to this insurance fund), and used only to reimburse the school for the institutional share of any...

El patrimonio como domesticación de la cultura. Comentarios al Dossier de ICONOS 20

Directory of Open Access Journals (Sweden)

Espinheira , Gey

2005-01-01

Full Text Available Tres de los artículos publicados en el dossier de ICONOS 20 ¿Patrimonio, memoria y ¿regeneración¿ urbana¿, convergen en reconocer algunos efectos perversos de la restauración de centros históricos y espacios públicos. Este artículo explora los argumentos presentados en esos artículos y los entiende como parte de un proceso que, en nombre del turismo, domestica la cultura.

44 CFR 208.39 - Reimbursement for personnel costs incurred during Activation.

Science.gov (United States)

2010-10-01

...) Reimbursement of additional salary and overtime costs. DHS will reimburse any identified additional salary and...). (g) Reimbursement for Backfill costs upon Activation. DHS will reimburse the cost to Backfill System... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for personnel...

47 CFR 27.1166 - Reimbursement under the Cost-Sharing Plan.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement under the Cost-Sharing Plan. 27... § 27.1166 Reimbursement under the Cost-Sharing Plan. (a) Registration of reimbursement rights. Claims for reimbursement under the cost-sharing plan are limited to relocation expenses incurred on or after...

47 CFR 24.245 - Reimbursement under the Cost-Sharing Plan.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement under the Cost-Sharing Plan. 24... 1850-1990 Mhz Band § 24.245 Reimbursement under the Cost-Sharing Plan. (a) Registration of reimbursement rights. (1) To obtain reimbursement, a PCS relocator must submit documentation of the relocation...

77 FR 22786 - Privately Owned Vehicle Mileage Reimbursement Rates

Science.gov (United States)

2012-04-17

... Owned Vehicle Mileage Reimbursement Rates AGENCY: Office of Governmentwide Policy (OGP), General... Privately Owned Vehicle Mileage Reimbursement Rates. SUMMARY: The General Services Administration's (GSA) special review of privately owned vehicle (POV) mileage reimbursement rates has resulted in adjusting the...

77 FR 76487 - Privately Owned Vehicle Mileage Reimbursement Rates

Science.gov (United States)

2012-12-28

... Vehicle Mileage Reimbursement Rates AGENCY: Office of Governmentwide Policy (OGP), General Services... Mileage Reimbursement Rates. SUMMARY: The General Services Administration's annual privately owned vehicle (POV) mileage reimbursement rate reviews have resulted in new CY 2013 rates for the use of privately...

75 FR 82029 - Privately Owned Vehicle Mileage Reimbursement Rates

Science.gov (United States)

2010-12-29

... Owned Vehicle Mileage Reimbursement Rates AGENCY: Office of Governmentwide Policy (OGP), General... Owned Vehicle Mileage Reimbursement Rates. SUMMARY: The General Services Administration's (GSA) annual privately owned vehicle (POV) mileage reimbursement rate reviews have resulted in new CY 2011 rates for the...

45 CFR 149.315 - Reimbursement conditioned upon available funds.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reimbursement conditioned upon available funds... TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.315 Reimbursement conditioned upon available funds. Notwithstanding a sponsor's compliance with...

EC initiatives promise mixed blessings: a Belgian utility perspective

International Nuclear Information System (INIS)

Fraix, J.

1992-01-01

The potential effects on nuclear power of European Community initiatives are analysed from the viewpoint of a Belgian utility. The initiatives fall under the three broad headings of: East-West co-operation; completing the internal market; and carbon dioxide emission. (Author)

The attitudes of Belgian adolescents towards peers with disabilities

NARCIS (Netherlands)

Bossaert, Goele; Colpin, Hilde; Pijl, Sip Jan; Petry, Katja

2011-01-01

This study aimed to explore Belgian adolescents' attitudes towards peers with disabilities and to explore factors associated with these attitudes. Based on the theory of persuasive communication, this study focused on receiver variables (the "whom"), characteristics of students with disabilities

Obtaining reimbursement in France and Italy for new diabetes products.

Science.gov (United States)

Schaefer, Elmar; Schnell, Gerald; Sonsalla, Jessica

2015-01-01

Manufacturers launching next-generation or innovative medical devices in Europe face a very heterogeneous reimbursement landscape, with each country having its own pathways, timing, requirements and success factors. We selected 2 markets for a deeper look into the reimbursement landscape: France, representing a country with central decision making with defined processes, and Italy, which delegates reimbursement decisions to the regional level, resulting in a less transparent approach to reimbursement. Based on our experience in working on various new product launches and analyzing recent reimbursement decisions, we found that payers in both countries do not reward improved next-generation products with incremental reimbursement. Looking at innovations, we observe that manufacturers face a challenging and lengthy process to obtain reimbursement. In addition, requirements and key success factors differ by country: In France, comparative clinical evidence and budget impact very much drive reimbursement decisions in terms of pricing and restrictions, whereas in Italy, regional key opinion leader (KOL) support and additional local observational data are key. © 2015 Diabetes Technology Society.

Cost effectiveness of atorvastatin in patients with type 2 diabetes mellitus: a pharmacoeconomic analysis of the collaborative atorvastatin diabetes study in the belgian population.

Science.gov (United States)

Annemans, L; Marbaix, S; Webb, K; Van Gaal, L; Scheen, A

2010-01-01

Patients with type 2 diabetes mellitus have a high risk of developing cardiovascular (CV) disease. The clinical benefit of use of statins in patients with type 2 diabetes has been demonstrated in several randomized, controlled trials, including the CARDS clinical trial. Based on the clinical CARDS data, the favourable cost effectiveness of atorvastatin 10 mg in patients with type 2 diabetes has been demonstrated in countries such as the UK and France. This study aimed to estimate the cost effectiveness in the Belgian setting of atorvastatin 10 mg compared with no treatment for the primary prevention of CV events in type 2 diabetes patients without a history of CV disease. A Markov model with 1-year cycles was developed to simulate the CV event and death risk according to the therapeutic approach initiated. The transition probabilities for CV events in the 'no statin treatment' group were derived from the risk equations reported from the large UKPDS. Risk reductions from the CARDS clinical trial were used to adjust these CV event probabilities in the atorvastatin 10 mg treatment group. The characteristics of type 2 diabetes patients without a CV history were derived from the Belgian OCAPI survey. The public healthcare payers' perspective was taken into account for costing. The direct medical costs of CV events were based on the Public Health Authorities' hospital database for acute care costs and on the literature for the follow-up costs. The impact on the reimbursement system of generic entry to the market was considered in the drug cost. Costs were valued as at year 2009; costs and outcomes were discounted at 3% and 1.5%, respectively. Based on a 5-year time horizon, atorvastatin was demonstrated to be cost effective with an incremental cost/quality-adjusted life-year (QALY) of euro 16,681. Over a lifetime horizon (25 years), atorvastatin was demonstrated to be a cost-saving therapeutic intervention. At a threshold of euro 30,000/QALY, atorvastatin had a 98

48 CFR 2052.215-77 - Travel approvals and reimbursement.

Science.gov (United States)

2010-10-01

... reimbursement. 2052.215-77 Section 2052.215-77 Federal Acquisition Regulations System NUCLEAR REGULATORY....215-77 Travel approvals and reimbursement. As prescribed at 2015.209-70(d), the contracting officer shall insert the following clause in cost reimbursement solicitations and contracts which require travel...

48 CFR 29.402-2 - Foreign cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Foreign cost-reimbursement... GENERAL CONTRACTING REQUIREMENTS TAXES Contract Clauses 29.402-2 Foreign cost-reimbursement contracts. (a) The contracting officer shall insert the clause at 52.229-8, Taxes—Foreign Cost-Reimbursement...

48 CFR 28.307 - Insurance under cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 28.307 Section 28.307 Federal Acquisition Regulations System FEDERAL ACQUISITION...-reimbursement contracts. Cost-reimbursement contracts (and subcontracts, if the terms of the prime contract are...

Casemix reimbursement: a Singapore Children's Hospital perspective.

Science.gov (United States)

Yoong, S L

2001-07-01

Casemix reimbursement was introduced to Singapore in October 1999 using the Australian National Diagnosis Related Groups Version 3.1 (AN-DRGs 3.1). The possible impact of this classification system on a Singapore Children's Hospital is discussed. Data on paediatric patients in KK Women's and Children's Hospital (KKH) were drawn from the inhouse Datamart warehouse system, and reviewed with regards to volume of patients, length of stay and charges. Several high cost categories were selected for a more in-depth review and discussed. The classification system and reimbursement method did not take into account the higher cost of treating children, thus penalising the Children's Hospital. The wide variety of cases treated also gave rise to difficulty in obtaining appropriate reimbursement. The lack of severity of illness measures was a drawback in the Diagnosis Related Group (DRG) for ventilated patients. The lack of outcome measures gave rise to potentially inequitable reimbursement in some high cost neonatal DRGs. While Casemix is an improvement over previous methods of providing Government funding in Singapore, particular aspects need to be reviewed, and reimbursement criteria refined to ensure equitable funding to Children's Hospital.

Annual report for the steering committee of the association Euratom-Belgian State for fusion 1996

Energy Technology Data Exchange (ETDEWEB)

Moons, F.; Bogaerts, W.; Decreton, M.; Biver, E.; Coenen, S.; Benoit, Ph.; Coheur, L.; Deboodt, P.; Andreev, D.

1996-09-01

This report is prepared for the annual steering committee meting of the Association Euratom - Belgian State for Fusion. The period October 1995 to September 1996 is reported on.The fusion technology work performed at the Belgian Nuclear Research Centre SCK/CEN, the Department of Metallurgy and Materials Engineering of the Louvain University (Belgium) and S.A. Gradel, a Luxemburg company, is described.

Annual report for the steering committee of the association Euratom-Belgian State for fusion 1996

International Nuclear Information System (INIS)

Moons, F.; Bogaerts, W.; Decreton, M.; Biver, E.; Coenen, S.; Benoit, Ph.; Coheur, L.; Deboodt, P.; Andreev, D.

1996-09-01

This report is prepared for the annual steering committee meting of the Association Euratom - Belgian State for Fusion. The period October 1995 to September 1996 is reported on.The fusion technology work performed at the Belgian Nuclear Research Centre SCK/CEN, the Department of Metallurgy and Materials Engineering of the Louvain University (Belgium) and S.A. Gradel, a Luxemburg company, is described

Emerging contaminants in Belgian marine waters: single toxicant and mixture risks of pharmaceuticals.

Science.gov (United States)

Claessens, Michiel; Vanhaecke, Lynn; Wille, Klaas; Janssen, Colin R

2013-06-15

Knowledge on the effects of pharmaceuticals on aquatic marine ecosystems is limited. The aim of this study was therefore to establish the effect thresholds of pharmaceutical compounds occurring in the Belgian marine environment for the marine diatom Phaeodactylum tricornutum, and subsequently perform an environmental risk assessment for these substances. Additionally, a screening-level risk assessment was performed for the pharmaceutical mixtures. No immediate risk for acute toxic effects of these compounds on P. tricornutum were apparent at the concentrations observed in the Belgian marine environment. In two Belgian coastal harbours however, a potential chronic risk was observed for the β-blocker propranolol. No additional risks arising from the exposure to mixtures of pharmaceuticals present in the sampling area could be detected. However, as risk characterization ratios for mixtures of up to 0.5 were observed, mixture effects could emerge should more compounds be taken into account. Copyright © 2013 Elsevier Ltd. All rights reserved.

48 CFR 2452.232-71 - Voucher submission (cost-reimbursement).

Science.gov (United States)

2010-10-01

...-reimbursement). 2452.232-71 Section 2452.232-71 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND... Clauses 2452.232-71 Voucher submission (cost-reimbursement). As prescribed in 2432.908(c)(2), insert a clause substantially the same as the following in all cost-reimbursement solicitations and contracts...

48 CFR 652.232-71 - Voucher Submission (Cost-Reimbursement).

Science.gov (United States)

2010-10-01

...-Reimbursement). 652.232-71 Section 652.232-71 Federal Acquisition Regulations System DEPARTMENT OF STATE CLAUSES... Voucher Submission (Cost-Reimbursement). As prescribed in 632.908(b), the contracting officer may insert a clause substantially the same as follows: Voucher Submission (Cost-Reimbursement) (AUG 1999) (a) General...

10 CFR 765.21 - Procedures for processing reimbursement claims.

Science.gov (United States)

2010-01-01

... Department shall complete a final review of all relevant information prior to making a reimbursement decision... 10 Energy 4 2010-01-01 2010-01-01 false Procedures for processing reimbursement claims. 765.21... AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.21...

7 CFR 215.8 - Reimbursement payments.

Science.gov (United States)

2010-01-01

... reimbursement for each half-pint (236 ml.) of milk served to children exceed the cost of the milk to the school or child care institution. (2) The rate of reimbursement for milk purchased and served free to needy... shall be the average cost of milk, i.e., the total cost of all milk purchased during the claim period...

Legal claims against Belgian reactors?; Rechtsmittel gegen belgische Reaktoren?

Energy Technology Data Exchange (ETDEWEB)

Raetzke, Christian [CONLAR Consulting on Nuclear Law and Regulation, Leipzig (Germany)

2016-06-15

The Belgian reactors Tihange 2 and Doel 3 have been restarted in November 2015 after the problem of hydrogen flakes in the reactor pressure vessels had been investigated. The permission to restart has been the object both of critical statements by the German Federal Ministry of the Environment (BMUB) and of lawsuits filed with Belgian law courts by a group of German municipalities led by the city of Aachen and by the Land North-Rhine-Westphalia. According to a general principle of the law of nations, a state is not permitted to operate installations near its border, which cause significant environmental damage in a neighbouring state. However, it is not quite clear how this principle applies to the issue of potential accidents of nuclear power plants. According to the author, a tangible threat of an accident is required; mere doubts and concerns about the extent of safety margins are not sufficient.

New Drug Reimbursement and Pricing Policy in Taiwan.

Science.gov (United States)

Chen, Gau-Tzu; Chang, Shu-Chen; Chang, Chee-Jen

2018-05-01

Taiwan has implemented a national health insurance system for more than 20 years now. The benefits of pharmaceutical products and new drug reimbursement scheme are determined by the Expert Advisory Meeting and the Pharmaceutical Benefit and Reimbursement Scheme (PBRS) Joint Committee in Taiwan. To depict the pharmaceutical benefits and reimbursement scheme for new drugs and the role of health technology assessment (HTA) in drug policy in Taiwan. All data were collected from the Expert Advisory Meeting and the PBRS meeting minutes; new drug applications with HTA reports were derived from the National Health Insurance Administration Web site. Descriptive statistics were used to analyze the timeline of a new drug from application submission to reimbursement effective, the distribution of approved price, and the approval rate for a new drug with/without local pharmacoeconomic study. After the second-generation national health insurance system, the timeline for a new drug from submission to reimbursement effective averages at 436 days, and that for an oncology drug reaches an average of 742 days. New drug approval rate is 67% and the effective rate (through the approval of the PBRS Joint Committee and the acceptance of the manufacturer) is 53%. The final approved price is 53.6% of the international median price and 70% of the proposed price by the manufacturer. Out of 95 HTA reports released during the period January 2011 to February 2017, 28 applications (30%) conducted an HTA with a local pharmacoeconomic study, and all (100%) received reimbursement approval. For the remaining 67 applications (70%) for which HTA was conducted without a local pharmacoeconomic analysis, 54 cases (81%) were reimbursed. New drug applications with local pharmacoeconomic studies are more likely to get reimbursement. Copyright © 2018. Published by Elsevier Inc.

44 CFR 206.8 - Reimbursement of other Federal agencies.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement of other... Reimbursement of other Federal agencies. (a) Assistance furnished under § 206.5 (a) or (b) of this subpart may... Administrator or the Regional Director may not approve reimbursement of costs incurred while performing work...

Risk-return of Belgian SRI funds

OpenAIRE

Van Liedekerke, Luc; De Moor, Lieven; Vanwalleghem, Dieter

2007-01-01

We analyse the risk-return profile of Belgian SRI funds versus conventional investment funds. We apply a four-factor conditional Carhart model to establish whether there are significant differences in risk-return profile between an SRI portfolio and a conventional portfolio and test for learning effects in SRI funds. We show that there is no difference in risk-return profile between SRI and conventional funds. If return is not the problem, then what is it that limits the development of an SRI...

[Pharmaco-economics: a point of view of the mutualities].

Science.gov (United States)

Legrand, D; Simon, I

1998-05-01

In Belgium, the mutualities are responsible for their budgets. They are playing an important role in drug pricing and reimbursement procedures. This document aims at explaining our line of arguments for a critical evaluation and the place for a pharmacoeconomic evaluation in the Belgian social security system. The available economic data for each molecule or pathology are essential but insufficient. Economic evaluations could help to reveal the costs and benefits of different uses of medical therapies and could thereby enhance the resources allocation in a health care system. But this science is still in its infancy, and in practice, the methodological quality of this kind of study is often weak. Furthermore it is not easy to transfer those evaluations to the Belgian reimburse systems. The clinical efficacy and the transparency is price setting should remain the two most important criterions to build reimbursement rules in order to ensure right price, rational use of medicine and accessibility for all.

44 CFR 208.40 - Reimbursement of fringe benefit costs during Activation.

Science.gov (United States)

2010-10-01

... reimbursement sought from DHS. (c) DHS will not reimburse the Sponsoring Agency for fringe benefit costs for... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement of fringe... RESCUE RESPONSE SYSTEM Response Cooperative Agreements § 208.40 Reimbursement of fringe benefit costs...

Development of clinical pharmacy in Belgian hospitals through pilot projects funded by the government.

Science.gov (United States)

Somers, A; Spinewine, A; Spriet, I; Steurbaut, S; Tulkens, P; Hecq, J D; Willems, L; Robays, H; Dhoore, M; Yaras, H; Vanden Bremt, I; Haelterman, M

2018-04-30

Objectives The goal is to develop clinical pharmacy in the Belgian hospitals to improve drug efficacy and to reduce drug-related problems. Methods From 2007 to 2014, financial support was provided by the Belgian federal government for the development of clinical pharmacy in Belgian hospitals. This project was guided by a national Advisory Working Group. Each funded hospital was obliged to describe yearly its clinical pharmacy activities. Results In 2007, 20 pharmacists were funded in 28 pilot hospitals; this number was doubled in 2009 to 40 pharmacists over 54 institutions, representing more than half of all acute Belgian hospitals. Most projects (72%) considered patient-related activities, whereas some projects (28%) had a hospital-wide approach. The projects targeted patients at admission (30%), during hospital stay (52%) or at discharge (18%). During hospital stay, actions were mainly focused on geriatric patients (20%), surgical patients (15%), and oncology patients (9%). Experiences, methods, and tools were shared during meetings and workshops. Structure, process, and outcome indicators were reported and strengths, weaknesses, opportunities, and threats were described. The yearly reports revealed that the hospital board was engaged in the project in 87% of the cases, and developed a vision on clinical pharmacy in 75% of the hospitals. In 2014, the pilot phase was replaced by structural financing for clinical pharmacy in all acute Belgian hospitals. Conclusion The pilot projects in clinical pharmacy funded by the federal government provided a unique opportunity to launch clinical pharmacy activities on a broad scale in Belgium. The results of the pilot projects showed clear implementation through case reports, time registrations, and indicators. Tools for clinical pharmacy activities were developed to overcome identified barriers. The engagement of hospital boards and the results of clinical pharmacy activities persuaded the government to start structural

Trends in Medicare Reimbursement for Orthopedic Procedures: 2000 to 2016.

Science.gov (United States)

Eltorai, Adam E M; Durand, Wesley M; Haglin, Jack M; Rubin, Lee E; Weiss, Arnold-Peter C; Daniels, Alan H

2018-03-01

Understanding trends in reimbursement is critical to the financial sustainability of orthopedic practices. Little research has examined physician fee trends over time for orthopedic procedures. This study evaluated trends in Medicare reimbursements for orthopedic surgical procedures. The Medicare Physician Fee Schedule was examined for Current Procedural Terminology code values for the most common orthopedic and nonorthopedic procedures between 2000 and 2016. Prices were adjusted for inflation to 2016-dollar values. To assess mean growth rate for each procedure and subspecialty, compound annual growth rates were calculated. Year-to-year dollar amount changes were calculated for each procedure and subspecialty. Reimbursement trends for individual procedures and across subspecialties were compared. Between 2000 and 2016, annual reimbursements decreased for all orthopedic procedures examined except removal of orthopedic implant. The orthopedic procedures with the greatest mean annual decreases in reimbursement were shoulder arthroscopy/decompression, total knee replacement, and total hip replacement. The orthopedic procedures with the least annual reimbursement decreases were carpal tunnel release and repair of ankle fracture. Rate of Medicare procedure reimbursement change varied between subspecialties. Trauma had the smallest decrease in annual change compared with spine, sports, and hand. Annual reimbursement decreased at a significantly greater rate for adult reconstruction procedures than for any of the other subspecialties. These findings indicate that reimbursement for procedures has steadily decreased, with the most rapid decrease seen in adult reconstruction. [Orthopedics. 2018; 41(2):95-102.]. Copyright 2018, SLACK Incorporated.

48 CFR 416.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 416.405 Section 416.405 Federal Acquisition Regulations System DEPARTMENT OF...-reimbursement incentive contracts. ...

An analysis of Belgian Cannabis Social Clubs' supply practices: A shapeshifting model?

Science.gov (United States)

Pardal, Mafalda

2018-04-13

Cannabis Social Clubs (CSCs) are associations of cannabis users that collectively organize the cultivation and distribution of cannabis. As this middle ground supply model has been active in Belgium for over a decade, this paper aims to examine CSCs' supply practices, noting any shifts from previously reported features of the model. We draw on interviews with directors of seven currently active Belgian CSCs (n = 21) and their cannabis growers (n = 23). This data was complemented by additional fieldwork, as well as a review of CSCs' key internal documents. Most Belgian CSCs are formally registered non-profit associations. One of the Belgian CSCs has developed a structure of sub-divisions and regional chapters. The Belgian CSCs supply cannabis to members only, and in some cases only medical users are admitted. CSCs rely on in-house growers, ensuring supply in a cooperative and closed-circuit way, despite changes to the distribution methods The associations are relatively small-scale and non-commercially driven. The introduction of formal quality control practices remains challenging. As the CSC model is often included in discussions about cannabis policy, but remains in most cases driven by self-regulatory efforts, it is important to take stock of how CSCs' supply function has been implemented in practice - as doing so will improve our understanding of the model and of the wider range of cannabis 'supply architectures'. This paper highlights the continuity and changes in CSC practices, noting the emergence of several different variants of the CSC model, which are classified in a first CSC typology. Copyright © 2018 Elsevier B.V. All rights reserved.

HEALTH INSURANCE: FIXED CONTRIBUTION AND REIMBURSEMENT MAXIMA

CERN Document Server

Human Resources Division

2001-01-01

Affected by the salary adjustments on 1 January 2001 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maxima, has changed significantly. An adjustment of the amounts of the reimbursement maxima and the fixed contributions is therefore necessary, as from 1 January 2001. Reimbursement maxima The revised reimbursement maxima will appear on the leaflet summarizing the benefits for the year 2001, which will be sent out with the forthcoming issue of the CHIS Bull'. This leaflet will also be available from the divisional secretariats and from the UNIQA office at CERN. Fixed contributions The fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions) : voluntarily insured member of the personnel, with normal health insurance cover : 910.- (was 815.- in 2000) voluntarily insured member of the personnel, with reduced heal...

48 CFR 46.308 - Cost-reimbursement research and development contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement... ACQUISITION REGULATION CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 46.308 Cost-reimbursement... of Research and Development—Cost-Reimbursement, in solicitations and contracts for research and...

44 CFR 63.6 - Reimbursable relocation costs.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursable relocation costs. 63.6 Section 63.6 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... OF SECTION 1306(c) OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 General § 63.6 Reimbursable relocation...

7 CFR 3015.104 - Requesting advances or reimbursements.

Science.gov (United States)

2010-01-01

... outlays for the month covered. These estimates shall be made on a cash basis, even if the recipient uses an accrual accounting system. (b) Reimbursements. If payments are made through reimbursement or by...

Application of American and French rules for the next belgian PWR

International Nuclear Information System (INIS)

Roch, M.; Cavaco, A.

1987-01-01

The licensing practice in Belgium is evolving from the precedent compliance with the USNRC rules (as applied to the 4 last Belgian PWRs) to a more sophisticated approach applied to the next Belgian PWR (N8), which incorporates a mixed compliance with the USNRC or with French rules, depending on the equipment, the structure or the system considered. In this paper, we present the approach concerning the licensing rules applicable to N8. The following aspects are covered: rules applicable to the NSSS; rules applicable to the BOP (codes of design for systems and structures); rules applicable to the equipment (code of construction for mechanical and electrical components); impact on the lay-out of the plant. Some examples of application of this methodology are given. (author)

48 CFR 49.603-5 - Cost-reimbursement contracts-partial termination.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement....603-5 Cost-reimbursement contracts—partial termination. [Insert the following in Block 14 of SF 30, Amendment of Solicitation/Modification of Contract, for settlement agreements for cost-reimbursement...

5 CFR 2634.304 - Gifts and reimbursements.

Science.gov (United States)

2010-01-01

... manners: (1) If the gift has been newly purchased or is readily available in the market, the value shall... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Gifts and reimbursements. 2634.304....304 Gifts and reimbursements. (a) Gifts. Except as indicated in § 2634.308(b), each financial...

48 CFR 216.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 216.405 Section 216.405 Federal Acquisition Regulations System DEFENSE ACQUISITION... Contracts 216.405 Cost-reimbursement incentive contracts. ...

48 CFR 52.246-5 - Inspection of Services-Cost-Reimbursement.

Science.gov (United States)

2010-10-01

...-Cost-Reimbursement. 52.246-5 Section 52.246-5 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-5 Inspection of Services—Cost-Reimbursement. As prescribed in 46.305, insert... furnishing of services, when a cost-reimbursement contract is contemplated: Inspection of Services—Cost...

48 CFR 52.246-3 - Inspection of Supplies-Cost-Reimbursement.

Science.gov (United States)

2010-10-01

...-Cost-Reimbursement. 52.246-3 Section 52.246-3 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-3 Inspection of Supplies—Cost-Reimbursement. As prescribed in 46.303, insert... furnishing of supplies, when a cost-reimbursement contract is contemplated: Inspection of Supplies—Cost...

Generic atorvastatin, the Belgian statin market and the cost-effectiveness of statin therapy.

Science.gov (United States)

Simoens, Steven; Sinnaeve, Peter R

2013-02-01

This study examines how the market entry of generic atorvastatin influences the Belgian statin market and the cost-effectiveness of statin therapy. Using IMS Health data, the Belgian 2000-2011 statin market was analyzed in terms of total expenditure, annual price of statin treatment, and patient numbers. A simulation analysis projected statin market shares from 2012 to 2015 following market entry of generic atorvastatin. This analysis was based on three scenarios regarding the number of patients taking specific statins. Savings associated with an atorvastatin price reduction of 50-70 % were calculated. A literature review of economic evaluations assessed the cost-effectiveness of generic atorvastatin. Statin expenditure increased from €113 million in 2000 to €285 million in 2011 due to higher expenditure on atorvastatin and rosuvastatin. Although the number of patients treated with simvastatin increased by nearly 800 %, the resulting increase in expenditure was partially offset by price reductions. Atorvastatin is projected to become the dominant product in the Belgian statin market (market share of 47-66 % by 2015). Annual savings would attain €108.6-€153.7 million for a 50 % reduction in the atorvastatin price and €152.0-€215.2 million for a 70 % price reduction. The literature suggests that generic atorvastatin is cost-effective as compared to simvastatin. The limited evidence about the cost-effectiveness of rosuvastatin as compared with generic atorvastatin is inconclusive. Generic atorvastatin is cost-effective as compared to simvastatin, is projected to become the dominant product in the Belgian statin market and is expected to generate substantial savings to health care payers.

An Analysis of Medicare Reimbursement to Ophthalmologists: Years 2012 to 2013.

Science.gov (United States)

Han, Everett; Baisiwala, Shivani; Jain, Atul; Bundorf, M Kate; Pershing, Suzann

2017-10-01

To analyze trends in utilization and payment of ophthalmic services in the Medicare population for years 2012 and 2013. Retrospective, cross-sectional study. A retrospective cross-sectional observational analysis was performed using publicly available Medicare Physician and Other Supplier aggregate file and the Physician and Other Supplier Public Use File. Variables analyzed included aggregate beneficiary demographics, Medicare payments to ophthalmologists, ophthalmic medical services provided, and the most common Medicare-reimbursed ophthalmic services. In 2013, total Medicare Part B reimbursement for ophthalmology was $5.8 billion, an increase of 3.6% from the previous year. From 2012 to 2013, the total number of ophthalmology services rendered increased by 2.2%, while average dollar amount reimbursed per ophthalmic service decreased by 5.4%. The top 5 highest reimbursed services accounted for 85% of total ophthalmic Medicare payments in 2013, an 11% increase from 2012. During 2013, drug reimbursement represented 32.8% of the total Medicare payments to ophthalmologists. Ranibizumab and aflibercept alone accounted for 95% of the entire $1.9 billion in drug reimbursements ophthalmologists in 2013. Medicare Part B reimbursement for ophthalmologists was primarily driven by use of anti-vascular endothelial growth factor (anti-VEGF) injections from 2012 to 2013. Of the total drug payments to ophthalmologists, biologic anti-VEGF agents ranibizumab and aflibercept accounted for 95% of all drug reimbursement. This is in contrast to other specialties, in which drug reimbursement represented only a small portion of Medicare reimbursement. Published by Elsevier Inc.

A Cohort Analysis of Postbariatric Panniculectomy--Current Trends in Surgeon Reimbursement.

Science.gov (United States)

Aherrera, Andrew S; Pandya, Sonal N

2016-01-01

The overall number of patients undergoing body contouring procedures after massive weight loss (MWL) has progressively increased over the past decade. The purpose of this study was to evaluate the charges and reimbursements for panniculectomy after MWL at a large academic institution in Massachusetts. A retrospective review was performed and included all identifiable panniculectomy procedures performed at our institution between January 2008 and January 2014. The annual number of patients undergoing panniculectomy, the type of insurance coverage and reimbursement method of each patient, and the amounts billed and reimbursed were evaluated. During our study period, 114 patients underwent a medically necessary panniculectomy as a result of MWL. The average surgeon fee billed was $3496 ± $704 and the average amount reimbursed was $1271 ± $589. Ten cases (8.8%) had no reimbursements, 31 cases (21.8%) reimbursed less than $1000, 66 cases (57.9%) reimbursed between $1000 and $2000, and no cases reimbursed the full amount billed. When evaluated by type of insurance coverage, collection ratios were 37.4% ± 17.4% overall, 41.7% ± 16.4% for private insurance, and 24.0% ± 13.0% for Medicare/Medicaid insurance (P Reimbursements for panniculectomy are remarkably low, and in many instances, absent, despite obtaining previous preauthorization of medical necessity. Although panniculectomy is associated with improvements in quality of life and high levels of patient satisfaction, poor physician reimbursement for this labor intensive procedure may preclude access to appropriate care required by the MWL patient population.

Reimbursement of school fees

CERN Multimedia

2003-01-01

Members of the personnel are reminded that only school fees from educational establishments recognized by local legislation are reimbursed by the Organization. Human Resources Division Tel. 72862/74474

Vertical integration and optimal reimbursement policy.

Science.gov (United States)

Afendulis, Christopher C; Kessler, Daniel P

2011-09-01

Health care providers may vertically integrate not only to facilitate coordination of care, but also for strategic reasons that may not be in patients' best interests. Optimal Medicare reimbursement policy depends upon the extent to which each of these explanations is correct. To investigate, we compare the consequences of the 1997 adoption of prospective payment for skilled nursing facilities (SNF PPS) in geographic areas with high versus low levels of hospital/SNF integration. We find that SNF PPS decreased spending more in high integration areas, with no measurable consequences for patient health outcomes. Our findings suggest that integrated providers should face higher-powered reimbursement incentives, i.e., less cost-sharing. More generally, we conclude that purchasers of health services (and other services subject to agency problems) should consider the organizational form of their suppliers when choosing a reimbursement mechanism.

Clay 2001 dossier: progress report on feasibility studies and research into deep geological disposal of high-level, long-lived waste; Dossier 2001 argile: sur l'avancement des etudes et recherches relatives a la faisabilite d'un stockage de dechets a haute activite et a vie longue en formation geologique profonde

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-12-01

A French Act of Parliament passed on 30 December 1991 set out the main areas of research required to prepare solutions for the long-term management of high-level, long-lived radioactive waste. The three avenues of research listed in the Act included a feasibility study of the deep geological disposal of these waste, with responsibility for steering the study given to ANDRA, France National Agency for Radioactive Waste Management. Following government decisions taken in 1998, the study focused on two types of geological medium, clay and granite. The clay formations study is essentially based on results from an underground laboratory sited at the border between the Meuse and Haute-Marne departments, where the Callovo-Oxfordian argillite beds are being investigated. No site has yet been chosen for an underground laboratory for the granite study, so for the time being this will draw on generic work and on research carried out in laboratories outside France. ANDRA has decided to present an initial report on the results of its research programme, publishing a dossier on the work on clay formations in 2001 with a second dossier covering the work on granite due for release in 2002. This dossier is thus a review of the work carried out by ANDRA on the feasibility study into a radioactive waste repository in a clay formation. It represents one step in a process of studies and research work leading up to the submission of a report due in 2005 containing ANDRA conclusions on the feasibility of a repository in the clay formation. (author)

48 CFR 52.229-8 - Taxes-Foreign Cost-Reimbursement Contracts.

Science.gov (United States)

2010-10-01

...-Reimbursement Contracts. 52.229-8 Section 52.229-8 Federal Acquisition Regulations System FEDERAL ACQUISITION... Clauses 52.229-8 Taxes—Foreign Cost-Reimbursement Contracts. As prescribed in 29.402-2(a), insert the following clause: Taxes—Foreign Cost-Reimbursement Contracts (MAR 1990) (a) Any tax or duty from which the...

75 FR 62348 - Reimbursement Offsets for Medical Care or Services

Science.gov (United States)

2010-10-08

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN55 Reimbursement Offsets for Medical Care... Veterans Affairs (VA) proposes to amend its regulations concerning the reimbursement of medical care and... situations where third-party payers are required to reimburse VA for costs related to care provided by VA to...

48 CFR 252.228-7000 - Reimbursement for war-hazard losses.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Reimbursement for war... CLAUSES Text of Provisions And Clauses 252.228-7000 Reimbursement for war-hazard losses. As prescribed in 228.370(a), use the following clause: Reimbursement for War-Hazard Losses (DEC 1991) (a) Costs for...

Pricing and Reimbursement of Biosimilars in Central and Eastern European Countries

Science.gov (United States)

Kawalec, Paweł; Stawowczyk, Ewa; Tesar, Tomas; Skoupa, Jana; Turcu-Stiolica, Adina; Dimitrova, Maria; Petrova, Guenka I.; Rugaja, Zinta; Männik, Agnes; Harsanyi, Andras; Draganic, Pero

2017-01-01

Objectives: The aim of this study was to review the requirements for the reimbursement of biosimilars and to compare the reimbursement status, market share, and reimbursement costs of biosimilars in selected Central and Eastern European (CEE) countries. Methods: A questionnaire-based survey was conducted between November 2016 and January 2017 among experts from the following CEE countries: Bulgaria, Czech Republic, Croatia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Romania. The requirements for the pricing and reimbursement of biosimilars were reviewed for each country. Data on the extent of reimbursement of biologic drugs (separately for original products and biosimilars) in the years 2014 and 2015 were also collected for each country, along with data on the total pharmaceutical and total public health care budgets. Results: Our survey revealed that no specific criteria were applied for the pricing and reimbursement of biosimilars in the selected CEE countries; the price of biosimilars was usually reduced compared with original drugs and specific price discounts were common. Substitution and interchangeability were generally allowed, although in most countries they were at the discretion of the physician after a clinical assessment. Original biologic drugs and the corresponding biosimilars were usually in the same homogeneous group, and internal reference pricing was usually employed. The reimbursement rate of biosimilars in the majority of the countries was the same and amounted to 100%. Generally, the higher shares of expenditures were shown for the reimbursement of original drugs than for biosimilars, except for filgrastim, somatropin, and epoetin (alfa and zeta). The shares of expenditures on the reimbursement of biosimilar products ranged from 8.0% in Estonia in 2014 to 32.4% in Lithuania in 2015, and generally increased in 2015. The share of expenditures on reimbursement of biosimilars in the total pharmaceutical budget differed between the

The impact of gendered friendship patterns on the prevalence of homophobia among belgian late adolescents.

Science.gov (United States)

Hooghe, Marc

2011-06-01

In order to assess the determinants of homophobia among Belgian adolescents, a shortened version of the Homophobia scale (Wright et al., 1999) was included in a representative survey among Belgian adolescents (n = 4,870). Principal component analysis demonstrated that the scale was one-dimensional and internally coherent. The results showed that homophobia is still widespread among Belgian adolescents, despite various legal reforms in the country aiming to combat discrimination of gay women and men. A multivariate regression analysis demonstrated that boys, ethnic minorities, individuals with high levels of ethnocentrism and an instrumental worldview, Muslim minorities, and those with low levels of associational involvement scored significantly higher on the scale. While among boys an extensive friendship network was associated with higher levels of homophobia, the opposite phenomenon was found among girls. We discuss the possible relation between notions of masculinity within predominantly male adolescent friendship networks and social support for homophobia.

45 CFR 2552.46 - What cost reimbursements are provided to Foster Grandparents?

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false What cost reimbursements are provided to Foster..., Status and Cost Reimbursements § 2552.46 What cost reimbursements are provided to Foster Grandparents? Cost reimbursements include: (a) Stipend. Foster Grandparents who are income eligible will receive a...

Drug reimbursement and GPs' prescribing decisions: a randomized case-vignette study about the pharmacotherapy of obesity associated with type 2 diabetes: how GPs react to drug reimbursement.

Science.gov (United States)

Verger, Pierre; Rolland, Sophie; Paraponaris, Alain; Bouvenot, Julien; Ventelou, Bruno

2010-08-01

This study sought to identify the effect of drug reimbursability--a decision made in France by the National Authority for Health--on physicians' prescribing practices for a diet drug such as rimonabant, approved for obese or overweight patients with type-2 diabetes. A cross-sectional survey of French general practitioners (GPs) presented a case-vignette about a patient for whom this drug is indicated in two alternative versions, differing only in its reimbursability, to two separate randomized subsamples of GPs in early 2007, before any decision was made about reimbursement. The results indicate that (i) more than 20% of GPs in private practice would be willing to prescribe a non-reimbursed diet drug for patients with obesity complicated by type 2 diabetes; (ii) the number of GPs willing to prescribe it would increase by 47.6% if the drug were reimbursed, and (iii) such a drug would be adopted at a higher rate by GPs who have regular contacts with pharmaceutical sales representatives. In France, unlike most other countries, drug reimbursement status is a signal of quality. However, our results suggest that a significant proportion of GPs would spontaneously adopt anti-obesity drugs even if they were not reimbursed. Decisions about reimbursement of pharmaceutical products should be made taking into account that reimbursement is likely to intensify prescription.

Impact of a VAP bundle in Belgian intensive care units.

Science.gov (United States)

Jadot, Laurent; Huyghens, Luc; De Jaeger, Annick; Bourgeois, Marc; Biarent, Dominique; Higuet, Adeline; de Decker, Koen; Vander Laenen, Margot; Oosterlynck, Baudewijn; Ferdinande, Patrick; Reper, Pascal; Brimioulle, Serge; Van Cromphaut, Sophie; De Clety, Stéphane Clement; Sottiaux, Thierry; Damas, Pierre

2018-05-21

In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients. For each of these, data about the application of the bundle and the possible treatment for VAP were recorded. Between 36.6 and 54.8% of the 120 Belgian ICUs participated in the successive surveys. While the characteristics of ventilated patients remained similar throughout the years, the percentage of ventilated patients and especially the duration of ventilation significantly decreased before and after the national VAP bundle campaign. Ventilator care also profoundly changed: Controlling cuff pressure, head positioning above 30° were obtained in more than 90% of cases. Oral care was more frequently performed within a day, using more concentrated solutions of chlorhexidine. Subglottic suctioning also was used but in only 24.7% of the cases in the last years. Regarding the prevalence of VAP, it significantly decreased from 28% of ventilated patients in 2010 to 10.1% in 2016 (p ≤ 0.0001). Although a causal relationship cannot be inferred from these data, the successive surveys revealed a potential impact of the VAP bundle campaign on both the respiratory care of ventilated patients and the prevalence of VAP in Belgian ICUs encouraging them to follow the guidelines.

45 CFR 1609.5 - Acceptance of reimbursement from a client.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Acceptance of reimbursement from a client. 1609.5... CORPORATION FEE-GENERATING CASES § 1609.5 Acceptance of reimbursement from a client. (a) When a case results in recovery of damages or statutory benefits, a recipient may accept reimbursement from the client...

45 CFR 2553.43 - What cost reimbursements are provided to RSVP volunteers?

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false What cost reimbursements are provided to RSVP... Reimbursements and Volunteer Assignments § 2553.43 What cost reimbursements are provided to RSVP volunteers? RSVP volunteers are provided the following cost reimbursements within the limits of the project's available...

45 CFR 2551.46 - What cost reimbursements are provided to Senior Companions?

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false What cost reimbursements are provided to Senior..., and Cost Reimbursements § 2551.46 What cost reimbursements are provided to Senior Companions? Cost reimbursements include: (a) Stipend. Senior Companions who are income eligible will receive a stipend in an...

48 CFR 1316.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 1316.405 Section 1316.405 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 1316.405 Cost-reimbursement...

48 CFR 916.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 916.405 Section 916.405 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 916.405 Cost-reimbursement...

International comparison of the factors influencing reimbursement of targeted anti-cancer drugs.

Science.gov (United States)

Lim, Carol Sunghye; Lee, Yun-Gyoo; Koh, Youngil; Heo, Dae Seog

2014-11-29

Reimbursement policies for anti-cancer drugs vary among countries even though they rely on the same clinical evidence. We compared the pattern of publicly funded drug programs and analyzed major factors influencing the differences. We investigated reimbursement policies for 19 indications with targeted anti-cancer drugs that are used variably across ten countries. The available incremental cost-effectiveness ratio (ICER) data were retrieved for each indication. Based on the comparison between actual reimbursement decisions and the ICERs, we formulated a reimbursement adequacy index (RAI): calculating the proportion of cost-effective decisions, either reimbursement of cost-effective indications or non-reimbursement of cost-ineffective indications, out of the total number of indications for each country. The relationship between RAI and other indices were analyzed, including governmental dependency on health technology assessment, as well as other parameters for health expenditure. All the data used in this study were gathered from sources publicly available online. Japan and France were the most likely to reimburse indications (16/19), whereas Sweden and the United Kingdom were the least likely to reimburse them (5/19 and 6/19, respectively). Indications with high cost-effectiveness values were more likely to be reimbursed (ρ = -0.68, P = 0.001). The three countries with high RAI scores each had a healthcare system that was financed by general taxation. Although reimbursement policies for anti-cancer drugs vary among countries, we found a strong correlation of reimbursements for those indications with lower ICERs. Countries with healthcare systems financed by general taxation demonstrated greater cost-effectiveness as evidenced by reimbursement decisions of anti-cancer drugs.

Vitamin D inadequacy in Belgian postmenopausal osteoporotic women

Directory of Open Access Journals (Sweden)

Collette Julien

2007-04-01

Full Text Available Abstract Background Inadequate serum vitamin D [25(OHD] concentrations are associated with secondary hyperparathyroidism, increased bone turnover and bone loss, which increase fracture risk. The objective of this study is to assess the prevalence of inadequate serum 25(OHD concentrations in postmenopausal Belgian women. Opinions with regard to the definition of vitamin D deficiency and adequate vitamin D status vary widely and there are no clear international agreements on what constitute adequate concentrations of vitamin D. Methods Assessment of 25-hydroxyvitamin D [25(OHD] and parathyroid hormone was performed in 1195 Belgian postmenopausal women aged over 50 years. Main analysis has been performed in the whole study population and according to the previous use of vitamin D and calcium supplements. Four cut-offs of 25(OHD inadequacy were fixed : Results Mean (SD age of the patients was 76.9 (7.5 years, body mass index was 25.7 (4.5 kg/m2. Concentrations of 25(OHD were 52.5 (21.4 nmol/L. In the whole study population, the prevalence of 25(OHD inadequacy was 91.3 %, 87.5 %, 43.1 % and 15.9% when considering cut-offs of 80, 75, 50 and 30 nmol/L, respectively. Women who used vitamin D supplements, alone or combined with calcium supplements, had higher concentrations of 25(OHD than non-users. Significant inverse correlations were found between age/serum PTH and serum 25(OHD (r = -0.23/r = -0.31 and also between age/serum PTH and femoral neck BMD (r = -0.29/r = -0.15. There is a significant positive relation between age and PTH (r = 0.16, serum 25(OHD and femoral neck BMD (r = 0.07. (P Vitamin D concentrations varied with the season of sampling but did not reach statistical significance (P = 0.09. Conclusion This study points out a high prevalence of vitamin D inadequacy in Belgian postmenopausal osteoporotic women, even among subjects receiving vitamin D supplements.

Florida's model of nursing home Medicaid reimbursement for disaster-related expenses.

Science.gov (United States)

Thomas, Kali S; Hyer, Kathryn; Brown, Lisa M; Polivka-West, LuMarie; Branch, Laurence G

2010-04-01

This study describes Florida's model of Medicaid nursing home (NH) reimbursement to compensate NHs for disaster-related expenses incurred as a result of 8 hurricanes within a 2-year period. This Florida model can serve as a demonstration for a national model for disaster-related reimbursement. Florida reimburses NHs for approved disaster-related costs through hurricane interim rate requests (IRRs). The state developed its unique Medicaid per diem rate temporary add-on by adapting its standard rate-setting reimbursement methodology. To understand the payment mechanisms and the costs that facilities incurred as a result of natural disasters, we examined the IRRs and cost reports for facilities requesting and receiving reimbursement. Cost reports and IRR applications indicated that Florida Medicaid spent close to $16 million to pay for hurricane-related costs to NHs. Without Florida's Hurricane IRR program, many facilities would have not been reimbursed for their hurricane-related costs. Florida's model is one that Medicare and other states should consider adopting to ensure that NHs receive adequate reimbursement for disaster-related expenses, including tornadoes, earthquakes, floods, blizzards, and other catastrophic events.

48 CFR 1816.405 - Cost-reimbursement incentive contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost-reimbursement incentive contracts. 1816.405 Section 1816.405 Federal Acquisition Regulations System NATIONAL AERONAUTICS... 1816.405 Cost-reimbursement incentive contracts. [62 FR 3478, Jan. 23, 1997. Redesignated at 62 FR...

Timing of Clinical Billing Reimbursement for a Local Health Department.

Science.gov (United States)

McCullough, J Mac

2016-01-01

A major responsibility of a local health department (LHD) is to assure public health service availability throughout its jurisdiction. Many LHDs face expanded service needs and declining budgets, making billing for services an increasingly important strategy for sustaining public health service provision. Yet, little practice-based data exist to guide practitioners on what to expect financially, especially regarding timing of reimbursement receipt. This study provides results from one LHD on the lag from service delivery to reimbursement receipt. Reimbursement records for all transactions at Maricopa County Department of Public Health immunization clinics from January 2013 through June 2014 were compiled and analyzed to determine the duration between service and reimbursement. Outcomes included daily and cumulative revenues received. Time to reimbursement for Medicaid and private payers was also compared. Reimbursement for immunization services was received a median of 68 days after service. Payments were sometimes taken back by payers through credit transactions that occurred a median of 333 days from service. No differences in time to reimbursement between Medicaid and private payers were found. Billing represents an important financial opportunity for LHDs to continue to sustainably assure population health. Yet, the lag from service provision to reimbursement may complicate budgeting, especially in initial years of new billing activities. Special consideration may be necessary to establish flexibility in the budget-setting processes for services with clinical billing revenues, because funds for services delivered in one budget period may not be received in the same period. LHDs may also benefit from exploring strategies used by other delivery organizations to streamline billing processes.

49 CFR 599.303 - Agency disposition of dealer application for reimbursement.

Science.gov (United States)

2010-10-01

... reimbursement. 599.303 Section 599.303 Transportation Other Regulations Relating to Transportation (Continued... PROCEDURES FOR CONSUMER ASSISTANCE TO RECYCLE AND SAVE ACT PROGRAM Qualifying Transactions and Reimbursement § 599.303 Agency disposition of dealer application for reimbursement. (a) Application review. Upon...

48 CFR 428.307 - Insurance under cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 428.307 Section 428.307 Federal Acquisition Regulations System DEPARTMENT OF...-reimbursement contracts. ...

Psychometric properties of the Belgian coach version of the coach-athlete relationship questionnaire (CART-Q).

Science.gov (United States)

Balduck, A-L; Jowett, S

2010-10-01

The study examined the psychometric properties of the Belgian coach version of the Coach-Athlete Relationship Questionnaire (CART-Q). The questionnaire includes three dimensions (Closeness, Commitment, and Complementarity) in a model that intends to measure the quality of the coach-athlete relationship. Belgian coaches (n=144) of athletes who performed at various competition levels in such sports as football, basketball, and volleyball responded to the CART-Q and to the Leadership Scale for Sport (LSS). A confirmatory factor analysis proved to be slightly more satisfactory for a three-order factor model, compared with a hierarchical first-order factor model. The three factors showed acceptable internal consistency scores. Moreover, functional associations between the three factors and coach leadership behaviors were found offering support to the instrument's concurrent validity. The findings support previous validation studies and verify the psychometric properties of the CART-Q applied to Belgian coaches of team sports. © 2009 John Wiley & Sons A/S.

47 CFR 27.1233 - Reimbursement costs of transitioning.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement costs of transitioning. 27.1233 Section 27.1233 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Policies Governing the Transition of the 2500-2690 Mhz Band for Brs and Ebs § 27.1233 Reimbursement costs...

Clay 2001 dossier: progress report on feasibility studies and research into deep geological disposal of high-level, long-lived waste; Dossier 2001 argile: sur l'avancement des etudes et recherches relatives a la faisabilite d'un stockage de dechets a haute activite et a vie longue en formation geologique profonde

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-12-01

A French Act of Parliament passed on 30 December 1991 set out the main areas of research required to prepare solutions for the long-term management of high-level, long-lived radioactive waste. The three avenues of research listed in the Act included a feasibility study of the deep geological disposal of these waste, with responsibility for steering the study given to ANDRA, France National Agency for Radioactive Waste Management. Following government decisions taken in 1998, the study focused on two types of geological medium, clay and granite. The clay formations study is essentially based on results from an underground laboratory sited at the border between the Meuse and Haute-Marne departments, where the Callovo-Oxfordian argillite beds are being investigated. No site has yet been chosen for an underground laboratory for the granite study, so for the time being this will draw on generic work and on research carried out in laboratories outside France. ANDRA has decided to present an initial report on the results of its research programme, publishing a dossier on the work on clay formations in 2001 with a second dossier covering the work on granite due for release in 2002. This dossier is thus a review of the work carried out by ANDRA on the feasibility study into a radioactive waste repository in a clay formation. It represents one step in a process of studies and research work leading up to the submission of a report due in 2005 containing ANDRA conclusions on the feasibility of a repository in the clay formation. (author)

Will Dutch Become Flemish? Autonomous Developments in Belgian Dutch

Science.gov (United States)

Van de Velde, Hans; Kissine, Mikhail; Tops, Evie; van der Harst, Sander; van Hout, Roeland

2010-01-01

In this paper a series of studies of standard Dutch pronunciation in Belgium and the Netherlands is presented. The research is based on two speech corpora: a diachronic corpus of radio speech (1935-1995) and a synchronic corpus of Belgian and Netherlandic standard Dutch from different regions at the turn of the millennium. It is shown that two…

Reimbursement rates and policies for primary molar pit-and-fissure sealants across state Medicaid programs.

Science.gov (United States)

Chi, Donald L; Singh, Jennifer

2013-11-01

Little is known about Medicaid policies regarding reimbursement for placement of sealants on primary molars. The authors identified Medicaid programs that reimbursed dentists for placing primary molar sealants and hypothesized that these programs had higher reimbursement rates than did state programs that did not reimburse for primary molar sealants. The authors obtained Medicaid reimbursement data from online fee schedules and determined whether each state Medicaid program reimbursed for primary molar sealants (no or yes). The outcome measure was the reimbursement rate for permanent tooth sealants (calculated in 2012 U.S. dollars). The authors compared mean reimbursement rates by using the t test (α = .05). Seventeen Medicaid programs reimbursed dentists for placing primary molar sealants (34 percent), and the mean reimbursement rate was $27.57 (range, $16.00 [Maine] to $49.68 [Alaska]). All 50 programs reimbursed dentists for placement of sealants on permanent teeth. The mean reimbursement for permanent tooth sealants was significantly higher in programs that reimbursed for primary molar sealants than in programs that did not ($28.51 and $23.67, respectively; P = .03). Most state Medicaid programs do not reimburse dentists for placing sealants on primary molars, but programs that do so have significantly higher reimbursement rates. Medicaid reimbursement rates are related to dentists' participation in Medicaid and children's dental care use. Reimbursement for placement of sealants on primary molars is a proxy for Medicaid program generosity.

48 CFR 1028.307 - Insurance under cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 1028.307 Section 1028.307 Federal Acquisition Regulations System DEPARTMENT OF THE...-reimbursement contracts. ...

Microbial diversity and metabolite composition of Belgian red-brown acidic ales.

Science.gov (United States)

Snauwaert, Isabel; Roels, Sanne P; Van Nieuwerburg, Filip; Van Landschoot, Anita; De Vuyst, Luc; Vandamme, Peter

2016-03-16

Belgian red-brown acidic ales are sour and alcoholic fermented beers, which are produced by mixed-culture fermentation and blending. The brews are aged in oak barrels for about two years, after which mature beer is blended with young, non-aged beer to obtain the end-products. The present study evaluated the microbial community diversity of Belgian red-brown acidic ales at the end of the maturation phase of three subsequent brews of three different breweries. The microbial diversity was compared with the metabolite composition of the brews at the end of the maturation phase. Therefore, mature brew samples were subjected to 454 pyrosequencing of the 16S rRNA gene (bacteria) and the internal transcribed spacer region (yeasts) and a broad range of metabolites was quantified. The most important microbial species present in the Belgian red-brown acidic ales investigated were Pediococcus damnosus, Dekkera bruxellensis, and Acetobacter pasteurianus. In addition, this culture-independent analysis revealed operational taxonomic units that were assigned to an unclassified fungal community member, Candida, and Lactobacillus. The main metabolites present in the brew samples were L-lactic acid, D-lactic acid, and ethanol, whereas acetic acid was produced in lower quantities. The most prevailing aroma compounds were ethyl acetate, isoamyl acetate, ethyl hexanoate, and ethyl octanoate, which might be of impact on the aroma of the end-products. Copyright © 2016 Elsevier B.V. All rights reserved.

Attitude of a group of Belgian stakeholders towards proposed agricultural countermeasures after a radioactive contamination: synthesis of the discussions within the Belgian EC-FARMING group

International Nuclear Information System (INIS)

Vandecasteele, C.M.; Hardeman, F.; Pauwels, O.; Bernaerts, M.; Carle, B.; Sombre, L.

2005-01-01

In the case of radioactive contamination of the environment with an impact on the food chain, the remediation strategy will not only be based on scientific knowledge and technical experience, but will also be dictated by peculiarities of the country. These characteristics include the agro-industrial structure, the local and international economical contexts and the political configuration including the distribution of responsibilities and competencies. This paper identifies and illustrates the most relevant characteristics of the Belgian agricultural system and political environment; it also describes the past experience with food chain contamination, which is expected to influence the attitude of Belgian stakeholders, who would be involved in the setting up of countermeasure strategies for maintaining agricultural production and food safety. The picture drawn explains why several countermeasures aiming to reduce the contamination in food products, although scientifically sound and technically feasible, are hardly acceptable or even not acceptable at all, to the stakeholders

Positioning and role of public relations in large Belgian organizations

NARCIS (Netherlands)

Gorp, B. van; Pauwels, L.M.A.

2007-01-01

This paper studies the position and role of public relations in the hierarchical structure of Belgian organizations of at least 50 employees. Empirical data was collected from a web survey (n = 750) to find out to what extent principles of excellence in public relations are applied in Belgium. The

[Reimbursement of health apps by the German statutory health insurance].

Science.gov (United States)

Gregor-Haack, Johanna

2018-03-01

A reimbursement category for "apps" does not exist in German statutory health insurance. Nevertheless different ways for reimbursement of digital health care products or processes exist. This article provides an overview and a description of the most relevant finance and reimbursement categories for apps in German statutory health insurance. The legal qualifications and preconditions of reimbursement in the context of single contracts with one health insurance fund will be discussed as well as collective contracts with national statutory health insurance funds. The benefit of a general outline appeals especially in respect to the numerous new players and products in the health care market. The article will highlight that health apps can challenge existing legal market access and reimbursement criteria and paths. At the same time, these criteria and paths exist. In terms of a learning system, they need to be met and followed.

48 CFR 228.307 - Insurance under cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 228.307 Section 228.307 Federal Acquisition Regulations System DEFENSE ACQUISITION....307 Insurance under cost-reimbursement contracts. ...

48 CFR 831.7001-7 - Reimbursement for other supplies and services.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Reimbursement for other... Principles and Procedures 831.7001-7 Reimbursement for other supplies and services. VA will provide reimbursement for other services and assistance that may be authorized under provisions of applicable Chapter 31...

Predicting the environmental risks of radioactive discharges from Belgian nuclear power plants

International Nuclear Information System (INIS)

Vandenhove, H.; Sweeck, L.; Vives i Batlle, J.; Wannijn, J.; Van Hees, M.; Camps, J.; Olyslaegers, G.; Miliche, C.; Lance, B.

2013-01-01

An environmental risk assessment (ERA) was performed to evaluate the impact on non-human biota from liquid and atmospheric radioactive discharges by the Belgian Nuclear Power Plants (NPP) of Doel and Tihange. For both sites, characterisation of the source term and wildlife population around the NPPs was provided, whereupon the selection of reference organisms and the general approach taken for the environmental risk assessment was established. A deterministic risk assessment for aquatic and terrestrial ecosystems was performed using the ERICA assessment tool and applying the ERICA screening value of 10 μGy h −1 . The study was performed for the radioactive discharge limits and for the actual releases (maxima and averages over the period 1999–2008 or 2000–2009). It is concluded that the current discharge limits for the Belgian NPPs considered do not result in significant risks to the aquatic and terrestrial environment and that the actual discharges, which are a fraction of the release limits, are unlikely to harm the environment. -- Highlights: • Impact of radioactive discharges by the Belgian NPPs of Doel and Tihange on wildlife was evaluated. • Deterministic risk assessment for aquatic and terrestrial ecosystems performed with the ERICA tool. • NPP discharge limits do not result in significant risks to the aquatic and terrestrial environment. • Actual discharges, a fraction of the release limits, are unlikely to harm the environment

Euthanasia: a "kit" sold in Belgian pharmacies.

Science.gov (United States)

2005-10-01

(1) In France, legislation adopted in 2005 recognises the right of dying patients to refuse further treatment, and the right of physicians to ease their suffering with treatments that, due to adverse effects, may shorten their life. Measures deliberately aimed at hastening death are forbidden. (2) In Belgium, medical euthanasia was decriminalised in 2002, and can now be carried out either in hospital or at home. Nearly 20 cases of euthanasia are reported per month in Belgium. (3) A Belgian pharmacy chain now markets a "euthanasia kit".

42 CFR 57.313a - Loan cancellation reimbursement.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Loan cancellation reimbursement. 57.313a Section 57.313a Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR... Loans § 57.313a Loan cancellation reimbursement. In the event that insufficient funds are available to...

Trends in laboratory test volumes for Medicare Part B reimbursements, 2000-2010.

Science.gov (United States)

Shahangian, Shahram; Alspach, Todd D; Astles, J Rex; Yesupriya, Ajay; Dettwyler, William K

2014-02-01

Changes in reimbursements for clinical laboratory testing may help us assess the effect of various variables, such as testing recommendations, market forces, changes in testing technology, and changes in clinical or laboratory practices, and provide information that can influence health care and public health policy decisions. To date, however, there has been no report, to our knowledge, of longitudinal trends in national laboratory test use. To evaluate Medicare Part B-reimbursed volumes of selected laboratory tests per 10,000 enrollees from 2000 through 2010. Laboratory test reimbursement volumes per 10,000 enrollees in Medicare Part B were obtained from the Centers for Medicare & Medicaid Services (Baltimore, Maryland). The ratio of the most recent (2010) reimbursed test volume per 10,000 Medicare enrollees, divided by the oldest data (usually 2000) during this decade, called the volume ratio, was used to measure trends in test reimbursement. Laboratory tests with a reimbursement claim frequency of at least 10 per 10,000 Medicare enrollees in 2010 were selected, provided there was more than a 50% change in test reimbursement volume during the 2000-2010 decade. We combined the reimbursed test volumes for the few tests that were listed under more than one code in the Current Procedural Terminology (American Medical Association, Chicago, Illinois). A 2-sided Poisson regression, adjusted for potential overdispersion, was used to determine P values for the trend; trends were considered significant at P reimbursement volumes were electrolytes, digoxin, carbamazepine, phenytoin, and lithium, with volume ratios ranging from 0.27 to 0.64 (P reimbursement volumes were meprobamate, opiates, methadone, phencyclidine, amphetamines, cocaine, and vitamin D, with volume ratios ranging from 83 to 1510 (P reimbursement volumes increased for most of the selected tests, other tests exhibited statistically significant downward trends in annual reimbursement volumes. The observed

48 CFR 3028.307 - Insurance under cost-reimbursement contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 3028.307 Section 3028.307 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND... Insurance 3028.307 Insurance under cost-reimbursement contracts. ...

Speaking Turkish in Belgian primary schools: teacher beliefs versus effective consequences

NARCIS (Netherlands)

Ağırdağ, O.; Jordens, K.; Van Houtte, M.

2014-01-01

In this mixed-method study, we explore teachers’ beliefs concerning the use of the Turkish language by Turkish children in Belgian primary schools, and we compare these findings with the effective consequences of language maintenance. The qualitative analyses revealed that teachers have very

The influence of a smoking ban on the profitability of Belgian restaurants.

Science.gov (United States)

De Schoenmaker, Sofie; Van Cauwenberge, Philippe; Vander Bauwhede, Heidi

2013-05-01

To examine whether the nationwide smoking ban, imposed in 2007, had an impact on the profitability of Belgian restaurants. Objective financial reporting data on 1613 restaurants were analysed with return on assets as the outcome measure. The data were collected from the Belfirst database and cover the period 2004-2009. To assess the impact of the smoking ban, a differences-in-differences estimation method was used, with bars serving as the control group. The regression model was estimated, while controlling for firm-specific characteristics and unobserved firm-level heterogeneity. The variable of interest is the interaction between the smoking ban dummy and the dummy for the treatment group. The coefficient of this variable is insignificant. The adoption of the nationwide smoking ban did not affect the profitability of Belgian restaurants.

The Case for Insurance Reimbursement of Couple Therapy.

Science.gov (United States)

Clawson, Robb E; Davis, Stephanie Y; Miller, Richard B; Webster, Tabitha N

2017-08-22

A case is made for why it may now be in the best interest of insurance companies to reimburse for marital therapy to treat marital distress. Relevant literature is reviewed with a considerable focus on the reasons that insurance companies would benefit from reimbursing marital therapy - the high costs of marital distress, the growing link between marital distress and a host of related physical and mental health problems, as well as the availability of empirically supported treatments for marital distress. This is followed by a focus on the major reasons insurance companies cite for not reimbursing marital therapy, along with a discussion of advances in several growing bodies of research to address these concerns. Main arguments include the direct medical offset costs of couple and family therapy (including for high utilizers of health insurance), and the fact that insurance companies already find it cost effective to reimburse for prevention of other health and psychological problems. This is followed by implications for practitioners and researchers. © 2017 American Association for Marriage and Family Therapy.

Assessing fundamental motor skills in Belgian children aged 3-8 years highlights differences to US reference sample.

Science.gov (United States)

Bardid, Farid; Huyben, Floris; Lenoir, Matthieu; Seghers, Jan; De Martelaer, Kristine; Goodway, Jacqueline D; Deconinck, Frederik J A

2016-06-01

This study aimed to understand the fundamental motor skills (FMS) of Belgian children using the process-oriented Test of Gross Motor Development, Second Edition (TGMD-2) and to investigate the suitability of using the United States (USA) test norms in Belgium. FMS were assessed using the TGMD-2. Gender, age and motor performance were examined in 1614 Belgian children aged 3-8 years (52.1% boys) and compared with the US reference sample. More proficient FMS performance was found with increasing age, from 3 to 6 years for locomotor skills and 3 to 7 years for object control skills. Gender differences were observed in object control skills, with boys performing better than girls. In general, Belgian children had lower levels of motor competence than the US reference sample, specifically for object control skills. The score distribution of the Belgian sample was skewed, with 37.4% scoring below average and only 6.9% scoring above average. This study supported the usefulness of the TGMD-2 as a process-oriented instrument to measure gross motor development in early childhood in Belgium. However, it also demonstrated that caution is warranted when using the US reference norms. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

76 FR 19909 - International Terrorism Victim Expense Reimbursement Program

Science.gov (United States)

2011-04-11

... 1121-AA78 International Terrorism Victim Expense Reimbursement Program AGENCY: Office of Justice... promulgating this interim-final rule for its International Terrorism Victim Expense Reimbursement Program... international terrorism. DATES: Effective date: This interim-final rule is effective April 11, 2011. Comment...

Last developments in the Belgian disposal programme for low and intermediate short-lived waste

International Nuclear Information System (INIS)

Boyazis, Jean-Paul

2006-01-01

After an historical reminder of the several phases of the Belgian program for the disposal of low and medium level short-lived waste since the creation of ONDRAF/NIRAS and the bad results obtained in the 90's by using a pure technical approach, the presentation will explain the main lines of the new methodology developed, as a consequence of the government decision of 16 January 1998 in ONDRAF/NIRAS to improve local acceptance for the disposal project. The way local partnerships were created with four nuclear municipalities under the form of a non-profit organization with a clear mission, the functioning, on a voluntary base, of the different partnerships during four to six years and the concrete results obtained until now using this very innovative method will be addressed. The last developments of the Belgian program for the disposal of low and medium level and short-lived waste will be presented, including the recent and very important decision of the Belgian government of 23 June 2006 to dispose of the low and medium active short-lived waste in a surface disposal installation on the territory of the municipality Dessel. (author)

A Blend of Romanism and Germanism: Experimental Science Instruction in Belgian State Secondary Education, 1880-1914

Science.gov (United States)

Onghena, Sofie

2013-04-01

A case study of secondary experimental science instruction in Belgium demonstrates the importance of cross-national communication in the study of science education. Belgian secondary science education in the years 1880-1914 had a clear internationalist dimension. French and German influences turn out to have been essential, stimulated by the fact that Belgium, as a result of its geographical position, considered itself as the centre of scientific relations between France and Germany, and as actually strengthened by its linguistic and cultural dualism in this regard. This pursuit of internationalist nationalism also affected the configuration of chemistry and physics as experimental courses at Belgian Royal State Schools, although the years preceding WWI are usually characterized as a period of rising nationalism in science, with countries such as Germany and France as prominent actors. To what extent did France and Germany influence Belgian debates on science education, science teachers' training, the use of textbooks, and the instalment of school laboratories and teaching collections?

44 CFR 208.42 - Reimbursement for other administrative costs.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for other administrative costs. 208.42 Section 208.42 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... SYSTEM Response Cooperative Agreements § 208.42 Reimbursement for other administrative costs. Costs...

76 FR 58567 - Proposed Information Collection (Request for Transportation Expense Reimbursement) Activity...

Science.gov (United States)

2011-09-21

... (Request for Transportation Expense Reimbursement) Activity; Comment Request AGENCY: Veterans Benefits... needed to determine children with spina bifida eligibility for reimbursement of transportation expenses...: Request for Transportation Expense Reimbursement (38 CFR 21.8370). OMB Control Number: 2900-0580. Type of...

Differences between Belgian and Brazilian group A Streptococcus epidemiologic landscape.

Directory of Open Access Journals (Sweden)

Pierre Robert Smeesters

Full Text Available BACKGROUND: Group A Streptococcus (GAS clinical and molecular epidemiology varies with location and time. These differences are not or are poorly understood. METHODS AND FINDINGS: We prospectively studied the epidemiology of GAS infections among children in outpatient hospital clinics in Brussels (Belgium and Brasília (Brazil. Clinical questionnaires were filled out and microbiological sampling was performed. GAS isolates were emm-typed according to the Center for Disease Control protocol. emm pattern was predicted for each isolate. 334 GAS isolates were recovered from 706 children. Skin infections were frequent in Brasília (48% of the GAS infections, whereas pharyngitis were predominant (88% in Brussels. The mean age of children with GAS pharyngitis in Brussels was lower than in Brasília (65/92 months, p<0.001. emm-typing revealed striking differences between Brazilian and Belgian GAS isolates. While 20 distinct emm-types were identified among 200 Belgian isolates, 48 were found among 128 Brazilian isolates. Belgian isolates belong mainly to emm pattern A-C (55% and E (42.5% while emm pattern E (51.5% and D (36% were predominant in Brasília. In Brasília, emm pattern D isolates were recovered from 18.5% of the pharyngitis, although this emm pattern is supposed to have a skin tropism. By contrast, A-C pattern isolates were infrequently recovered in a region where rheumatic fever is still highly prevalent. CONCLUSIONS: Epidemiologic features of GAS from a pediatric population were very different in an industrialised country and a low incomes region, not only in term of clinical presentation, but also in terms of genetic diversity and distribution of emm patterns. These differences should be taken into account for designing treatment guidelines and vaccine strategies.

Iron microbial communities in Belgian Frasnian carbonate mounds

OpenAIRE

Boulvain, F.; De Ridder, C.; Mamet, B.; Preat, A.; Gillan, D.

2001-01-01

The Belgian Frasnian carbonate mounds occur in three stratigraphic levels in an overall backstepping succession. Petit-Mont and Arche Members form the famous red and grey “marble” exploited for ornamental stone since Roman times. The evolution and distribution of the facies in the mounds is thought to be associated with ecologic evolution and relative sea-level fluctuations. Iron oxides exist in five forms in the Frasnian mounds; four are undoubtedly endobiotic organized structures: (1) micro...

Analysis of the Genetic Diversity and Population Structure of Austrian and Belgian Wheat Germplasm within a Regional Context Based on DArT Markers

Directory of Open Access Journals (Sweden)

Mohamed A. El-Esawi

2018-01-01

Full Text Available Analysis of crop genetic diversity and structure provides valuable information needed to broaden the narrow genetic base as well as to enhance the breeding and conservation strategies of crops. In this study, 95 Austrian and Belgian wheat cultivars maintained at the Centre for Genetic Resources (CGN in the Netherlands were characterised using 1052 diversity array technology (DArT markers to evaluate their genetic diversity, relationships and population structure. The rarefacted allelic richness recorded in the Austrian and Belgian breeding pools (A25 = 1.396 and 1.341, respectively indicated that the Austrian germplasm contained a higher genetic diversity than the Belgian pool. The expected heterozygosity (HE values of the Austrian and Belgian pools were 0.411 and 0.375, respectively. Moreover, the values of the polymorphic information content (PIC of the Austrian and Belgian pools were 0.337 and 0.298, respectively. Neighbour-joining tree divided each of the Austrian and Belgian germplasm pools into two genetically distinct groups. The structure analyses of the Austrian and Belgian pools were in a complete concordance with their neighbour-joining trees. Furthermore, the 95 cultivars were compared to 618 wheat genotypes from nine European countries based on a total of 141 common DArT markers in order to place the Austrian and Belgian wheat germplasm in a wider European context. The rarefacted allelic richness (A10 varied from 1.224 (Denmark to 1.397 (Austria. Cluster and principal coordinates (PCoA analyses divided the wheat genotypes of the nine European countries into two main clusters. The first cluster comprised the Northern and Western European wheat genotypes, whereas the second included the Central European cultivars. The structure analysis of the 618 European wheat genotypes was in a complete concordance with the results of cluster and PCoA analyses. Interestingly, a highly significant difference was recorded between regions (26.53%. In

Proceedings of the 9th Dutch-Belgian Information Retrieval Workshop

NARCIS (Netherlands)

Aly, Robin; Hauff, C.; den Hamer, Ida; Hiemstra, Djoerd; Huibers, Theo W.C.; de Jong, Franciska M.G.

Welcome to the 9th Dutch-Belgian Information Retrieval Workshop (DIR). I very well remember the DIR workshop in 2001 that was also organized in Twente. It took place exactly one day before my PhD defense, to give us the opportunity to have one of the PhD committee members, Stephen Robertson, as the

47 CFR 64.1170 - Reimbursement procedures where the subscriber has paid charges.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Reimbursement procedures where the subscriber... Preferred Telecommunications Service Providers § 64.1170 Reimbursement procedures where the subscriber has... reimburse the authorized carrier for reasonable expenses. (e) If the authorized carrier has not received...

The fairness of the PPS reimbursement methodology.

Science.gov (United States)

Gianfrancesco, F D

1990-01-01

In FY 1984 the Medicare program implemented a new method of reimbursing hospitals for inpatient services, the Prospective Payment System (PPS). Under this system, hospitals are paid a predetermined amount per Medicare discharge, which varies according to certain patient and hospital characteristics. This article investigates the presence of systematic biases and other potential imperfections in the PPS reimbursement methodology as revealed by its effects on Medicare operating ratios. The study covers the first three years of the PPS (approximately 1984-1986) and is based on hospital data from the Medicare cost reports and other related sources. Regression techniques were applied to these data to determine how Medicare operating ratios were affected by specific aspects of the reimbursement methodology. Several possible imbalances were detected. The potential undercompensation relating to these can be harmful to certain classes of hospitals and to the Medicare populations that they serve. PMID:2109738

PRICING, REIMBURSEMENT, AND HEALTH TECHNOLOGY ASSESSMENT OF MEDICINAL PRODUCTS IN BULGARIA.

Science.gov (United States)

Benisheva-Dimitrova, Tatyana; Sidjimova, Dobriana; Cherneva, Daniela; Kralimarkov, Nikolay

2017-01-01

The aim of this study was to investigate the analysis, discussion, and challenges of the price and reimbursement process of medicinal products in Bulgaria in the period 2000-15 and health technology assessment (HTA) role in these processes. The dynamics of the reform, with respect to the healthcare and pharmaceutical sectors, are tracked by documentary review of regulations, articles, and reports in the European Union (EU), as well as analytical and historical analysis. Pricing and reimbursement processes have passed through a variety of committees between 2003 and 2012. Separate units for pricing and reimbursement of medicinal products were established in Bulgaria for the first time, in 2013, when an independent body, the National Council at Prices and Reimbursement of Medicinal Products, was set up to approve medicinal products with new international nonproprietary names (INN) for reimbursement in Bulgaria. Over the course of 2 years (2013-14), thirty-three new INNs were approved for reimbursement. In December 2015, a new HTA body was introduced, and assigned to the National Centre for Public Health and Analyses. Although Bulgaria has current legislation on pricing and reimbursement which is in accordance with the EU rules, there is no mechanism for reporting and monitoring these processes or the financial resources annually, so as to provide an overall objective assessment and analysis by year. Therefore, this financial assessment should become a national policy objective for the future.

Reimbursement of school fees

CERN Multimedia

2003-01-01

In order to answer regular enquiries on this subject, members of the personnel are reminded that only school fees from educational establishments recognized as such by the competent authorities of the Member State concerned are reimbursed by the Organization. Human Resources Division Tel. 72862/74474

COGNOS : Care for People With Cognitive Dysfunction A National Observational Study

NARCIS (Netherlands)

Mets, Tony; De Deyn, Peter P.; Pals, Philippe; De Lepeleire, Jan; Vandewoude, Maurits; Ventura, Manfredi; Ivanoiu, Adrian; Albert, Adelin; Seghers, An-Katrien

2013-01-01

Care plans are intended to improve the independence and functioning of patients with cognitive dysfunction and support the caregivers involved. They are an integral part of the Belgian reimbursement procedure for cholinesterase inhibitors. This nationwide, multicenter, observational study examined

42 CFR 405.515 - Reimbursement for clinical laboratory services billed by physicians.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Reimbursement for clinical laboratory services... Criteria for Determining Reasonable Charges § 405.515 Reimbursement for clinical laboratory services billed... limitation on reimbursement for markups on clinical laboratory services billed by physicians. If a physician...

48 CFR 1352.228-71 - Deductibles under required insurance coverage-cost reimbursement.

Science.gov (United States)

2010-10-01

... insurance coverage-cost reimbursement. 1352.228-71 Section 1352.228-71 Federal Acquisition Regulations... Provisions and Clauses 1352.228-71 Deductibles under required insurance coverage—cost reimbursement. As... Coverage—Cost Reimbursement (APR 2010) (a) The contractor is required to present evidence of the amount of...

48 CFR 219.7104 - Developmental assistance costs eligible for reimbursement or credit.

Science.gov (United States)

2010-10-01

... costs eligible for reimbursement or credit. 219.7104 Section 219.7104 Federal Acquisition Regulations... reimbursement or credit. (a) Developmental assistance provided under an approved mentor-protege agreement is... eligible for reimbursement are set forth in appendix I. (b) Before incurring any costs under the Program...

48 CFR 1552.211-73 - Level of effort-cost-reimbursement term contract.

Science.gov (United States)

2010-10-01

...-reimbursement term contract. 1552.211-73 Section 1552.211-73 Federal Acquisition Regulations System... Provisions and Clauses 1552.211-73 Level of effort—cost-reimbursement term contract. As prescribed in 1511.011-73, insert the following contract clause in cost-reimbursement term contracts including cost...

77 FR 12925 - Federal Acquisition Regulation; Proper Use and Management of Cost-Reimbursement Contracts

Science.gov (United States)

2012-03-02

...-Reimbursement Contracts AGENCIES: Department of Defense (DoD), General Services Administration (GSA), and... addresses the use and management of cost- reimbursement contracts. DATES: Effective Date: April 2, 2012 FOR...-reimbursement contracts in the following three areas: 1. Circumstances when cost-reimbursement contracts are...

36 CFR 64.15 - Financial reporting requirements and reimbursements.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Financial reporting requirements and reimbursements. 64.15 Section 64.15 Parks, Forests, and Public Property NATIONAL PARK SERVICE... RIGHTS-OF-WAY § 64.15 Financial reporting requirements and reimbursements. Payments to applicants will...

78 FR 76626 - Privately Owned Vehicle Mileage Reimbursement Rates

Science.gov (United States)

2013-12-18

... Procedure GSA posts the POV mileage reimbursement rates, formerly published in 41 CFR Chapter 301, solely on... official travel. Notices published periodically in the Federal Register, such as this one, and the changes... reimbursement rates for Federal agencies. Dated: December 12, 2013. Carolyn Austin-Diggs, Acting Deputy...

Performance Measurement in Belgian Hospitals : a state-of-the-art

OpenAIRE

Van Caillie, Didier; Rouhana, Rima; Santin, Sarah

2007-01-01

This communication proposes a global state-of-the-art around the central question : "How is performance measured and controlled in Belgian hospitals. As a first step in a global research project dedicated to the use of Balanced ScoreCard in publics hospitals around the world, it is essentially focused on global economic aspects and on major macroeconomic statistics.

48 CFR 52.246-8 - Inspection of Research and Development-Cost-Reimbursement.

Science.gov (United States)

2010-10-01

... Development-Cost-Reimbursement. 52.246-8 Section 52.246-8 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-8 Inspection of Research and Development—Cost-Reimbursement. As prescribed in... (b) a cost-reimbursement contract is contemplated; unless use of the clause is impractical and the...

48 CFR 52.229-9 - Taxes-Cost-Reimbursement Contracts With Foreign Governments.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Taxes-Cost-Reimbursement... Provisions and Clauses 52.229-9 Taxes—Cost-Reimbursement Contracts With Foreign Governments. As prescribed in 29.402-2(b), insert the following clause: Taxes—Cost-Reimbursement Contracts With Foreign Governments...

Antibodies to elastin peptides in sera of Belgian Draught horses with chronic progressive lymphoedema.

Science.gov (United States)

van Brantegem, L; de Cock, H E V; Affolter, V K; Duchateau, L; Hoogewijs, M K; Govaere, J; Ferraro, G L; Ducatelle, R

2007-09-01

Chronic progressive lymphoedema (CPL) is a recently recognised disease of the lymphatic system characterised by lesions in the skin of the lower legs in several draught horse breeds, including the Belgian Draught hourse. Clinical signs slowly progress and result in severe disfigurement of the limbs. Ideally, supportive treatment should be started early in the disease process. However early diagnosis and monitoring progression of CPL is still a challenge. Elastin changes, characterised by morphological alterations as well as increased desmosine levels, in the skin of the distal limbs of horses affected with CPL are probably associated with a marked release of elastin degradation products, which elicit production of circulating anti-elastin antibodies (AEAbs) in the serum. An enzyme-linked immunosorbent assay (ELISA) for detection of serum AEAbs may document elastin breakdown. An ELISA technique was used to evaluate levels of AEAbs in sera of 97 affected Belgian Draught horses that were clinically healthy except for possible skin lesions, associated with CPL in their distal limbs. The horses were divided into 5 groups according to the severity of these skin lesions: normal horses (Group 1, n = 36), horses with mild lesions (Group 2, n = 43), horses with moderate lesions (Group 3, n = 8), horses with severe lesions (Group 4, n = 10) and, as a control, healthy Warmblood horses, unaffected by the disease (Group 5, n = 83). Horses with clinical signs of CPL had significantly higher AEAb levels compared to clinically normal Belgian Draught horses and to healthy Warmblood horses. These levels correlated with severity of lesions. CPL in draught horses is associated with an increase of serum AEAbs. Evaluation of serum levels of AEAbs by ELISA might be a useful diagnostic aid for CPL. Pathological degradation of elastic fibres, resulting in deficient support of the distal lymphatics, is proposed as a contributing factor for CPL in Belgian Draught horses.

Capital budgeting and cost reimbursement in investor-owned and not-for-profit hospitals.

Science.gov (United States)

Hubbard, C M

1983-01-01

Net present value estimates cannot be made in health care finance without the appropriate cost reimbursement adjustments. The results of new regulations could radically alter the effects of reimbursement on capital budgeting. Debates on the effects of cost reimbursement on decision making in hospitals will continue as long as reimbursement exists in a manner that affects operating cash flows or the cost of capital.

The Drug Reimbursement Decision-Making System in Iran.

Science.gov (United States)

Ansaripour, Amir; Uyl-de Groot, Carin A; Steenhoek, Adri; Redekop, William K

2014-05-01

Previous studies of health policies in Iran have not focused exclusively on the drug reimbursement process. The aim of this study was to describe the entire drug reimbursement process and the stakeholders, and discuss issues faced by policymakers. Review of documents describing the administrative rules and directives of stakeholders, supplemented by published statistics and interviews with experts and policymakers. Iran has a systematic process for the assessment, appraisal, and judgment of drug reimbursements. The two most important organizations in this process are the Food and Drug Organization, which considers clinical effectiveness, safety, and economic issues, and the Supreme Council of Health Insurance, which considers various criteria, including budget impact and cost-effectiveness. Ultimately, the Iranian Cabinet approves a drug and recommends its use to all health insurance organizations. Reimbursed drugs account for about 53.5% of all available drugs and 77.3% of drug expenditures. Despite its strengths, the system faces various issues, including conflicting stakeholder aims, lengthy decision-making duration, limited access to decision-making details, and rigidity in the assessment process. The Iranian drug reimbursement system uses decision-making criteria and a structured approach similar to those in other countries. Important shortcomings in the system include out-of-pocket contributions due to lengthy decision making, lack of transparency, and conflicting interests among stakeholders. Iranian policymakers should consider a number of ways to remedy these problems, such as case studies of individual drugs and closer examination of experiences in other countries. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Air crew exposure on board of long-haul flights of the Belgian airlines

International Nuclear Information System (INIS)

Verhaegen, F.; Poffijn, A.

2000-01-01

New European radiation protection recommendations state that measures need to be taken for flight crew members whose annual radiation exposure exceeds 1 mSv. This will be the case for flight crew members who accumulate most of their flying hours on long-haul flights. The Recommendations for the Implementation of the Basic Safety Standards Directive states that for annual exposure levels between 1 and 6 mSv individual dose estimates should be obtained, whereas for annual exposures exceeding 6 mSv, which might rarely occur, record keeping with appropriate medical surveillance is recommended. To establish the exposure level of Belgian air crews, radiation measurements were performed on board of a total of 44 long-haul flights of the Belgian airlines. The contribution of low linear energy transfer (LET) radiation (photons, electrons, protons) was assessed by using TLD-700H detectors. The exposure to high-LET radiation (mostly neutrons) was measured with bubble detectors. Results were compared to calculations with an adapted version of the computer code CARI. For the low-LET radiation the calculations were found to be in good agreement with the measurements. The measurements of the neutron dose were consistently lower than the calculations. With the current flight schedules used by the Belgian airlines, air crew members are unlikely to receive annual doses exceeding 4 mSv. (author)

12 CFR 701.33 - Reimbursement, insurance, and indemnification of officials and employees.

Science.gov (United States)

2010-01-01

... specifically excludes: (i) Payment (by reimbursement to an official or direct credit union payment to a third... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Reimbursement, insurance, and indemnification... Reimbursement, insurance, and indemnification of officials and employees. (a) Official. An official is a person...

Medicaid reimbursement, prenatal care and infant health.

Science.gov (United States)

Sonchak, Lyudmyla

2015-12-01

This paper evaluates the impact of state-level Medicaid reimbursement rates for obstetric care on prenatal care utilization across demographic groups. It also uses these rates as an instrumental variable to assess the importance of prenatal care on birth weight. The analysis is conducted using a unique dataset of Medicaid reimbursement rates and 2001-2010 Vital Statistics Natality data. Conditional on county fixed effects, the study finds a modest, but statistically significant positive relationship between Medicaid reimbursement rates and the number of prenatal visits obtained by pregnant women. Additionally, higher rates are associated with an increase in the probability of obtaining adequate care, as well as a reduction in the incidence of going without any prenatal care. However, the effect of an additional prenatal visit on birth weight is virtually zero for black disadvantaged mothers, while an additional visit yields a substantial increase in birth weight of over 20 g for white disadvantaged mothers. Copyright © 2015 Elsevier B.V. All rights reserved.

Relating illness complexity to reimbursement in CKD patients.

Science.gov (United States)

Bessette, Russell W; Carter, Randy L

2011-01-01

Despite significant investments of federal and state dollars to transition patient medical records to an all-electronic system, a chasm still exists between health care quality and payment for it. A major reason for this gap is the difficulty in evaluating health care outcomes based on claims data. Since both payers and patients may not appreciate how illness complexity impacts treatment outcomes, it is difficult to determine fair provider compensation. Chronic kidney disease (CKD) typifies these problems and is often associated with comorbidities that impact cost, health, and work productivity. Thus, the objective of this study was to evaluate an illness complexity score (ICS) based on a linear regression of select blood values that might assist in predicting average monthly reimbursements in CKD patients. A second objective was to compare the results of this ICS prediction to results obtained by prediction of average monthly reimbursement using CKD stage. A third objective was to analyze the relationship between the change in ICS, estimated glomerular filtration rate (eGFR), and CKD stage over time to average monthly reimbursement. We calculated parsimonious values for select variables associated with CKD patients and compared the ICS to ordinal staging of renal disease. Data from 177 de-identified patients over 13 months was collected, which included 15 blood chemistry observations along with complete claims data for all medical expenses. To test for the relationship between average blood chemistry values, stages of CKD, age, and average monthly reimbursement, we modeled an association through a linear regression function of age, eGFR, and the Z-scores calculated from average monthly values of phosphorus, parathyroid hormone, glucose, hemoglobin, bicarbonate, albumin, creatinine, blood urea nitrogen, potassium, calcium, sodium, alkaline phosphatase, alanine aminotransferase, and white blood cells. The results of our study demonstrated that the association

Relating illness complexity to reimbursement in CKD patients

Directory of Open Access Journals (Sweden)

Bessette RW

2011-09-01

Full Text Available Russell W Bessette1, Randy L Carter2,3 1Department of Health Sciences, Institute for Healthcare Informatics, 2Department of Biostatistics, 3Population Health Observatory, University at Buffalo, State University of New York, Buffalo, NY, USA Background: Despite significant investments of federal and state dollars to transition patient medical records to an all-electronic system, a chasm still exists between health care quality and payment for it. A major reason for this gap is the difficulty in evaluating health care outcomes based on claims data. Since both payers and patients may not appreciate how illness complexity impacts treatment outcomes, it is difficult to determine fair provider compensation. Objectives: Chronic kidney disease (CKD typifies these problems and is often associated with comorbidities that impact cost, health, and work productivity. Thus, the objective of this study was to evaluate an illness complexity score (ICS based on a linear regression of select blood values that might assist in predicting average monthly reimbursements in CKD patients. A second objective was to compare the results of this ICS prediction to results obtained by prediction of average monthly reimbursement using CKD stage. A third objective was to analyze the relationship between the change in ICS, estimated glomerular filtration rate (eGFR, and CKD stage over time to average monthly reimbursement. Methods: We calculated parsimonious values for select variables associated with CKD patients and compared the ICS to ordinal staging of renal disease. Data from 177 de-identified patients over 13 months was collected, which included 15 blood chemistry observations along with complete claims data for all medical expenses. To test for the relationship between average blood chemistry values, stages of CKD, age, and average monthly reimbursement, we modeled an association through a linear regression function of age, eGFR, and the Z-scores calculated from average

Determination of contamination pathways of phthalates in food products sold on the Belgian market.

Science.gov (United States)

Van Holderbeke, Mirja; Geerts, Lieve; Vanermen, Guido; Servaes, Kelly; Sioen, Isabelle; De Henauw, Stefaan; Fierens, Tine

2014-10-01

As numerous studies have indicated that food ingestion is the most important exposure pathway to several phthalates, this study aimed to determine possible contamination pathways of phthalates in food products sold on the Belgian market. To do this, concentrations of eight phthalates (dimethyl phthalate (DMP), diethyl phthalate (DEP), diisobutyl phthalate (DiBP), di-n-butyl phthalate (DnBP), benzylbutyl phthalate (BBP), dicyclohexyl phthalate (DCHP), di(2-ethylhexyl) phthalate (DEHP) and di-n-octyl phthalate (DnOP)) were determined in 591 foods and 30 packaging materials. In general, the four most prominent phthalates in Belgian food products were DEHP, DiBP, DnBP and BBP. Special attention was given to the origin of these phthalates in bread, since high phthalate concentrations (especially DEHP) were determined in this frequently consumed food product. Phthalates seemed to occur in Belgian bread samples due to the use of contaminated ingredients (i.e. use of contaminated flour) as well as due to migration from phthalate containing contact materials used during production (e.g. coated baking trays). Also the results of the conducted concentration profiles of apple, bread, salami and two cheese types revealed the important role of processing - and not packaging - on phthalate contents in foods. Copyright © 2014 Elsevier Inc. All rights reserved.

Reimbursement for school nursing health care services: position statement.

Science.gov (United States)

Lowe, Janet; Cagginello, Joan; Compton, Linda

2014-09-01

Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and reduce costs. The goal is to promote a comprehensive and cost-effective health care delivery model that integrates schools, families, providers, and communities.

The Status of Billing and Reimbursement in Pediatric Obesity Treatment Programs

Science.gov (United States)

Gray, Jane Simpson; Filigno, Stephanie Spear; Santos, Melissa; Ward, Wendy L.; Davis, Ann M.

2014-01-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service. PMID:23224661

The status of billing and reimbursement in pediatric obesity treatment programs.

Science.gov (United States)

Gray, Jane Simpson; Spear Filigno, Stephanie; Santos, Melissa; Ward, Wendy L; Davis, Ann M

2013-07-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service.

14 CFR 331.7 - What losses will be reimbursed?

Science.gov (United States)

2010-01-01

... PROVIDERS IN THE WASHINGTON, DC AREA General Provisions § 331.7 What losses will be reimbursed? (a) You may... which you are or were an operator or provider not been closed as the result of Federal government...-recurring, or unusual adjustments, and capital losses are normally ineligible for reimbursement. If you wish...

CERN Health Insurance Scheme (CHIS) – Reimbursement of contraception and sterilisation

CERN Multimedia

HR Department

2016-01-01

In line with the practice in many Member States and in other international organisations based in Geneva, the CHIS will, as of 1 March 2016, reimburse upon presentation of a medical prescription:   contraceptive medicine (e.g. oral medicine or implant); intrauterine contraceptive devices; and medical sterilisation operations (vasectomy, tubal ligations). These methods of contraception will be considered as pharmaceutical costs or medical treatments, to which the reimbursement rate according to the general rule and the reimbursement bonus apply. Treatment undertaken, or paid for, before March 2016 will not be reimbursed. For more information, do not hesitate to contact the third-party administrator of the CHIS: UNIQA (Tel.: 72730 / uniqa-assurance@cern.ch).

78 FR 7750 - Summer Food Service Program; 2013 Reimbursement Rates

Science.gov (United States)

2013-02-04

...This notice informs the public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service Program for Children. These adjustments address changes in the Consumer Price Index, as required under the Richard B. Russell National School Lunch Act. The 2013 reimbursement rates are presented as a combined set of rates to highlight simplified cost accounting procedures. The 2013 rates are also presented individually, as separate operating and administrative rates of reimbursement, to show the effect of the Consumer Price Index adjustment on each rate.

77 FR 5228 - Summer Food Service Program; 2012 Reimbursement Rates

Science.gov (United States)

2012-02-02

...This notice informs the public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service Program for Children. These adjustments address changes in the Consumer Price Index, as required under the Richard B. Russell National School Lunch Act. The 2012 reimbursement rates are presented as a combined set of rates to highlight simplified cost accounting procedures. The 2012 rates are also presented individually, as separate operating and administrative rates of reimbursement, to show the effect of the Consumer Price Index adjustment on each rate.

7 CFR 400.712 - Research and development reimbursement, maintenance reimbursement, and user fees.

Science.gov (United States)

2010-01-01

...) Loss adjustment expenses; (vii) Sales commission; (viii) Marketing costs; (ix) Indirect overhead costs..., development, preparation or marketing of the policy; (xiii) Costs of making program changes as a result of any... submission may be eligible for a one-time payment of research and development costs and reimbursement of...

77 FR 3460 - Reimbursement for Costs of Remedial Action at Active Uranium and Thorium Processing Sites

Science.gov (United States)

2012-01-24

... available funding, the approved claim amounts will be reimbursed on a prorated basis. All reimbursements are...., statutory increases in the reimbursement ceilings). Title X requires DOE to reimburse eligible uranium and... DEPARTMENT OF ENERGY Reimbursement for Costs of Remedial Action at Active Uranium and Thorium...

Regularities of Formation of the Labour Reimbursement Institute in the Market Economy

Directory of Open Access Journals (Sweden)

Povoroznyuk Inna M.

2013-11-01

Full Text Available The article considers theoretical issues of formation of the labour reimbursement institute in the market economy. It proves that functioning of the labour reimbursement institute identifies proportions of distribution of the total amount of expenditures on labour reimbursement between different professional and qualification groups of workers. Also, functioning of the labour reimbursement institute significantly influences proportions of distribution of income between owners of the means of production and hired labour, although, to a big extent, this institute is adapted, on the one hand, to the existing in the society forms of resolution of contradictions, inherent in means of production ownership relations, and, on the other hand, to the situation in a relevant labour market segment. However, the labour reimbursement institute itself significantly influences realisation of interests of employees and employers. The article states that wages in the modern economy should be understood as an incomplete labour reimbursement – the entrepreneur spends on an employee not only the sum of wages, but also uses other forms of resource provision of the processes of acquisition of certain benefits by the enterprise employees.

Sustainable policy: Higher medication use & adherence during reimbursement of pharmacologic smoking cessation treatments

NARCIS (Netherlands)

Van Boven, J.F.; Vemer, P.

2014-01-01

Background: The discussion on the reimbursement of Smoking Cessation Treatment (SCT) has known many stages in The Netherlands. From January 2011, SCTs were reimbursed, until January 2012 when the reimbursement of nicotine replacement therapies (NRTs) and pharmacotherapeutic SCT (pSCT) was

Reimbursement of VAT on written-off Receivables

DEFF Research Database (Denmark)

Florentsen, Bjarne; Møller, Michael; Nielsen, Niels Chr.

2003-01-01

In many OECD countries, a seller has a right to reimbursement of VAT (RVAT) she has paid on goods sold, but for which she has not yet received payment. Such reimbursement of VAT on receivables is economically inefficient. It leads to:@* Distortion of credit markets, by subsidizing direct credit...... at the cost of financial intermediaries.@* Price discrimination, by subsidizing buyers with low creditworthiness.@* A less efficient collection of bad debts, as trade with bad debts is made extremely expensive.The finance literature presents several `good' arguments in favor of trade credits, e.g. transaction...

Impact of purchasing the CPAP device on acceptance and long-term adherence: a Belgian model.

Science.gov (United States)

Leemans, Joke; Rodenstein, Daniel; Bousata, Jamila; Mwenge, Gimbada Benny

2018-02-01

In Belgium, patients with moderate to severe OSA (AHI > 20) who show less than 30 micro-arousals per hour slept (MAI) cannot benefit from CPAP refund by the social security (SS). To assess the influence of reimbursement on CPAP acceptance, and long-term adherence. OSA patients (AHI > 20) were included regardless of MAI. All patients were offered a CPAP trial of 3-5 days for habituation. Two groups were defined and compared: «Out of pocket money» patients (OOP) with MAI < 30 that were invited to purchase their device and «reimbursed group» that were offered a CPAP reimbursed by the social security. 812 patients were found: 59 in the OOP group, mostly females, sleepier and using more hypnotics. Out of the reimbursed group, 183 patients were matched to the OOP patients on the grounds of age, AHI and BMI. 90% of OOP and 94% of reimbursed patients (p 0.379) accepted a CPAP trial; 74% of OOP and 90% of reimbursed patients acquired a CPAP device (p 0.005) thereafter, whereas 82% and, respectively, 84% of those (p 0.254) were still on CPAP after a mean follow-up of 711 and 604 days with a mean ± SD daily compliance of 5.3 ± 3 and 6.1 ± 2 h, respectively (p 0.159). Only fatigue scale seems to influence the purchase of CPAP by OOP patients. CPAP reimbursement influences the purchase of CPAP but once the device becomes available there is no difference with reimbursed patients in long-term adherence.

42 CFR 405.1803 - Intermediary determination and notice of amount of program reimbursement.

Science.gov (United States)

2010-10-01

... program reimbursement. 405.1803 Section 405.1803 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Provider Reimbursement Determinations and Appeals § 405.1803 Intermediary determination and notice of amount of program reimbursement. (a) General requirement. Upon receipt of a provider's cost report, or...

75 FR 34336 - Reimbursement Transportation Cost Payment Program for Geographically Disadvantaged Farmers and...

Science.gov (United States)

2010-06-17

... DEPARTMENT OF AGRICULTURE Farm Service Agency 7 CFR Part 755 RIN 0560-AI08 Reimbursement... Reimbursement Transportation Cost Payment (RTCP) Program for geographically disadvantaged farmers and ranchers.... To be eligible for reimbursement, the transportation costs must have been incurred in the FY for...

Trends in Medicaid Reimbursements for Insulin From 1991 Through 2014.

Science.gov (United States)

Luo, Jing; Avorn, Jerry; Kesselheim, Aaron S

2015-10-01

Insulin is a vital medicine for patients with diabetes mellitus. Newer, more expensive insulin products and the lack of generic insulins in the United States have increased costs for patients and insurers. To examine Medicaid payment trends for insulin products. Cost information is available for all 50 states and has been recorded since the 1990s. A time-series analysis comparing reimbursements and prices. Using state- and national-level Medicaid data from 1991 to 2014, we identified all patients who used 1 or more of the 16 insulin products that were continuously available in the United States between 2006 and 2014. Insulin products were classified into rapid-acting and long-acting analogs, short-acting, intermediate, and premixed insulins based on American Diabetes Association Guidelines. Inflation-adjusted payments made to pharmacies by Medicaid per 1 mL (100 IU) of insulin in 2014 US dollars. Since 1991, Medicaid reimbursement per unit (1 mL) of insulin dispensed has risen steadily. In the 1990s, Medicaid reimbursed pharmacies between $2.36 and $4.43 per unit. By 2014, reimbursement for short-acting insulins increased to $9.64 per unit; intermediate, $9.22; premixed, $14.79; and long-acting, $19.78. Medicaid reimbursement for rapid-acting insulin analogs rose to $19.81 per unit. The rate of increase in reimbursement was higher for insulins with patent protection ($0.20 per quarter) than without ($0.05 per quarter) (Preimbursements peaked at $407.4 million dollars in quarter 2 of 2014. Total volume peaked at 29.9 million units in quarter 4 of 2005 and was 21.2 million units in quarter 2 of 2014. Between 1991 and 2014, there was a near-exponential upward trend in Medicaid payments on a per-unit basis for a wide variety of insulin products regardless of formulation, duration of action, and whether the product was patented. Although reimbursements for newer, patent-protected insulin analogs increased at a faster rate than reimbursements for older insulins, payments

The role of the sickness funds in the Belgian health care market

NARCIS (Netherlands)

W. Nonneman (Nonneman); E.K.A. van Doorslaer (Eddy)

1994-01-01

textabstractThis article reviews some of the salient features of the Belgian health care finance and delivery system. Special attention is paid to the role played by the third-party payers, i.e. the Health Insurance Associations (HIAs) in administering the compulsory national health insurance

50 CFR 86.71 - How will I be reimbursed?

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false How will I be reimbursed? 86.71 Section 86.71 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR...) PROGRAM How States Manage Grants § 86.71 How will I be reimbursed? For details on how we will pay you...

Pyrrolizidine alkaloids in food and feed on the Belgian market.

Science.gov (United States)

Huybrechts, Bart; Callebaut, Alfons

2015-01-01

Pyrrolizidine alkaloids (PAs) are widely distributed plant toxins with species dependent hepatotoxic, carcinogenic, genotoxic and pneumotoxic risks. In a recent European Food Safety Authority (EFSA) opinion, only two data sets from one European country were received for honey, while one feed data set was included. No data are available for food or feed samples from the Belgian market. We developed an LC-MS/MS method, which allowed the detection and quantification of 16 PAs in a broad range of matrices in the sub ng g(-1) range. The method was validated in milk, honey and hay and applied to honey, tea (Camellia sinensis), scented tea, herbal tea, milk and feed samples bought on the Belgian market. The results confirmed that tea, scented tea, herbal tea and honey are important food sources of pyrrolizidine alkaloid contamination in Belgium. Furthermore, we detected PAs in 4 of 63 commercial milk samples. A high incidence rate of PAs in lucerne (alfalfa)-based horse feed and in rabbit feed was detected, while bird feed samples were less contaminated. We report for the first time the presence of monocrotaline, intermedine, lycopsamine, heliotrine and echimidine in cat food.

45 CFR 149.610 - Secretary's authority to reopen and revise a reimbursement determination.

Science.gov (United States)

2010-10-01

... reimbursement determination. 149.610 Section 149.610 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES... of Data Inaccuracies § 149.610 Secretary's authority to reopen and revise a reimbursement determination. (a) The Secretary may reopen and revise a reimbursement determination upon the Secretary's own...

44 CFR 208.37 - Reimbursement for equipment and supply costs incurred during Activation.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for equipment... SEARCH AND RESCUE RESPONSE SYSTEM Response Cooperative Agreements § 208.37 Reimbursement for equipment and supply costs incurred during Activation. (a) Allowable costs. DHS will reimburse costs incurred...

42 CFR 447.257 - FFP: Conditions relating to institutional reimbursement.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false FFP: Conditions relating to institutional reimbursement. 447.257 Section 447.257 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...: Conditions relating to institutional reimbursement. FFP is not available for a State's expenditures for...

48 CFR 452.232-70 - Reimbursement for Bond Premiums-Fixed-Price Construction Contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Reimbursement for Bond... Provisions and Clauses 452.232-70 Reimbursement for Bond Premiums—Fixed-Price Construction Contracts. As prescribed in 432.111, insert the following clause: Reimbursement for Bond Premiums—Fixed-Price Construction...

Factors associated with non-reimbursable activity on an inpatient pediatric consultation-liaison service.

Science.gov (United States)

Bierenbaum, Melanie L; Katsikas, Steven; Furr, Allen; Carter, Bryan D

2013-12-01

The aim of this study was to identify factors contributing to clinician time spent in non-reimbursable activity on an inpatient pediatric consultation-liaison (C-L) service. A retrospective study was conducted using inpatient C-L service data on 1,246 consecutive referrals. For this patient population, the strongest predictor of level of non-reimbursable clinical activity was illness chronicity and the number of contacts with C-L service clinicians during their hospital stay. Patients with acute life-threatening illnesses required the highest mean amount of non-reimbursable service activity. On average, 28 % of total clinician time in completing a hospital consultation was spent in non-reimbursable activity. Effective C-L services require a proportion of time spent in non-reimbursable clinical activity, such as liaison and coordinating care with other providers. Identifying referral and systemic factors contributing to non-reimbursable activity can provide insight into budgeting/negotiating for institutional support for essential clinical and non-clinical functions in providing competent quality patient care.

Quantitative evaluation of radiation oncologists' adaptability to lower reimbursing treatment programs.

Science.gov (United States)

Gill, Beant S; Beriwal, Sushil; Rajagopalan, Malolan S; Wang, Hong; Hodges, Kimberly; Greenberger, Joel S

2015-01-01

Rapid development of sophisticated modalities has challenged radiation oncologists to evaluate workflow and care delivery processes. Our study assesses treatment modality use and willingness to alter management with anticipated limitations in reimbursement and resources. A web-based survey was sent to 43 radiation oncologists in a National Cancer Institute-designated comprehensive cancer center network. The survey contained 7 clinical cases with various acceptable treatment options based on our institutional clinical pathways. Each case was presented in 3 modules with varying situations: (1) unlimited resources with current reimbursement, (2) restricted reimbursement (bundled payment), and (3) both restricted reimbursement and resources. Reimbursement rates were based on the 2013 Medicare fee schedule. Adoption of lower reimbursing options (LROs) was defined as the percentage of scenarios in which a respondent selected an LRO compared with baseline. Forty-three physicians completed the survey, 11 (26%) at academic and 32 (74%) at community facilities. When bundled payment was imposed (module 1 vs 2), an increase in willingness to adopt LROs was observed (median 11.1%). When physicians were limited to both bundled payment and resource restriction, adoption of LROs was more pronounced (module 1 vs 3; median 22.2%, P 25 years, P = .02). Radiation oncologists were more likely to choose lower reimbursing treatment options when both resource restriction and bundled payment were presented. Those with fewer years of clinical practice were less inclined to alter management, perhaps reflecting modern residency training. Future cost-utility analyses may help to better guide radiation oncologists in selection of LROs. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Assessment of doses received by the Belgian population due to the Chernobyl releases

International Nuclear Information System (INIS)

Govaerts, P.; Fieuw, G.; Deworm, J.P.; Zeevaert, Th.

1986-01-01

The consequences of the exposure during the first year and beyond the first year after the Chernobyl accident in terms of radiation effects on the Belgian population are discussed as well as some uncertainties in these evaluations. (A.F.)

Capital cost reimbursement to community hospitals under Federal health insurance programs.

Science.gov (United States)

Kinney, E D; Lefkowitz, B

1982-01-01

Issues in current capital cost reimbursement to community hospitals by Medicare and Medicaid are described, and options for change analyzed. Major reforms in the way the federal government pays for capital costs--in particular substitution of other methods of payment for existing depreciation reimbursement--could have significant impact on the structure of the health care system and on government expenditures. While such reforms are likely to engender substantial political opposition, they may be facilitated by broader changes in the reimbursement system.

26 CFR 601.804 - Reimbursements.

Science.gov (United States)

2010-04-01

... provided for in cooperative agreements, the Internal Revenue Service will provide amounts to program.... Cooperative agreements will establish the items for which reimbursements will be allowed and the method of..., and accounting and financial control systems. (b) Direct, reasonable, and prudent expenses...

Challenges for the registration of vaccines in emerging countries: Differences in dossier requirements, application and evaluation processes.

Science.gov (United States)

Dellepiane, Nora; Pagliusi, Sonia

2018-06-07

The divergence of regulatory requirements and processes in developing and emerging countries contributes to hamper vaccines' registration, and therefore delay access to high-quality, safe and efficacious vaccines for their respective populations. This report focuses on providing insights on the heterogeneity of registration requirements in terms of numbering structure and overall content of dossiers for marketing authorisation applications for vaccines in different areas of the world. While it also illustrates the divergence of regulatory processes in general, as well as the need to avoid redundant reviews, it does not claim to provide a comprehensive view of all processes nor existing facilitating mechanisms, nor is it intended to touch upon the differences in assessments made by different regulatory authorities. This report describes the work analysed by regulatory experts from vaccine manufacturing companies during a meeting held in Geneva in May 2017, in identifying and quantifying differences in the requirements for vaccine registration in three aspects for comparison: the dossier numbering structure and contents, the application forms, and the evaluation procedures, in different countries and regions. The Module 1 of the Common Technical Document (CTD) of 10 countries were compared. Modules 2-5 of the CTDs of two regions and three countries were compared to the CTD of the US FDA. The application forms of eight countries were compared and the registration procedures of 134 importing countries were compared as well. The analysis indicates a high degree of divergence in numbering structure and content requirements. Possible interventions that would lead to significant improvements in registration efficiency include alignment in CTD numbering structure, a standardised model-application form, and better convergence of evaluation procedures. Copyright © 2018.

The Belgian nuclear research centre

International Nuclear Information System (INIS)

Moons, F.

2001-01-01

The Belgian Nuclear Research Centre is almost exclusively devoted to nuclear R and D and services and is able to generate 50% of its resources (out of 75 million Euro) by contract work and services. The main areas of research include nuclear reactor safety, radioactive waste management, radiation protection and safeguards. The high flux reactor BR2 is extensively used to test fuel and structural materials. PWR-plant BR3 is devoted to the scientific analysis of decommissioning problems. The Centre has a strong programme on the applications of radioisotopes and radiation in medicine and industry. The centre has plans to develop an accelerator driven spallation neutron source for various applications. It has initiated programmes to disseminate correct information on issues of nuclear energy production and non-energy nuclear applications to different target groups. It has strong linkages with the IAEA, OECD-NEA and the Euratom. (author)

What are estimated reimbursements for lower extremity prostheses capable of surgical and nonsurgical lengthening?

Science.gov (United States)

Henderson, Eric R; Pepper, Andrew M; Letson, G Douglas

2012-04-01

Growing prostheses accommodate skeletally immature patients with bone tumors undergoing limb-preserving surgery. Early devices required surgical procedures for lengthening; recent devices lengthen without surgery. Expenses for newer expandable devices that lengthen without surgery are more than for their predecessors but overall reimbursement amounts are not known. We sought to determine reimbursement amounts associated with lengthening of growing prostheses requiring surgical and nonsurgical lengthening. We retrospectively reviewed 17 patients with growing prostheses requiring surgical expansion and eight patients with prostheses capable of nonsurgical expansion. Insurance documents were reviewed to determine the reimbursement for implantation, lengthening, and complications. Growth data were obtained from the literature. Mean reimbursement amounts of surgical and nonsurgical lengthenings were $9950 and $272, respectively. Estimated reimbursements associated with implantation of a growing prosthesis varied depending on age, sex, and location. The largest difference was found for 4-year-old boys with distal femoral replacement where reimbursement for expansion to maturity for surgical and nonsurgical lengthening prostheses would be $379,000 and $208,000, respectively. For children requiring more than one surgical expansion, net reimbursements were lower when a noninvasive lengthening device was used. Annual per-prosthesis maintenance reimbursements to address complications for surgical and nonsurgical lengthening prostheses were $3386 and $1856, respectively. This study showed that reimbursements for lengthening of growing endoprostheses capable of nonsurgical expansion may be less expensive in younger patients, particularly male patients undergoing distal femur replacement, than endoprostheses requiring surgical lengthening. Longer outcomes studies are required to see if reimbursements for complications differ between devices. Level III, economic and decision

Reimbursed drugs in patients with sleep-disordered breathing: A static-charge-sensitive bed study.

Science.gov (United States)

Anttalainen, Ulla; Polo, Olli; Vahlberg, Tero; Saaresranta, Tarja

2010-01-01

Co-morbidities in men and women with sleep-disordered breathing (SDB) were compared retrospectively to an age-standardized, general Finnish population. The prevalence of diseases was based on the reimbursement refunds of medications. Two hundred thirty-three age- and BMI-matched male-female pairs and 368 consecutive women identified from our sleep recording database were included. Data on medication were gathered from the National Agency for Medicines and Social Insurance Institution database. Men with SDB had three-fold prevalence of reimbursed medication for diabetes and two-fold prevalence of reimbursed medication for chronic arrhythmia. Women with SDB had three-fold prevalence of reimbursed medication for thyroid insufficiency, and postmenopausal women had two-fold prevalence of reimbursed medication for psychosis. BMI and age did not explain prevalence of reimbursed medications for chronic arrhythmia or psychosis. In both genders with SDB, prevalence of reimbursed medications compared to the general population was two-fold for hypertension and seven-fold for asthma and/or chronic obstructive pulmonary disease (COPD). Partial upper airway obstruction was associated with three-fold prevalence of reimbursed medication for asthma and/or COPD in both genders and 60% reduced prevalence of reimbursed medication for hypertension in females matched for age and BMI. Co-morbidity profile differed between genders. Our results emphasize the importance of diagnosis and treatment of co-morbidities and partial upper airway obstruction. Copyright 2009 Elsevier B.V. All rights reserved.

76 FR 5328 - Summer Food Service Program; 2011 Reimbursement Rates

Science.gov (United States)

2011-01-31

...This notice informs the public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service Program for Children. These adjustments address changes in the Consumer Price Index, as required under the Richard B. Russell National School Lunch Act. The 2011 reimbursement rates are presented as a combined set of rates to highlight simplified cost accounting procedures that are extended nationwide by enactment of the Fiscal Year 2008 Consolidated Appropriations Act. The 2011 rates are also presented individually, as separate operating and administrative rates of reimbursement, to show the effect of the Consumer Price Index adjustment on each rate.

75 FR 3197 - Summer Food Service Program; 2010 Reimbursement Rates

Science.gov (United States)

2010-01-20

...This notice informs the public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service Program for Children. These adjustments address changes in the Consumer Price Index, as required under the Richard B. Russell National School Lunch Act. The 2010 reimbursement rates are presented as a combined set of rates to highlight simplified cost accounting procedures that are extended nationwide by enactment of the Fiscal Year 2008 Consolidated Appropriations Act. The 2010 rates are also presented individually, as separate operating and administrative rates of reimbursement, to show the effect of the Consumer Price Index adjustment on each rate.

A comparison of patient-centered and case-mix reimbursement for nursing home care.

Science.gov (United States)

Willemain, T R

1980-01-01

The trend in payment for nursing home services has been toward making finer distinctions amont patients and the rates at which their care is reimbursed. The ultimate in differentiation is patient-centered reimbursement, whereas each patient's rate is individually determined. This paper introduces a model of overpayment and under-payment for comparing the potential performance of alternative reimbursement schemes. The model is used in comparing the patient-centered approach with case-mix reimbursement, which assigns a single rate to all patients in a nursing home on the basis of the facility's case mix. Roughly speaking, the case-mix approach is preferable whenever the differences between patient's needs are smaller than the errors in needs assessment. Since this condition appears to hold in practice today, case-mix reimbursement seems preferable for the short term.

Dynamic Profit Inefficiency: A DEA Application to Belgian Dairy Farms

OpenAIRE

Ang, Frederic; Oude Lansink, Alfons

2014-01-01

Using a nonparametric framework, we analyze dynamic profit inefficiency for a sample of Belgian, specialized dairy farms from 1996–2008. Profit inefficiency is decomposed into contributions of output, input, and investment. Moreover, we identify the contributions of technical and allocative inefficiency in each input and output. The results suggest substantial profit inefficiency under the current dairy-quota system, mainly driven by an average underproduction of approximately 50 percent and ...

The mud deposits and the high turbidity in the Belgian-Dutch coastal zone, Southern Bight of the North Sea

OpenAIRE

Fettweis, M.; Van den Eynde, D.

2003-01-01

The suspended sediment processes and the mudfields found in the Belgian/Dutch coastal area (Southern North Sea) are discussed by presenting an integrated data-modelling approach of the suspended sediment transport along the Belgian-Dutch coast, using a fine-grid coupled 2D hydrodynamic and sediment transport model and existing field and literature data. These mudfields and turbidity maxima are situated in a well-mixed, highly energetic hydrodynamic environment. In the past the occurrence of t...

Études des pratiques funéraires éthiopiennes : contextes, sources et enjeux. Introduction au dossier

Directory of Open Access Journals (Sweden)

Anaïs Wion

2012-01-01

Full Text Available Ce dossier rassemble des articles issus d’un séminaire de recherche sur la mort et les funérailles en Éthiopie qui a eu lieu entre 2002 et 2004 au Centre de recherches africaines de l’Université Paris 1 Panthéon-Sorbonne, animé par les enseignants-chercheurs, chercheurs, doctorants et post-doctorants travaillant sur l’Éthiopie. Ce séminaire se voulait délibérément ouvert aux différentes périodes, aux disciplines, aux aires culturelles qui recouvrent l’espace éthiopien d’aujourd’hui, même si l...

48 CFR 5152.245-9001 - Government property for installation support services (cost-reimbursement contracts).

Science.gov (United States)

2010-10-01

... installation support services (cost-reimbursement contracts). 5152.245-9001 Section 5152.245-9001 Federal... CONTRACT CLAUSES 5152.245-9001 Government property for installation support services (cost-reimbursement... Installation Support Services (Cost-Reimbursement Contracts) (OCT 1989) (DEV) (a) Government-furnished property...

Cost analysis of radiological interventional procedures and reimbursement within a clinic

International Nuclear Information System (INIS)

Strotzer, M.; Voelk, M.; Lenhart, M.; Fruend, R.; Feuerbach, S.

2002-01-01

Purpose: Analysis of costs for vascular radiological interventions on a per patient basis and comparison with reimbursement based on GOAe(Gebuehrenordnung fuer Aerzte) and DKG-NT (Deutsche Krankenhausgesellschaft-Nebenkostentarif). Material and Methods: The ten procedures most frequently performed within 12 months were evaluated. Personnel costs were derived from precise costs per hour and estimated procedure time for each intervention. Costs for medical devices were included. Reimbursement based on GOAewas calculated using the official conversion factor of 0.114 DM for each specific relative value unit and a multiplication factor of 1.0. The corresponding conversion factor for DKG-NT, determined by the DKG, was 0.168 DM. Results: A total of 832 interventional procedures were included. Marked differences between calculated costs and reimbursement rates were found. Regarding the ten most frequently performed procedures, there was a deficit of 1.06 million DM according GOAedata (factor 1.0) and 0.787 million DM according DKG-NT. The percentage of reimbursement was only 34.2 (GOAe; factor 1.0) and 51.3 (DKG-NT), respectively. Conclusion: Reimbursement of radiological interventional procedures based on GOAeand DKG-NT data is of limited value for economic controlling purposes within a hospital. (orig.) [de

Dust suppression in Belgian coal mines. Situation at the beginning of 1978

Energy Technology Data Exchange (ETDEWEB)

Preat, B; Vanstraelen, M

1978-01-01

Gives a general view of dust control in Belgian mines. Statistical data are presented in tables. Prior spraying, wet cutting, and water infusion and pneumatic drills with sprays are used; in some cases, two or more of these techniques are used together in the same face. (In French and In Dutch)

Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion

Science.gov (United States)

Jones, Christine D.; Scott, Serena J.; Anoff, Debra L.; Pierce, Read G.; Glasheen, Jeffrey J.

2015-01-01

Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P reimbursement for encounter type by payer accounted for −0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion. PMID:26310500

Reimbursing live organ donors for incurred non-medical expenses: a global perspective on policies and programs.

Science.gov (United States)

Sickand, M; Cuerden, M S; Klarenbach, S W; Ojo, A O; Parikh, C R; Boudville, N; Garg, A X

2009-12-01

Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support.

Reimbursing Live Organ Donors for Incurred Non-Medical Expenses: A Global Perspective on Policies and Programs

Science.gov (United States)

Sickand, M.; Cuerden, M. S.; Klarenbach, S. W.; Ojo, A. O.; Parikh, C. R.; Boudville, N.; Garg, A. X.

2015-01-01

Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support. PMID:19788503

49 CFR 577.11 - Reimbursement notification.

Science.gov (United States)

2010-10-01

...-notification remedies and identify the type of remedy eligible for reimbursement; (3) Identify any limits on..., and arguments, that all covered vehicles are under warranty or that no person would be eligible for...

Belgian Workshop (November 2003) - Executive Summary and International Perspective

International Nuclear Information System (INIS)

2004-01-01

The fourth workshop of the OECD/NEA Forum on Stakeholder Confidence (FSC) was hosted by ONDRAF/NIRAS, the Belgian Agency for Radioactive Waste Management and enriched fissile materials. The central theme of the workshop was 'Dealing with interests, values and knowledge in managing risk' within the Belgian context of local partnerships for the long term management of low-level, short-lived radioactive waste. The four-day workshop started with a half-day session in Brussels giving a general introduction on the Belgian context and the local partnership methodology. This was followed by community visits to three local partnerships, PaLoFF in Fleurus-Farciennes, MONA in Mol, and STOLA in Dessel. After the visits, the workshop continued with two full-day sessions in Brussels. One hundred and nineteen registered participants, representing 13 countries, attended the workshop or participated in the community visits. About two thirds were Belgian stakeholders; the remainder came from FSC member organisations. The participants included representatives of municipal governments, civil society organisations, government agencies, industrial companies, the media, and international organisations as well as private citizens, consultants and academics. The four-day meeting was structured as follows: Day 1 morning was devoted to introductory presentations. Information was given on the general radioactive waste management context in Belgium. Regarding the management of LLW, and in particular the search for a disposal facility site, the workshop heard about the local partnership methodology developed by university researchers of the University of Antwerp and the Fondation Universitaire Luxembourgeoise (FUL). These partnerships between the potential host municipalities and the radwaste agency have the mission to develop an integrated facility proposal adapted to local conditions. Community visits took place on Day 1 afternoon and Day 2. Visits offered an opportunity for

Similarities and differences between five European drug reimbursement systems

OpenAIRE

Franken, Margreet

2012-01-01

3349-357 Objectives: The aim of our study is to compare five European drug reimbursement systems, describe similarities and differences, and obtain insight into their strengths and weaknesses and formulate policy recommendations. Methods: We used the analytical Hutton Framework to assess in detail drug reimbursement systems in Austria, Belgium, France, the Netherlands, and Sweden. We investigated policy documents, explored literature, and conducted fifty-seven interviews with relevant s...

Focal epilepsy in the Belgian shepherd

DEFF Research Database (Denmark)

Berendt, Mette; Gulløv, Christina Hedal; Fredholm, Merete

2009-01-01

and deceased) were ascertained through a telephone interview using a standardised questionnaire regarding seizure history and phenomenology. Living dogs were invited to a detailed clinical evaluation. Litters more than five years of age, or where epilepsy was present in all offspring before the age of five......, were included in the calculations of inheritance. results: Out of 199 family members, 66 dogs suffered from epilepsy. The prevalence of epilepsy in the family was 33%. Fifty-five dogs experienced focal seizures with or without secondary generalisation, while four dogs experienced primary generalised...... seizures. In seven dogs, seizures could not be classified. The mode of inheritance of epilepsy was simple Mendelian. CLINICAL SIGNIFICANCE: This study identified that the Belgian shepherd suffers from genetically transmitted focal epilepsy. The seizure phenomenology expressed by family members have...

76 FR 30696 - Reimbursement for Costs of Remedial Action at Active Uranium and Thorium Processing Sites

Science.gov (United States)

2011-05-26

... in the reimbursement ceilings). Title X requires DOE to reimburse eligible uranium and thorium... DEPARTMENT OF ENERGY Reimbursement for Costs of Remedial Action at Active Uranium and Thorium... reimbursement under Title X of the Energy Policy Act of 1992. In our Federal Register Notice of November 24...

76 FR 24871 - Reimbursement for Costs of Remedial Action at Active Uranium and Thorium Processing Sites

Science.gov (United States)

2011-05-03

... in the reimbursement ceilings). Title X requires DOE to reimburse eligible uranium and thorium... DEPARTMENT OF ENERGY Reimbursement for Costs of Remedial Action at Active Uranium and Thorium... reimbursement under Title X of the Energy Policy Act of 1992. DATES: In our Federal Register Notice of November...

The Belgian experience on the backfitting and safety upgrading of old operating nuclear power plants

International Nuclear Information System (INIS)

Brognon, T.

1993-01-01

The paper describes the methodology for backfitting and safety upgrading during the reevaluation of the Belgian NPP's: first generation (Doel-1, Doel-2, Tihange-1) and second generation plants (Doel-3, Doel-4, Tihange-2 and Tihange-3). A list of essential safety subjects and topics is given. The experience has proved the feasibility of a safety upgrading of operating NPP without injury to its availability, the benefit of a close cooperation between owner, engineering company and safety authorities throughout the project. A global approach to solving numerous specific deficiencies along with the optimization of the investments regarding the safety improvement of the NPP is suggested. Further increase of the know-how will be achieved through the present Belgian programme along with similar activities abroad. (R.I.)

Non-suicidal self-injury among Dutch and Belgian adolescents: Personality, stress and coping

NARCIS (Netherlands)

Kiekens, G.; Bruffaerts, R.; Nock, M.K.; Ven, M.O.M. van de; Witteman, C.L.M.; Mortier, P.; Demyttenaere, K.; Claes, L.

2015-01-01

Background This study examines: (1) the prevalence of Non-Suicidal Self-Injury (NSSI) among Dutch and Belgian adolescents, (2) the associations between Big Five personality traits and NSSI engagement/versatility (i.e., number of NSSI methods), and (3) whether these associations are mediated by

Recruitment in a Monopsonistic Labour Market: Will Travel Costs be reimbursed?

NARCIS (Netherlands)

Rouwendal, Jan; Ommeren, van Jos

2007-01-01

Reimbursement of commuting costs by employers has attracted little attention from economists. We develop a theoretical model of a monopsonistic employer who determines an optimal recruitment policy in a spatial labour market with search frictions and show that partial reimbursement of commuting cost

Providing Mailing Cost Reimbursements: The Effect on Reporting Timeliness of Sexually Transmitted Diseases in Virginia.

Science.gov (United States)

Vasiliu, Oana E; Stover, Jeffrey A; Mays, Marissa J E; Bissette, Jennifer M; Dolan, Carrie B; Sirbu, Corina M

2009-01-01

We investigated the effect of providing mailing cost reimbursements to local health departments on the timeliness of the reporting of sexually transmitted diseases (STDs) in Virginia. The Division of Disease Prevention, Virginia Department of Health, provided mailing cost reimbursements to 31 Virginia health districts from October 2002 to December 2004. The difference (in days) between the diagnosis date (or date the STD paperwork was initiated) and the date the case/STD report was entered into the STD surveillance database was used in a negative binomial regression model against time (as divided into three periods-before, during, and after reimbursement) to estimate the effect of providing mailing cost reimbursements on reporting timeliness. We observed significant decreases in the number of days between diagnosis and reporting of a case, which were sustained after the reimbursement period ended, in 25 of the 31 health districts included in the analysis. We observed a significant initial decrease (during the reimbursement period) followed by a significant increase in the after-reimbursement phase in one health district. Two health districts had a significant initial decrease, while one health district had a significant decrease in reporting timeliness in the period after reimbursement. Two health districts showed no significant changes in the number of days to report to the central office. Providing reimbursements for mailing costs was statistically associated with improved STD reporting timeliness in almost all of Virginia's health districts. Sustained improvement after the reimbursement period ended is likely indicative of improved local health department reporting habits.

47 CFR 54.413 - Reimbursement for revenue forgone in offering a Link Up program.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Reimbursement for revenue forgone in offering a... § 54.413 Reimbursement for revenue forgone in offering a Link Up program. (a) Eligible telecommunications carriers may receive universal service support reimbursement for the revenue they forgo in...

76 FR 14543 - Federal Acquisition Regulation; Proper Use and Management of Cost-Reimbursement Contracts

Science.gov (United States)

2011-03-16

..., Sequence 1] RIN 9000-AL78 Federal Acquisition Regulation; Proper Use and Management of Cost-Reimbursement... other than firm-fixed-price contracts (e.g., cost-reimbursement, time-and-material, and labor-hour...-reimbursement contracts and identifies the following three areas that the Defense Acquisition Regulation Council...

48 CFR 49.603-3 - Cost-reimbursement contracts-complete termination, if settlement includes cost.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement... Termination Forms and Formats 49.603-3 Cost-reimbursement contracts—complete termination, if settlement includes cost. [Insert the following in Block 14 of SF 30 for settlement of cost-reimbursement contracts...

Encouraging smokers to quit: the cost effectiveness of reimbursing the costs of smoking cessation treatment.

Science.gov (United States)

Kaper, Janneke; Wagena, Edwin J; van Schayck, Constant P; Severens, Johan L

2006-01-01

Smoking cessation should be encouraged in order to increase life expectancy and reduce smoking-related healthcare costs. Results of a randomised trial suggested that reimbursing the costs of smoking cessation treatment (SCT) may lead to an increased use of SCT and an increased number of quitters versus no reimbursement. To assess whether reimbursement for SCT is a cost-effective intervention (from the Dutch societal perspective), we calculated the incremental costs per quitter and extrapolated this outcome to incremental costs per QALY saved versus no reimbursement. In the reimbursement trial, 1266 Dutch smokers were randomly assigned to the intervention or control group using a randomised double consent design. Reimbursement for SCT was offered to the intervention group for a period of 6 months. No reimbursement was offered to the control group. Prolonged abstinence from smoking was determined 6 months after the end of the reimbursement period. The QALYs gained from quitting were calculated until 80 years of age using data from the US. Costs (year 2002 values) were determined from the societal perspective during the reimbursement period (May-November 2002). Benefits were discounted at 4% per annum. The uncertainty of the incremental cost-effectiveness ratios was estimated using non-parametric bootstrapping. Eighteen participants in the control group (2.8%) and 35 participants in the intervention group (5.5%) successfully quit smoking. The costs per participant were 291 euro and 322 euro, respectively. If society is willing to pay 1000 euro or 10,000 euro for an additional 12-month quitter, the probability that reimbursement for SCT would be cost effective was 50% or 95%, respectively. If society is willing to pay 18,000 euro for a QALY, the probability that reimbursement for SCT would be cost effective was 95%. However, the external validity of the extrapolation from quitters to QALYs is uncertain and several assumptions had to be made. Reimbursement for SCT may

Energy press kit; Dossier energie

Energy Technology Data Exchange (ETDEWEB)

Czarnes, R.; Chauvot, M.; Depagneux, M.A.; Bollack, L.; Cittanova, M.L.; Madelaine, N.; Alves, J.; Burg, D

2004-06-01

This special dossier treats of the changes that will happen in France with the deregulation of energy markets. It comprises 19 articles dealing with: the big bang of July 1, 2004 in the electricity and gas sector (on July 1, 2004, all professional consumers will have the possibility to chose their electricity and gas supplier. If Electricite de France (EdF) and Gaz de France (GdF) monopolies will split up, several questions remain unanswered for clients); the impossible penetration of the French market (3 weeks before the enhanced opening of power markets, EdF's competitors remain surprisingly limited and are mainly French actors. The big European competitors follow a wait-and-see policy); the independent power producer Compagnie Generale du Rhone wants to diversify its clients and is looking towards local authorities; Direct Energie: the 'low-cost' company for the mutualization of electricity purchases of small professionals; Endesa, the French daughter company of the Spanish electric utility, is looking for a balance between production and sales; HEW, daughter company of Vattenfall Europe and present in France since April 2000, wants to increase its margins more than its capacity; energy profilers are making consumption profiles for EdF's competitors; Poweo, energy retailing company built in 2002, is fetching very small companies; Atel, French daughter company of the Swiss power producer, does not foresee important changes in July 1; interview of F. Roussely, head of EdF about the liberalization of the electricity sector; the main energy groups favorable to deregulation; case study: Accor, the hotel trade group, has chosen Compagnie Generale du Rhone as power supplier; electricity: why prices are increasing; various foreign experiences; UK: the consolidation time (fully liberalized and privatized between several companies, the British energy market is under total re-building); USA: the deregulation process has failed and stays stuck to 24

Estimation of the furan contamination across the Belgian food chain

OpenAIRE

Scholl , Georges; Scippo , Marie-Louise; Eppe , Gauthier; De Pauw , Edwin; Saegerman , Claude

2011-01-01

Abstract The current paper provides the estimate of the furan content in Belgian foods. The objective of the study was to achieve the best food chain coverage with a restrictive number of samples (n=496). The geographic distribution, the different market chains and labels, but also the consumption frequencies were taken into account for the sampling plan construction. Weighting factors on contamination levels, consumption frequency and diversity of food items were applied to set ...

76 FR 39043 - TRICARE; Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical...

Science.gov (United States)

2011-07-05

...: Federal Docket Management System Office, Room 3C843, 1160 Defense Pentagon, Washington, DC 20301-1160... paid under the Medicare Diagnosis- Related Group (DRG) method for all of that hospital's Medicare... reimbursement is usually substantially greater than what would be paid using the Diagnosis- Related Group (DRG...

Challenges with participant reimbursement: experiences from a post-trial access study.

Science.gov (United States)

Mngadi, Kathryn Therese; Frohlich, Janet; Montague, Carl; Singh, Jerome; Nkomonde, Nelisiwe; Mvandaba, Nomzamo; Ntombeka, Fanelesibonge; Luthuli, Londiwe; Abdool Karim, Quarraisha; Mansoor, Leila

2015-11-01

Reimbursement of trial participants remains a frequently debated issue, with specific guidance lacking. Trials combining post-trial access and implementation science may necessitate new strategies and models. CAPRISA 008, a post-trial access study testing the feasibility of using family planning services to rollout a prelicensure HIV prevention intervention, tried to balance the real-life scenario of no reimbursement for attendance at public sector clinics with that of a trial including some visits that focused on research procedures and others that focused on standard of care procedures. A reduced reimbursement was offered for 'standard of care' visits, meant primarily to cover transport costs to and from the clinic only. This impacted negatively on accrual, retention and participant morale, primarily due to the protracted delay in regulatory approval, during which time, the costs of living, including travel costs had increased. Relevant guidelines were reviewed and institutional policy was updated to incorporate the South African National Health Research Ethics Committee guidelines on reimbursement (taking into account participant time, travel and inconvenience). The reimbursement amount for 'standard of care' visits was increased accordingly. The question remains whether a trial that combines post-trial access with implementation science, with clear benefits for the participants and the provision of above standard medical care, should have reimbursement rates that approach those of a proof-of-concept trial, for 'standard of care' visits. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Medical Comorbidities Impact the Episode-of-Care Reimbursements of Total Hip Arthroplasty.

Science.gov (United States)

Rosas, Samuel; Sabeh, Karim G; Buller, Leonard T; Law, Tsun Yee; Roche, Martin W; Hernandez, Victor H

2017-07-01

Total hip arthroplasty (THA) costs are a source of great interest in the currently evolving health care market. The initiation of a bundled payment system has led to further research into costs drivers of this commonly performed procedure. One aspect that has not been well studied is the effect of comorbidities on the reimbursements of THA. The purpose of this study was to determine if common medical comorbidities affect these reimbursements. A retrospective, level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary THA between 2007 and 2015. Patients were stratified by medical comorbidities and compared using the analysis of variance for reimbursements of the day of surgery, and over the 90-day postoperative period. A cohort of 250,343 patients was identified. Greatest reimbursements on the day of surgery were found among patients with a history of cirrhosis, morbid obesity, obesity, chronic kidney disease (CKD) and hepatitis C. Patients with cirrhosis, hepatitis C, chronic obstructive pulmonary disease, atrial fibrillation, and CKD incurred in the greatest reimbursements over the 90-day period after surgery. Medical comorbidities significantly impact reimbursements, and inferentially costs, after THA. The most costly comorbidities at 90 days include cirrhosis, hepatitis C, chronic obstructive pulmonary disease, atrial fibrillation, and CKD. Copyright © 2017 Elsevier Inc. All rights reserved.

Predicting the environmental risks of radioactive discharges from Belgian nuclear power plants.

Science.gov (United States)

Vandenhove, H; Sweeck, L; Vives I Batlle, J; Wannijn, J; Van Hees, M; Camps, J; Olyslaegers, G; Miliche, C; Lance, B

2013-12-01

An environmental risk assessment (ERA) was performed to evaluate the impact on non-human biota from liquid and atmospheric radioactive discharges by the Belgian Nuclear Power Plants (NPP) of Doel and Tihange. For both sites, characterisation of the source term and wildlife population around the NPPs was provided, whereupon the selection of reference organisms and the general approach taken for the environmental risk assessment was established. A deterministic risk assessment for aquatic and terrestrial ecosystems was performed using the ERICA assessment tool and applying the ERICA screening value of 10 μGy h(-1). The study was performed for the radioactive discharge limits and for the actual releases (maxima and averages over the period 1999-2008 or 2000-2009). It is concluded that the current discharge limits for the Belgian NPPs considered do not result in significant risks to the aquatic and terrestrial environment and that the actual discharges, which are a fraction of the release limits, are unlikely to harm the environment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Application of the CALUX bioassay for epidemiological study. Analyses of Belgian human plasma

Energy Technology Data Exchange (ETDEWEB)

Wouwe, N. van; Debacker, N.; Sasse, A. [Scientific Institute of Public Health, Brussels (BE)] (and others)

2004-09-15

The CALUX bioassay is a promising screening method for the detection of dioxin-like compounds. The observed good sensitivity, low number of false negative results as well as the good correlations with the GC-HRMS TEQ-values in case of feed and food analyses allow this method to climb in the first assessment methods' scale. The low amount of sample needed in addition to those latest advantages suggest that the CALUX bioassay could be a good screening method for epidemiological studies. The Belgian epidemiological study concerning the possible effect of the dioxin incident on the body burden of the Belgian population was an opportunity to test this method in comparison to the gold reference one: the GC-HRMS. The first part of this abstract presents epidemiological parameters (sensibility, specificity,) of the CALUX bioassay using CALUX TEQ-values as estimators of the TEQ-values of the 17 PCDD/Fs. The second part examines epidemiological determinants observed for CALUX and GCHRMS TEQ-values.

An analysis of the public perception of flood risk on the Belgian coast.

Science.gov (United States)

Kellens, Wim; Zaalberg, Ruud; Neutens, Tijs; Vanneuville, Wouter; De Maeyer, Philippe

2011-07-01

In recent years, perception of flood risks has become an important topic to policy makers concerned with risk management and safety issues. Knowledge of the public risk perception is considered a crucial aspect in modern flood risk management as it steers the development of effective and efficient flood mitigation strategies. This study aimed at gaining insight into the perception of flood risks along the Belgian coast. Given the importance of the tourism industry on the Belgian coast, the survey considered both inhabitants and residential tourists. Based on actual expert's risk assessments, a high and a low risk area were selected for the study. Risk perception was assessed on the basis of scaled items regarding storm surges and coastal flood risks. In addition, various personal and residence characteristics were measured. Using multiple regression analysis, risk perception was found to be primarily influenced by actual flood risk estimates, age, gender, and experience with previous flood hazards. © 2011 Society for Risk Analysis.

SAFIR-2 and the Belgian methodological R and D programme on deep disposal

International Nuclear Information System (INIS)

Preter, Peter de

2002-01-01

Peter de Preter (NIRAS/ONDRAF, Belgium) provided an overview of the Belgian programme of research and development on deep disposal. The planned submission in December 2001 of SAFIR 2 (the second Safety Assessment and Feasibility Interim Report) would mark an important milestone, as the report would inform a decision by the Belgian government on the nature of future research. An independent committee of scientists established by NIRAS/ONDRAF had reviewed a draft version of the report. The committee was generally in agreement with the technical R and D priorities proposed in the report but suggested that there should be more integration of technical and societal aspects. The committee also recommended that a future research programme should compare the option of deep disposal with other strategies for long-term management of radioactive wastes. It was suggested that a strategic environmental assessment might provide an appropriate mechanism for comparing alternative management strategies, and would enable societal dimensions also to be addressed

Toward a new payment system for inpatient rehabilitation. Part II: Reimbursing providers.

Science.gov (United States)

Saitto, Carlo; Marino, Claudia; Fusco, Danilo; Arcà, Massimo; Perucci, Carlo A

2005-09-01

The major fault with existing reimbursement systems lies in their failure to discriminate for the effectiveness of stay, both when paying per day and when paying per episode of treatment. We sought to define an average length of effective stay and recovery trends by impairment category, to design a prospective payment system that takes into account costs and expected recovery trends, and to compare the calculated reimbursement with the predicted costs estimated in a previous study (Saitto C, Marino C, Fusco D, et al. A new prospective payment system for inpatient rehabilitation. Part I: predicting resource consumption. Med Care. 2005;43:844-855). We considered all rehabilitation admissions from 5 Italian inpatient facilities during a 12-month period for which total cost of care had already been estimated and daily cost predicted through regression model. We ascertained recovery trends by impairment category through repeated MDS-PAC schedules and factorial analysis of functional status. We defined effective stay and daily resource consumption by impairment category and used these parameters to calculate reimbursement for the admission. We compared our reimbursement with predicted cost through regression analysis and evaluated the goodness of fit through residual analysis. We calculated reimbursement for 2079 admissions. The r(2) values for the reimbursement to cost correlation ranged from 0.54 in the whole population to 0.56 for "multiple trauma" to 0.85 for "other medical disorders." The best fit was found in the central quintiles of the cost and severity distributions. For each impairment category, we determined the number of days of effective hospital stay and the trends of functional gain. We demonstrated, at least within the Italian health care system, the feasibility of a reimbursement system that matches costs with functional recovery. By linking reimbursement to effective stay adjusted for trends of functional gain, we suggest it is possible to avoid both

48 CFR 252.235-7001 - Indemnification under 10 U.S.C. 2354-cost reimbursement.

Science.gov (United States)

2010-10-01

....S.C. 2354-cost reimbursement. 252.235-7001 Section 252.235-7001 Federal Acquisition Regulations.... 2354—cost reimbursement. As prescribed in 235.070-3, use the following clause: Indemnification Under 10 U.S.C. 2354—Cost Reimbursement (DEC 1991) (a) This clause provides for indemnification under 10 U.S...

30 CFR 285.823 - Will MMS reimburse me for my expenses related to inspections?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Will MMS reimburse me for my expenses related... Conducted Under SAPs, COPs and GAPs Inspections and Assessments § 285.823 Will MMS reimburse me for my expenses related to inspections? Upon request, MMS will reimburse you for food, quarters, and...

Primary Care Physician and Patient Perceptions of Reimbursement for Total Knee and Hip Replacement.

Science.gov (United States)

Wiznia, Daniel H; Kim, Chang-Yeon; Wang, Yuexin; Swami, Nishwant; Pelker, Richard R

2016-07-01

The opinions of nonspecialists and patients will be important to determining reimbursements for specialists such as orthopedic surgeons. In addition, primary care physician (PCP) perceptions of reimbursements may affect utilization of orthopedic services. We distributed a web-based survey to PCPs, asking how much they believed orthopedic surgeons were reimbursed for total hip arthroplasty (THA) and total knee arthroplasty (TKA). We also proctored a paper-based survey to postoperative patients, asking how much orthopedic surgeons should be reimbursed. There was a significant difference between perceived and actual reimbursement values for THA and TKA. Hospital-affiliated PCPs estimated higher reimbursements for both THA ($1657 vs $838, P < .0001 for Medicaid and $2246 vs $1515, P = .018 for Medicare) and TKA ($1260 vs $903, P = .052 for Medicaid and $2022 vs $1514, P = .049 for Medicare). Similarly, larger practices estimated higher reimbursements for both THA ($1861 vs $838, P < .0001 for Medicaid and $2635 vs $1515, P = .004 for Medicare) and TKA ($1583 vs $903, P = .005 for Medicaid and $2380 vs $1514, P = .011 for Medicare). Compared to PCPs, patients estimated that orthopedic surgeons should be paid 4 times higher for both THA ($9787 vs $2235, P < .0001) and TKA ($9088 vs $2134, P < .0001). PCPs believe that reimbursements for orthopedic procedures are higher than actual values. The effect that these perceptions will have on efforts at cost reform and utilization of orthopedic services requires further study. Copyright © 2016 Elsevier Inc. All rights reserved.

Criteria for Drug Reimbursement Decision-Making: An Emerging Public Health Challenge in Bulgaria

Directory of Open Access Journals (Sweden)

Georgi Iskrov

2016-02-01

Full Text Available Background: During times of fiscal austerity, means of reimbursement decision-making are of particular interest for public health theory and practice. Introduction of advanced health technologies, growing health expenditures and increased public scrutiny over drug reimbursement decisions have pushed governments to consider mechanisms that promote the use of effective health technologies, while constraining costs. Aims: The study’s aim was to explore the current rationale of the drug reimbursement decision-making framework in Bulgaria. Our pilot research focused on one particular component of this process – the criteria used – because of the critical role that criteria are known to have in setting budgets and priorities in the field of public health. The analysis pursued two objectives: to identify important criteria relevant to drug reimbursement decision-making and to unveil relationships between theory and practice. Study Design: Cross-sectional study. Methods: The study was realized through a closed-ended survey on reimbursement criteria among four major public health stakeholders – medical professionals, patients, health authorities, and industry. Empirical outcomes were then cross-compared with the theoretical framework, as defined by current Bulgarian public health legislation. Analysis outlined what is done and what needs to be done in the field of public health reimbursement decision-making. Results: Bulgarian public health stakeholders agreed on 15 criteria to form a tentative optimal framework for drug reimbursement decision-making. The most apparent gap between the empirically found preferences and the official legislation is the lack of consideration for the strength of evidence in reimbursement decisions. Conclusion: Bulgarian policy makers need to address specific gaps, such as formal consideration for strength of evidence, explicit role of efficiency criteria, and means to effectively empower patient and citizen

48 CFR 2052.215-78 - Travel approvals and reimbursement-Alternate 1.

Science.gov (United States)

2010-10-01

... reimbursement-Alternate 1. 2052.215-78 Section 2052.215-78 Federal Acquisition Regulations System NUCLEAR... Clauses 2052.215-78 Travel approvals and reimbursement—Alternate 1. As prescribed in 2015.209-70(d), the contracting officer shall insert the following clause in cost reimbursement solicitations and contracts which...

Pricing and reimbursement of orphan drugs: the need for more transparency

Directory of Open Access Journals (Sweden)

Simoens Steven

2011-06-01

Full Text Available Abstract Pricing and reimbursement of orphan drugs are an issue of high priority for policy makers, legislators, health care professionals, industry leaders, academics and patients. This study aims to conduct a literature review to provide insight into the drivers of orphan drug pricing and reimbursement. Although orphan drug pricing follows the same economic logic as drug pricing in general, the monopolistic power of orphan drugs results in high prices: a orphan drugs benefit from a period of marketing exclusivity; b few alternative health technologies are available; c third-party payers and patients have limited negotiating power; d manufacturers attempt to maximise orphan drug prices within the constraints of domestic pricing and reimbursement policies; and e substantial R&D costs need to be recouped from a small number of patients. Although these conditions apply to some orphan drugs, they do not apply to all orphan drugs. Indeed, the small number of patients treated with an orphan drug and the limited economic viability of orphan drugs can be questioned in a number of cases. Additionally, manufacturers have an incentive to game the system by artificially creating monopolistic market conditions. Given their high price for an often modest effectiveness, orphan drugs are unlikely to provide value for money. However, additional criteria are used to inform reimbursement decisions in some countries. These criteria may include: the seriousness of the disease; the availability of other therapies to treat the disease; and the cost to the patient if the medicine is not reimbursed. Therefore, the maximum cost per unit of outcome that a health care payer is willing to pay for a drug could be set higher for orphan drugs to which society attaches a high social value. There is a need for a transparent and evidence-based approach towards orphan drug pricing and reimbursement. Such an approach should be targeted at demonstrating the relative effectiveness

Pricing and reimbursement of orphan drugs: the need for more transparency.

Science.gov (United States)

Simoens, Steven

2011-06-17

Pricing and reimbursement of orphan drugs are an issue of high priority for policy makers, legislators, health care professionals, industry leaders, academics and patients. This study aims to conduct a literature review to provide insight into the drivers of orphan drug pricing and reimbursement. Although orphan drug pricing follows the same economic logic as drug pricing in general, the monopolistic power of orphan drugs results in high prices: a) orphan drugs benefit from a period of marketing exclusivity; b) few alternative health technologies are available; c) third-party payers and patients have limited negotiating power; d) manufacturers attempt to maximise orphan drug prices within the constraints of domestic pricing and reimbursement policies; and e) substantial R&D costs need to be recouped from a small number of patients. Although these conditions apply to some orphan drugs, they do not apply to all orphan drugs. Indeed, the small number of patients treated with an orphan drug and the limited economic viability of orphan drugs can be questioned in a number of cases. Additionally, manufacturers have an incentive to game the system by artificially creating monopolistic market conditions. Given their high price for an often modest effectiveness, orphan drugs are unlikely to provide value for money. However, additional criteria are used to inform reimbursement decisions in some countries. These criteria may include: the seriousness of the disease; the availability of other therapies to treat the disease; and the cost to the patient if the medicine is not reimbursed. Therefore, the maximum cost per unit of outcome that a health care payer is willing to pay for a drug could be set higher for orphan drugs to which society attaches a high social value. There is a need for a transparent and evidence-based approach towards orphan drug pricing and reimbursement. Such an approach should be targeted at demonstrating the relative effectiveness, cost-effectiveness and

30 CFR 250.133 - Will MMS reimburse me for my expenses related to inspections?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Will MMS reimburse me for my expenses related... Inspection of Operations § 250.133 Will MMS reimburse me for my expenses related to inspections? Upon request, MMS will reimburse you for food, quarters, and transportation that you provide for MMS representatives...

77 FR 2297 - Office of Asset and Transportation Management; Privately Owned Vehicle Mileage Reimbursement Rates

Science.gov (United States)

2012-01-17

... of Asset and Transportation Management; Privately Owned Vehicle Mileage Reimbursement Rates AGENCY... Bulletin 12-02, Calendar Year (CY) 2012 Privately Owned Vehicle Mileage Reimbursement Rates. SUMMARY: The General Services Administration's (GSA) annual privately owned vehicle (POV) mileage reimbursement rate...

Comparing Compositional Effects in Two Education Systems: The Case of the Belgian Communities

Science.gov (United States)

Danhier, Julien; Martin, Émilie

2014-01-01

The Belgian educational field includes separate educational systems reflecting the division of the country into linguistic communities. Even if the French-speaking and the Dutch-speaking communities keep sharing important similarities in terms of funding rules and structures, they present a huge gap between their respective pupils' achievement.…

Restructuring in response to case mix reimbursement in nursing homes: a contingency approach.

Science.gov (United States)

Zinn, Jacqueline; Feng, Zhanlian; Mor, Vincent; Intrator, Orna; Grabowski, David

2008-01-01

Resident-based case mix reimbursement has become the dominant mechanism for publicly funded nursing home care. In 1998 skilled nursing facility reimbursement changed from cost-based to case mix adjusted payments under the Medicare Prospective Payment System for the costs of all skilled nursing facility care provided to Medicare recipients. In addition, as of 2004, 35 state Medicaid programs had implemented some form of case mix reimbursement. The purpose of the study is to determine if the implementation of Medicare and Medicaid case mix reimbursement increased the administrative burden on nursing homes, as evidenced by increased levels of nurses in administrative functions. The primary data for this study come from the Centers for Medicare and Medicaid Services Online Survey Certification and Reporting database from 1997 through 2004, a national nursing home database containing aggregated facility-level information, including staffing, organizational characteristics and resident conditions, on all Medicare/Medicaid certified nursing facilities in the country. We conducted multivariate regression analyses using a facility fixed-effects model to examine the effects of the implementation of Medicaid case mix reimbursement and Medicare Prospective Payment System on changes in the level of total administrative nurse staffing in nursing homes. Both Medicaid case mix reimbursement and Medicare Prospective Payment System increased the level of administrative nurse staffing, on average by 5.5% and 4.0% respectively. However, lack of evidence for a substitution effect suggests that any decline in direct care staffing after the introduction of case mix reimbursement is not attributable to a shift from clinical nursing resources to administrative functions. Our findings indicate that the administrative burden posed by case mix reimbursement has resource implications for all freestanding facilities. At the margin, the increased administrative burden imposed by case mix may

Rates, Amounts, and Determinants of Ambulatory Blood Pressure Monitoring Claim Reimbursements Among Medicare Beneficiaries

Science.gov (United States)

Kent, Shia T.; Shimbo, Daichi; Huang, Lei; Diaz, Keith M.; Viera, Anthony J.; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

2014-01-01

Ambulatory blood pressure monitoring (ABPM) can be used to identify white coat hypertension and guide hypertensive treatment. We determined the percentage of ABPM claims submitted between 2007–2010 that were reimbursed. Among 1,970 Medicare beneficiaries with submitted claims, ABPM was reimbursed for 93.8% of claims that had an ICD-9 diagnosis code of 796.2 (“elevated blood pressure reading without diagnosis of hypertension”) versus 28.5% of claims without this code. Among claims without an ICD-9 diagnosis code of 796.2 listed, those for the component (e.g., recording, scanning analysis, physician review, reporting) versus full ABPM procedures and performed by institutional versus non-institutional providers were each more than two times as likely to be successfully reimbursed. Of the claims reimbursed, the median payment was $52.01 (25–75th percentiles: $32.95–$64.98). In conclusion, educating providers on the ABPM claims reimbursement process and evaluation of Medicare reimbursement may increase the appropriate use of ABPM and improve patient care. PMID:25492833

Medicaid payment rates, case-mix reimbursement, and nursing home staffing--1996-2004.

Science.gov (United States)

Feng, Zhanlian; Grabowski, David C; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent

2008-01-01

We examined the impact of state Medicaid payment rates and case-mix reimbursement on direct care staffing levels in US nursing homes. We used a recent time series of national nursing home data from the Online Survey Certification and Reporting system for 1996-2004, merged with annual state Medicaid payment rates and case-mix reimbursement information. A 5-category response measure of total staffing levels was defined according to expert recommended thresholds, and examined in a multinomial logistic regression model. Facility fixed-effects models were estimated separately for Registered Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nurse Aide (CNA) staffing levels measured as average hours per resident day. Higher Medicaid payment rates were associated with increases in total staffing levels to meet a higher recommended threshold. However, these gains in overall staffing were accompanied by a reduction of RN staffing and an increase in both LPN and CNA staffing levels. Under case-mix reimbursement, the likelihood of nursing homes achieving higher recommended staffing thresholds decreased, as did levels of professional staffing. Independent of the effects of state, market, and facility characteristics, there was a significant downward trend in RN staffing and an upward trend in both LPN and CNA staffing. Although overall staffing may increase in response to more generous Medicaid reimbursement, it may not translate into improvements in the skill mix of staff. Adjusting for reimbursement levels and resident acuity, total staffing has not increased after the implementation of case-mix reimbursement.

The labelling and reporting of euthanasia by Belgian physicians: a study of hypothetical cases

NARCIS (Netherlands)

Smets, T.; Cohen, J.; Bilsen, J.; van Wesemael, Y.; Rurup, M.L.; Deliens, L.

2012-01-01

Background: Belgium legalized euthanasia in 2002. Physicians must report each euthanasia case to the Federal Control and Evaluation Committee. This study examines which end-of-life decisions (ELDs) Belgian physicians label 'euthanasia', which ELDs they think should be reported and the physician

Medicare payment data for spine reimbursement; important but flawed data for evaluating utilization of resources.

Science.gov (United States)

Menger, Richard P; Wolf, Michael E; Kukreja, Sunil; Sin, Anthony; Nanda, Anil

2015-01-01

Medicare data showing physician-specific reimbursement for 2012 were recently made public in the mainstream media. Given the ongoing interest in containing healthcare costs, we analyze these data in the context of the delivery of spinal surgery. Demographics of 206 leading surgeons were extracted including state, geographic area, residency training program, fellowship training, and academic affiliation. Using current procedural terminology (CPT) codes, information was evaluated regarding the number of lumbar laminectomies, lumbar fusions, add-on laminectomy levels, and anterior cervical fusions reimbursed by Medicare in 2012. In 2012 Medicare reimbursed the average neurosurgeon slightly more than an orthopedic surgeon for all procedures ($142,075 vs. $110,920), but this was not found to be statistically significant (P = 0.218). Orthopedic surgeons had a statistical trend illustrating increased reimbursement for lumbar fusions specifically, $1187 versus $1073 (P = 0.07). Fellowship trained spinal surgeons also, on average, received more from Medicare ($125,407 vs. $76,551), but again this was not statistically significant (P = 0.112). A surgeon in private practice, on average, was reimbursed $137,495 while their academic counterparts were reimbursed $103,144 (P = 0.127). Surgeons performing cervical fusions in the Centers for Disease Control West Region did receive statistically significantly less reimbursement for that procedure then those surgeons in other parts of the country (P = 0.015). Surgeons in the West were reimbursed on average $849 for CPT code 22,551 while those in the Midwest received $1475 per procedure. Medicare reimbursement data are fundamentally flawed in determining healthcare expenditure as it shows a bias toward delivery of care in specific patient demographics. However, neurosurgeons, not just policy makers, must take ownership to analyze, investigate, and interpret these data as it will affect healthcare reimbursement and delivery moving

Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion

Directory of Open Access Journals (Sweden)

Christine D. Jones MD, MS

2015-08-01

Full Text Available Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P < .001, uninsured encounters decreased (18.4% to 6.3%, P < 0.001, and private payer encounters also decreased (14.1% to 13.3%, P = .001. The median reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P < .001. In a sensitivity analysis, changes in length of stay, proportions in encounter type by payer, payer mix, and reimbursement for encounter type by payer accounted for −0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion.

Methods used to seismically upgrade. The safety related components of Belgian plants

International Nuclear Information System (INIS)

Lafaille, J.P.

1993-01-01

Belgian nuclear power amounts to about 6,000 MW, generated by seven plants that started operation as early as 1967. The latest plant started in 1985. Some of these plants were designed with no seismic requirements whatsoever. Even for those that had seismic requirements at the design stage, seismic demand was raised after design had been frozen (late during construction or at the 10 years revision). As a consequence all the plants had to undergo, to a variable extent, a seismic reevaluation and/or backfitting. Civil structures were concerned as well as electro-mechanical equipment and piping systems. The present paper deals with the mechanical aspect of the problem (equipment and piping). In order to minimize hardware modifications, advanced analytical techniques were used throughout the process, starting with the elaboration of a site specific spectrum, and using a full soil-structure interaction in order to get as 'realistic' as possible floor response spectra. In some instances, non linear elasto-plastic time history analysis was performed on piping-systems in order to qualify them without hardware modifications. In other cases a 'Load Coefficient Method' was used. Sometimes stresses or displacements taken from the original stress reports and scaled by comparison of applicable spectra, allowed to assess the seismic validity of the system under investigation. Seismic acceptability of installed active equipment is more difficult to demonstrate, as this is usually done by testing. This problem is a generic issue in the US, identified under the label USI-A-46 (Unresolved Safety Issue). It is treated by. a group of Utilities (SQUG = Seismic Qualification Utilities Group). The Belgian Utility is member of that group since 1985. The application of this program is starting in the US. SQUG methodology has been applied to three Belgian plants starting in 1988 and is now completed. The required fixes are being implemented. Experience gained in the process has been applied

78 FR 53507 - Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form...

Science.gov (United States)

2013-08-29

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form) Activity Under OMB Review AGENCY: Veterans Health... Control No. 2900- NEW (Beneficiary Travel Mileage Reimbursement Application Form)'' in any correspondence...

Reimbursed Price of Orphan Drugs: Current Strategies and Potential Improvements.

Science.gov (United States)

Mincarone, Pierpaolo; Leo, Carlo Giacomo; Sabina, Saverio; Sarriá-Santamera, Antonio; Taruscio, Domenica; Serrano-Aguilar, Pedro Guillermo; Kanavos, Panos

2017-01-01

The pricing and reimbursement policies for pharmaceuticals are relevant to balance timely and equitable access for all patients, financial sustainability, and reward for valuable innovation. The proliferation of high-cost specialty medicines is particularly true in rare diseases (RDs) where the pricing mechanism is characterised by a lack of transparency. This work provides an overall picture of current strategies for the definition of the reimbursed prices of orphan drugs (ODs) and highlights some potential improvements. Current strategies and suggestions are presented along 4 dimensions: (1) comprehensive value assessment, (2) early dialogs among relevant stakeholders, (3) innovative reimbursement approaches, and (4) societal participation in producing ODs. Comprehensive value assessment could be achieved by clarifying the approach of distributive justice to adopt, ensuring a representative participation of stakeholders, and with a broad consideration of value-bearing factors. With respect to early dialogs, cross-border cooperation can be determinant to companies and agencies. The cost-benefit ratio of early dialogs needs to be demonstrated and the "regulatory capture" effect should be monitored. Innovative reimbursement approaches were developed to balance the need for evidence-based decisions with the timely access to innovative drugs. The societal participation in producing ODs needs to be recognised in a collaborating framework where adaptive agreements can be developed with mutual satisfaction. Such agreements could also impact on coverage and reimbursement decisions as additional elements for the determination of a comprehensive societal value of ODs. Further research is needed to investigate the highlighted open challenges so that RDs will not remain, in practical terms, orphan diseases. © 2017 S. Karger AG, Basel.

77 FR 38173 - TRICARE Reimbursement Revisions

Science.gov (United States)

2012-06-27

... specific numeric diagnosis-related group values and replacing them with their narrative description. DATES... reference to specific DRG numbers and descriptions became obsolete, so we are removing the numeric... follows: Sec. 199.14 Provider reimbursement methods. * * * * * (a) * * * (1) * * * (ii) * * * (C) * * * (3...

Contribution of VPS35 genetic variability to LBD in the Flanders-Belgian population

NARCIS (Netherlands)

Verstraeten, Aline; Wauters, Eline; Crosiers, David; Meeus, Bram; Corsmit, Ellen; Elinck, Ellen; Mattheijssens, Maria; Peeters, Karin; Cras, Patrick; Pickut, Barbara; Vandenberghe, Rik; Engelborghs, Sebastiaan; De Deyn, Peter Paul; Van Broeckhoven, Christine; Theuns, Jessie

VPS35 was recently identified as a novel autosomal dominant gene for Parkinson disease. In this study, we aimed to determine the contribution of simple and complex VPS35 variations to the genetic etiology of the spectrum of Lewy body disorders (LBD) in a Flanders-Belgian patient cohort (n = 677). We

The actual practice of air cleaning in Belgian nuclear facilities

Energy Technology Data Exchange (ETDEWEB)

Goossens, W.R. [PEGO, Mol (Belgium)

1995-02-01

With 60% of its power generation from nuclear stations Belgium has 7 nuclear power stations in operation with a total capacity of 5.4 MWe. Enriched uranium is imported and converted to fuel assemblies. The actinides of reprocessed fuel are recycled as MOX fuel. A main waste conditioning operation has been performed in the PAMELA vitrifier. The actual practice of nuclear air cleaning in the Belgian PWR station DOEL-4 and in the PAMELA -vitrification plant for high level liquid waste is reviewed.

Population impact of reimbursement for smoking cessation: a natural experiment in The Netherlands.

Science.gov (United States)

Willemsen, Marc C; Segaar, Dewi; van Schayck, Onno C P

2013-03-01

To report on the impact of financial reimbursement of pharmacotherapy for smoking cessation in combination with behavioural support on the number of enrollees to proactive counselling in the Dutch national quitline. Descriptive time-series analysis was used to compare quitline enrolment in 2010 and 2012 (no reimbursement) with 2011 (reimbursement). National smoking cessation quitline. Smokers signing up for proactive counselling. Treatment enrolment data recorded by the quitline as part of usual care from 2010, 2011 and 2012 (until May). In 2010, a total of 848 smokers started treatment. In 2011, 9091 smokers enrolled. In 2012, the number of enrollees dropped dramatically, even below the 2010 level. In addition, the proportion of smokers in the population dropped from 27.2% in 2010 to 24.7% in 2011. The introduction of a national reimbursement system in the Netherlands was associated with a more than 10-fold increase in telephone counselling for smoking cessation and suggests that reimbursement for smoking cessation contributed to improvements in public health. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Occupational stress, work-home interference and burnout among Belgian veterinary practitioners

Directory of Open Access Journals (Sweden)

Hansez I

2008-04-01

Full Text Available Abstract There have been few formal studies on stress in veterinary surgeons and, in the rare studies available, stress is not examined jointly through the levels of job strain and job engagement, the sources of stress in the issue of work environment and the work-home interference. The authors' goal in this study was to analyse job engagement, job strain, burnout, work-home interference and job stress factors among 216 Belgian veterinary surgeons. Rural practice was compared to small animal and mixed activity. The mean job strain and job engagement level in veterinary surgeons was not higher than what we found in other working populations. However, 15.6% of the group were found to be suffering from high burnout. Rural practitioners had a lower level of job engagement than small animal veterinary surgeons. These small animal practitioners had a lower level of job strain than the mixed practitioners. The level of burnout did not differ significantly across the three types of activity. In comparison to other Belgian and Dutch workers, veterinary surgeons perceived more negative work-home interference. Bovine and mixed practitioners were the most concerned with this problem. The two most important sources of stress reported by bovine practitioners were relations to farmers and working time management (including emergencies and availability.

SCK-CEN 2006 barometer on risk perception of the Belgian population

International Nuclear Information System (INIS)

Carle, B.

2009-01-01

Starting with 2000, the expert group Society and Policy Support carries out research on various aspects of risk governance. Measuring several risk perception items at regular intervals with the Belgian population is an important part of this research. SCK-CEN has organised a first risk perception barometer in 2002 and a second one in 2006. The 2006 barometer is based on 1063 Computer Assisted Personal Interviews, with a duration of approximately 35 minutes. The large scale of the survey ensures that general trends can be detected and allows specific and detailed analysis on subgroups of the population. Besides the classical background variables used to obtain a sample representative for the Belgian 18+ population (age, language, habitat, gender and social class), several questions were included assessing the sociological context and the psychological personality profile. A series of questions on risk perception, confidence in authorities and specific nuclear topics were repeated in 2006 and constitute a fixed core, allowing comparison over time in Belgium, as well as with the results from the IRSN French barometer. In addition, a number of topics such as acceptance of legal norms and management options for radioactively contaminated milk, energy, nuclear waste and the perception of the Chernobyl accident were covered in detail in the 2006 edition of the SCK-CEN barometer

Occupational stress, work-home interference and burnout among Belgian veterinary practitioners.

Science.gov (United States)

Hansez, I; Schins, F; Rollin, F

2008-04-01

There have been few formal studies on stress in veterinary surgeons and, in the rare studies available, stress is not examined jointly through the levels of job strain and job engagement, the sources of stress in the issue of work environment and the work-home interference. The authors' goal in this study was to analyse job engagement, job strain, burnout, work-home interference and job stress factors among 216 Belgian veterinary surgeons. Rural practice was compared to small animal and mixed activity. The mean job strain and job engagement level in veterinary surgeons was not higher than what we found in other working populations. However, 15.6% of the group were found to be suffering from high burnout. Rural practitioners had a lower level of job engagement than small animal veterinary surgeons. These small animal practitioners had a lower level of job strain than the mixed practitioners. The level of burnout did not differ significantly across the three types of activity. In comparison to other Belgian and Dutch workers, veterinary surgeons perceived more negative work-home interference. Bovine and mixed practitioners were the most concerned with this problem. The two most important sources of stress reported by bovine practitioners were relations to farmers and working time management (including emergencies and availability).

En diálogo con los artículos del dossier psicoanálisis y filosofía. ¿Hay un diálogo posible?/In dialogue with the articles of dossier psychoanalysis and phylosophy. Is there a possible dialogue?

Directory of Open Access Journals (Sweden)

Ana María Fernández

2010-03-01

Full Text Available A partir de la pregunta que anima este número de la revista ¿hay un diálogo posible entre el psicoanálisis y la filosofía? el presente artículo tiene como cometido realizar un dialogo con algunos autores del Dossier, tomando como punto de referencia los trabajos en los cuales está presente cierta problematización del psicoanálisis a través de los trabajos de Foucault. The main question that brings about this new issue of the Journal is about the possible or impossible dialog between psychoanalysis and philosophy. Particularly, this article considers author contributions to this issue challenging psychoanalysis through the lens of Foucauldian theory.

School-located influenza vaccination with third-party billing: outcomes, cost, and reimbursement.

Science.gov (United States)

Kempe, Allison; Daley, Matthew F; Pyrzanowski, Jennifer; Vogt, Tara; Fang, Hai; Rinehart, Deborah J; Morgan, Nicole; Riis, Mette; Rodgers, Sarah; McCormick, Emily; Hammer, Anne; Campagna, Elizabeth J; Kile, Deidre; Dickinson, Miriam; Hambidge, Simon J; Shlay, Judith C

2014-01-01

To assess rates of immunization; costs of conducting clinics; and reimbursements for a school-located influenza vaccination (SLIV) program that billed third-party payers. SLIV clinics were conducted in 19 elementary schools in the Denver Public School district (September 2010 to February 2011). School personnel obtained parental consent, and a community vaccinator conducted clinics and performed billing. Vaccines For Children vaccine was available for eligible students. Parents were not billed for any fees. Data were collected regarding implementation costs and vaccine cost was calculated using published private sector prices. Reimbursement amounts were compared to costs. Overall, 30% of students (2784 of 9295) received ≥1 influenza vaccine; 39% (1079 of 2784) needed 2 doses and 80% received both. Excluding vaccine costs, implementation costs were $24.69 per vaccination. The percentage of vaccine costs reimbursed was 62% overall (82% from State Child Health Insurance Program (SCHIP), 50% from private insurance). The percentage of implementation costs reimbursed was 19% overall (23% from private, 27% from Medicaid, 29% from SCHIP and 0% among uninsured). Overall, 25% of total costs (implementation plus vaccine) were reimbursed. A SLIV program resulted in vaccination of nearly one third of elementary students. Reimbursement rates were limited by 1) school restrictions on charging parents fees, 2) low payments for vaccine administration from public payers and 3) high rates of denials from private insurers. Some of these problems might be reduced by provisions in the Affordable Care Act. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

42 CFR 137.336 - What is the difference between fixed-price and cost-reimbursement agreements?

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What is the difference between fixed-price and cost-reimbursement agreements? 137.336 Section 137.336 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND...-reimbursement agreements? (a) Cost-reimbursement agreements generally have one or more of the following...

Equal work for unequal pay: the gender reimbursement gap for healthcare providers in the United States.

Science.gov (United States)

Desai, Tejas; Ali, Sadeem; Fang, Xiangming; Thompson, Wanda; Jawa, Pankaj; Vachharajani, Tushar

2016-10-01

Gender disparities in income continue to exist, and many studies have quantified the gap between male and female workers. These studies paint an incomplete picture of gender income disparity because of their reliance on notoriously inaccurate or incomplete surveys. We quantified gender reimbursement disparity between female and male healthcare providers using objective, non-self-reported data and attempted to adjust the disparity against commonly held beliefs as to why it exists. We analysed over three million publicly available Medicare reimbursement claims for calendar year 2012 and compared the reimbursements received by male and female healthcare providers in 13 medical specialties. We adjusted these reimbursement totals against how hard providers worked, how productive each provider was, and their level of experience. We calculated a reimbursement differential between male and female providers by primary medical specialty. The overall adjusted reimbursement differential against female providers was -US$18 677.23 (95% CI -US$19 301.94 to -US$18 052.53). All 13 specialties displayed a negative reimbursement differential against female providers. Only two specialties had reimbursement differentials that were not statistically significant. After adjustment for how hard a physician works, his/her years of experience and his/her productivity, female healthcare providers are still reimbursed less than male providers. Using objective, non-survey data will provide a more accurate understanding of this reimbursement inequity and perhaps lead the medical profession (as a whole) towards a solution that can reverse this decades-old injustice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

United Nations Reimbursements for DOD Troop Contributions

National Research Council Canada - National Science Library

1997-01-01

.... Those rates together with the number of troops provided are used to calculate the level of reimbursement to be made to a participating country for the incremental costs incurred for providing troops...

Species diversity and metabolic impact of the microbiota are low in spontaneously acidified Belgian sausages with an added starter culture of Staphylococcus carnosus.

Science.gov (United States)

Janssens, M; Myter, N; De Vuyst, L; Leroy, F

2012-04-01

Quality of fermented sausages is affected by acidifying lactic acid bacteria (LAB) and colour- and flavour-promoting coagulase-negative staphylococci (CNS), whether or not used as starter culture. Artisan fermented sausages are often perceived as superior to industrial variants, partially because of the specific microbiota due to spontaneous acidification, which may be considered as an artisan characteristic. Therefore, two kinds of spontaneously acidified Belgian sausages were prepared (Belgian-type salami and Boulogne sausage), but with addition of a Staphylococcus carnosus culture. The Belgian-type salami was made from pork and beef, whereas the Boulogne sausage contained pork and horse meat. In all cases, Lactobacillus sakei was the dominant LAB species present on the raw materials and during fermentation, whereas enterococci remained present in the background. Enterobacteriaceae vanished after fermentation. The CNS species diversity on the raw materials was large and differed between the pork, beef, and horse meat. Nevertheless, this species diversity was annihilated during fermentation by the added S. carnosus culture. The volatiles fraction was mainly composed of aldehydes that originated from lipid oxidation and spices-derived compounds. Aromatic compounds that are typically associated to CNS activity, such as end-products from the metabolism of branched-chain amino acids, were not present in the Belgian-type salami and only marginally present in the Boulogne sausage. In conclusion, spontaneous acidification of Belgian-type fermented sausages leads to dominance of L. sakei and is no guarantee for bacterial contribution to the aroma profile when S. carnosus is added as a starter culture. Copyright © 2011 Elsevier Ltd. All rights reserved.

42 CFR 403.822 - Reimbursement of transitional assistance and associated sponsor requirements.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Reimbursement of transitional assistance and associated sponsor requirements. 403.822 Section 403.822 Public Health CENTERS FOR MEDICARE & MEDICAID... Prescription Drug Discount Card and Transitional Assistance Program § 403.822 Reimbursement of transitional...

Extraction d'association d'EIM à partir de dossiers patients : expérimentation avec les structures de patrons et les ontologies

OpenAIRE

Personeni , Gabin; Devignes , Marie-Dominique; Dumontier , Michel; Smaïl-Tabbone , Malika; Coulet , Adrien

2016-01-01

National audience; Les Dossiers Médicaux Electroniques (DME) constituent une ressource de grand intérêt pour étudier les Evènements Indésirables Médicamenteux (EIM). Nous proposons ici de fouiller les DME pour identifier des EIM fréquemment associés dans des sous-groupes de patients. Les EIM ayant des manifestations complexes, nous utilisons l'analyse formelle de concepts et ses structures de patrons, un cadre mathématique permettant la généralisation, en exploitant les connaissances du domai...

Contribution of the Belgian hospital physicists association to quality assurance in radiotherapy

International Nuclear Information System (INIS)

Hoornaert, M.Th.; Vynckier, S.; Dam, J. van; Bouiller, A.

1997-01-01

In 1987, the Belgian Hospital Physicists Association (BHPA) has started a program in order to uniformize the dosimetry in the Belgian radiotherapy centres. Several initiatives were taken: a) Dosimetry, of photon beams: Endorsement of the Dutch dosimetry, code of practice (NCS) (1), calibration of ionisation chambers in a common laboratory (Laboratory for standard dosimetry, RUG), on site visits where, besides mechanical checks of simulators and radiation units, absorbed dose was measured at different locations in a water phantom. Since 1987, a total of 23 centres were visited involving 18 simulators, 17 cobalt units and 22 linear accelerators with 33 photon beams. The energy of those photon beams ranged from 4 to 25 MeV (2). b) Dosimetry of electron beams: Endorsement of the Dutch dosimetry code of practice (3), calibration of several parallel plate chambers following the recommendations of the IAEA (4) and the NCS, on site visits for local measurements in electron beams. This program started last year. three centres were visited with a total of 23 energies ranging from 4.5 to 21 MeV. c) Elaboration of procedures and common reporting form for daily quality control will be published. (author)

A Comparison of Reimbursement Recommendations by European HTA Agencies: Is There Opportunity for Further Alignment?

Directory of Open Access Journals (Sweden)

Nicola Allen

2017-06-01

Full Text Available Introduction: In Europe and beyond, the rising costs of healthcare and limited healthcare resources have resulted in the implementation of health technology assessment (HTA to inform health policy and reimbursement decision-making. European legislation has provided a harmonized route for the regulatory process with the European Medicines Agency, but reimbursement decision-making still remains the responsibility of each country. There is a recognized need to move toward a more objective and collaborative reimbursement environment for new medicines in Europe. Therefore, the aim of this study was to objectively assess and compare the national reimbursement recommendations of 9 European jurisdictions following European Medicines Agency (EMA recommendation for centralized marketing authorization.Methods: Using publicly available data and newly developed classification tools, this study appraised 9 European reimbursement systems by assessing HTA processes and the relationship between the regulatory, HTA and decision-making organizations. Each national HTA agency was classified according to two novel taxonomies. The System taxonomy, focuses on the position of the HTA agency within the national reimbursement system according to the relationship between the regulator, the HTA-performing agency, and the reimbursement decision-making coverage body. The HTA Process taxonomy distinguishes between the individual HTA agency's approach to economic and therapeutic evaluation and the inclusion of an independent appraisal step. The taxonomic groups were subsequently compared with national HTA recommendations.Results: This study identified European national reimbursement recommendations for 102 new active substances (NASs approved by the EMA from 2008 to 2012. These reimbursement recommendations were compared using a novel classification tool and identified alignment between the organizational structure of reimbursement systems (System taxonomy and HTA

78 FR 21352 - Update on Reimbursement for Costs of Remedial Action at Active Uranium and Thorium Processing Sites

Science.gov (United States)

2013-04-10

... reimbursement ceilings). Title X requires DOE to reimburse eligible uranium and thorium licensees for certain... DEPARTMENT OF ENERGY Update on Reimbursement for Costs of Remedial Action at Active Uranium and... not currently available for reimbursement for cleanup work performed by licensees at eligible uranium...

77 FR 45520 - Reimbursed Entertainment Expenses

Science.gov (United States)

2012-08-01

... as compensation and wages, the employee may be able to deduct the expense as an employee business...(e)(3) has the same meaning as in section 62(2)(A) (dealing with employee business expenses, later... Reimbursed Entertainment Expenses AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of...

Billing for pharmacists' cognitive services in physicians' offices: multiple methods of reimbursement.

Science.gov (United States)

Scott, Mollie Ashe; Hitch, William J; Wilson, Courtenay Gilmore; Lugo, Amy M

2012-01-01

To evaluate the charges and reimbursement for pharmacist services using multiple methods of billing and determine the number of patients that must be managed by a pharmacist to cover the cost of salary and fringe benefits. Large teaching ambulatory clinic in North Carolina. Annual charges and reimbursement, patient no-show rate, clinic capacity, number of patients seen monthly and annually, and number of patients that must be seen to pay for a pharmacist's salary and benefits. A total of 6,930 patient encounters were documented during the study period. Four different clinics were managed by the pharmacists, including anticoagulation, pharmacotherapy, osteoporosis, and wellness clinics. "Incident to" level 1 billing was used for the anticoagulation and pharmacotherapy clinics, whereas level 4 codes were used for the osteoporosis clinic. The wellness clinic utilized a negotiated fee-for-service model. Mean annual charges were $65,022, and the mean reimbursement rate was 47%. The mean charge and collection per encounter were $41 and $19, respectively. Eleven encounters per day were necessary to generate enough charges to pay for the cost of the pharmacist. Considering actual reimbursement rates, the number of patient encounters necessary increased to 24 per day. "What if" sensitivity analysis indicated that billing at the level of service provided instead of level 1 decreased the number of patients needed to be seen daily. Billing a level 4 visit necessitated that five patients would need to be seen daily to generate adequate charges. Taking into account the 47% reimbursement rate, 10 level 4 encounters per day were necessary to generate appropriate reimbursement to pay for the pharmacist. Unique opportunities for pharmacists to provide direct patient care in the ambulatory setting continue to develop. Use of a combination of billing methods resulted in sustainable reimbursement. The ability to bill at the level of service provided instead of a level 1 visit would

Nagra technical report 14-02, Geological basics - Dossier VI - Barrier properties of proposed host rock sediments and neighbouring rock

International Nuclear Information System (INIS)

Gautschi, A.; Deplazes, G.; Traber, D.; Marschall, P.; Mazurek, M.; Gimmi, T.; Maeder, U.

2014-01-01

This dossier is the sixth of a series of eight reports concerning the safety and technical aspects of locations for the disposal of radioactive wastes in Switzerland. It discusses the barrier properties of the proposed host rock sediments and neighbouring rock layers. The mineralogical composition of the host rocks are discussed as are their pore densities and hydrological properties. Diffusion aspects are discussed. The aquifer systems in the proposed depository areas and their classification are looked at. The barrier properties of the host rocks and those of neighbouring sediments are discussed. Finally, modelling concepts and parameters for the transport of radionuclides in the rocks are discussed

Health care information systems and formula-based reimbursement: an empirical study.

Science.gov (United States)

Palley, M A; Conger, S

1995-01-01

Current initiatives in health care administration use formula-based approaches to reimbursement. Examples of such approaches include capitation and diagnosis related groups (DRGs). These approaches seek to contain medical costs and to facilitate managerial control over scarce health care resources. This article considers various characteristics of formula-based reimbursement, their operationalization on hospital information systems, and how these relate to hospital compliance costs.

Hospitals push back against reimbursement cuts due to Two-Midnight rule.

Science.gov (United States)

2016-04-01

The American Hospital Association (AHA) and other hospitals are suing CMS, challenging the 0.2% cut in Medicare reimbursement that CMS instituted to compensate for the financial effect of the Two-Midnight rule. CMS' actuaries reported that inpatient claims are likely to increase under the rule, resulting in $220 million additional reimbursement for hospitals. Hospitals disagree and a study commissioned by the AHA concluded that the CMS study was based on data not available to the public and that data from the Medicare Provider and Analysis Review (MedPAR) would lead to a different conclusion. The AHA suit asks CMS to rescind the cut, restore the base rate for Medicare payments to its previous level, and reimburse hospitals retroactively for the reductions.

48 CFR 53.301-1437 - Settlement Proposal for Cost-Reimbursement Type Contracts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Settlement Proposal for Cost-Reimbursement Type Contracts. 53.301-1437 Section 53.301-1437 Federal Acquisition Regulations...-1437 Settlement Proposal for Cost-Reimbursement Type Contracts. ER09DE97.012 [62 FR 64951, Dec. 9, 1997] ...

Anticipated changes in reimbursements for US outpatient emergency department encounters after health reform.

Science.gov (United States)

Galarraga, Jessica E; Pines, Jesse M

2014-04-01

We study how reimbursements to emergency departments (EDs) for outpatient visits may be affected by the insurance coverage expansion of the Patient Protection and Affordable Care Act as previously uninsured patients gain coverage either through the Medicaid expansion or through health insurance exchanges. We conducted a secondary analysis of data (2005 to 2010) from the Medical Expenditure Panel Survey. We specified multiple linear regression models to examine differences in the payments, charges, and reimbursement ratios by insurance category. Comparisons were made between 2 groups to reflect likely movements in insurance status after the Patient Protection and Affordable Care Act implementation: (1) the uninsured who will be Medicaid eligible afterward versus Medicaid insured, and (2) the uninsured who will be Medicaid ineligible afterward versus the privately insured. From 2005 to 2010, as a percentage of total ED charges, outpatient ED encounters for Medicaid beneficiaries reimbursed 17% more than for uninsured individuals who will become Medicaid eligible after Patient Protection and Affordable Care Act implementation: 40.0% versus 34.0%, mean absolute difference=5.9%, 95% confidence interval 5.7% to 6.2%. During the same period, the privately insured reimbursed 39% more than for uninsured individuals who will not be Medicaid eligible after Patient Protection and Affordable Care Act implementation: 54.0% versus 38.8%, mean absolute difference=15.2%, 95% confidence interval 12.8% to 17.6%. Assuming historical reimbursement patterns remain after Patient Protection and Affordable Care Act implementation, outpatient ED encounters could reimburse considerably more for both the previously uninsured patients who will obtain Medicaid insurance and for those who move into private insurance products through health insurance exchanges. Although our study does provide insight into the future, multiple factors will ultimately influence reimbursements after implementation

Indirect Cost Reimbursement: An Industrial View.

Science.gov (United States)

Bolton, Robert

1987-01-01

The meaning of indirect costs in an industrial environment is discussed. Other factors considered are corporate policies; nature of work being supported; the uniqueness of the work; who is doing the negotiating for industry; and indirect rates. Suggestions are offered for approaches to indirect cost reimbursement. (Author/MLW)

Value-Based Reimbursement: Impact of Curtailing Physician Autonomy in Medical Decision Making.

Science.gov (United States)

Gupta, Dipti; Karst, Ingolf; Mendelson, Ellen B

2016-02-01

In this article, we define value in the context of reimbursement and explore the effect of shifting reimbursement paradigms on the decision-making autonomy of a women's imaging radiologist. The current metrics used for value-based reimbursement such as report turnaround time are surrogate measures that do not measure value directly. The true measure of a physician's value in medicine is accomplishment of better health outcomes, which, in breast imaging, are best achieved with a physician-patient relationship. Complying with evidence-based medicine, which includes data-driven best clinical practices, a physician's clinical expertise, and the patient's values, will improve our science and preserve the art of medicine.

Genetic parameters for chronic progressive lymphedema in Belgian Draught Horses.

Science.gov (United States)

De Keyser, K; Janssens, S; Peeters, L M; Foqué, N; Gasthuys, F; Oosterlinck, M; Buys, N

2014-12-01

Genetic parameters for chronic progressive lymphedema (CPL)-associated traits in Belgian Draught Horses were estimated, using a multitrait animal model. Clinical scores of CPL in the four limbs/horse (CPLclin ), skinfold thickness and hair samples (hair diameter) were studied. Due to CPLclin uncertainty in younger horses (progressive CPL character), a restricted data set (D_3+) was formed, excluding records from horses under 3 years from the complete data set (D_full). Age, gender, coat colour and limb hair pigmentation were included as fixed, permanent environment and date of recording as random effects. Higher CPLclin certainty (D_3+) increased heritability coefficients of, and genetic correlations between traits, with CPLclin heritabilities (SE) for the respective data sets: 0.11 (0.06) and 0.26 (0.05). A large proportion of the CPLclin variance was attributed to the permanent environmental effect in D_full, but less in D_3+. Date of recording explained a proportion of variance from 0.09 ± 0.03 to 0.61 ± 0.08. Additive genetic correlations between CPLclin and both skinfold thickness and hair diameter showed the latter two traits cannot be used as a direct diagnostic aid for CPL. Due to the relatively low heritability of CPLclin , selection should focus on estimated breeding values (from repeated clinical examinations) to reduce CPL occurrence in the Belgian Draught Horse. © 2014 Blackwell Verlag GmbH.

An international comparison of reimbursement for DIEAP flap breast reconstruction.

Science.gov (United States)

Reid, A W N; Szpalski, C; Sheppard, N N; Morrison, C M; Blondeel, P N

2015-11-01

The deep inferior epigastric artery perforator (DIEAP) flap is currently considered the gold standard for autologous breast reconstruction. With the current economic climate and health cutbacks, we decided to survey reimbursement for DIEAP flaps performed at the main international centres in order to assess whether they are funded consistently. Data were collected confidentially from the main international centres by an anonymous questionnaire. Our results illustrate the wide disparity in international DIEAP flap breast reconstruction reimbursement: a unilateral DIEAP flap performed in New York, USA, attracts €20,759, whereas the same operation in Madrid, Spain, will only be reimbursed for €300. Only 35.7% of the surgeons can set up their own fee. Moreover, 85.7% of the participants estimated that the current fees are insufficient, and most of them feel that we are evolving towards an even lower reimbursement rate. In 55.8% of the countries represented, there is no DIEAP-specific coding; in comparison, 74.4% of the represented countries have a specific coding for transverse rectus abdominis (TRAM) flaps. Finally, despite the fact that DIEAP flaps have become the gold standard for breast reconstruction, they comprise only a small percentage of all the total number of breast reconstruction procedures performed (7-15%), with the only exception being Belgium (40%). Our results demonstrate that DIEAP flap breast reconstruction is inconsistently funded. Unfortunately though, it appears that the current reimbursement offered by many countries may dissuade institutions and surgeons from offering this procedure. However, substantial evidence exists supporting the cost-effectiveness of perforator flaps for breast reconstruction, and, in our opinion, the long-term clinical benefits for our patients are so important that this investment of time and money is absolutely essential. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons

Shaba II: The French and Belgian Intervention in Zaire in 1978

Science.gov (United States)

1993-04-01

morning. By 0500, the sun was climbing. Some of the foreigners were awake and preparing breakfast. Some looking out their doors found the streets...project and was equipped with its own aircraft. With two DC-3s, one Piper Aztec , and two Bell 206 helicopters, the company was already considering an...flew in to compliment the French and Belgians on the operation. Taken to visit the massacre site in the new town, the shocked dictator gasped, "My God

Waste disposal[1997 Scientific Report of the Belgian Nuclear Research Centre

Energy Technology Data Exchange (ETDEWEB)

Neerdael, B.; Marivoet, J.; Put, M.; Verstricht, J.; Van Iseghem, P.; Buyens, M.

1998-07-01

The primary mission of the Waste Disposal programme at the Belgian Nuclear Research Centre SCK/CEN is to propose, develop, and assess solutions for the safe disposal of radioactive waste. In Belgium, deep geological burial in clay is the primary option for the disposal of High-Level Waste and spent nuclear fuel. The main achievements during 1997 in the following domains are described: performance assessment, characterization of the geosphere, characterization of the waste, migration processes, underground infrastructure.

76 FR 73020 - Agency Information Collection (Request for Transportation Expense Reimbursement): Activity Under...

Science.gov (United States)

2011-11-28

... for Transportation Expense Reimbursement): Activity Under OMB Review AGENCY: Veterans Benefits... for Transportation Expense Reimbursement (38 CFR 21.8370). OMB Control Number: 2900-0580. Type of... transportation expenses. To be eligible, the child must provide supportive documentation of actual expenses...

75 FR 71677 - Reimbursement for Costs of Remedial Action at Active Uranium and Thorium Processing Sites

Science.gov (United States)

2010-11-24

... DEPARTMENT OF ENERGY Reimbursement for Costs of Remedial Action at Active Uranium and Thorium... in FY 2011 from eligible active uranium and thorium processing site licensees for reimbursement under... approximately $24.3 million of Recovery Act funds available for reimbursement in FY 2011, as well as the $10...

76 FR 30598 - Payment or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-VA...

Science.gov (United States)

2011-05-26

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN86 Payment or Reimbursement for Emergency...) ``Payment or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-VA Facilities... Reimbursement Act. Some of the revisions in this proposed rule are purely technical, matching the language of...

Operating experience with diesel generators in Belgian nuclear power plants

International Nuclear Information System (INIS)

Merny, R.

1986-01-01

Various problems have occurred on the diesel generators in the Belgian nuclear power plants, independently of the D.G. manufacturer or from the operating crew. Furthermore no individual part of the D.G. can be incriminated as being the main cause of the incidents. The incidents reported in this paper are chosen because of the importance for the safety or for the long repair period. The unavailability of a D.G. can only be detected by periodic tests and controls. Combined with a good preventive maintenance, the risks of incidents can be reduced. (author)

Assessing the Risk of K-loss within the Belgian TSO

International Nuclear Information System (INIS)

Bernard, B.

2016-01-01

Full text: Organisations lose knowledge. Considering knowledge as a valuable asset, attention must be paid to the risk of losing it. The contribution of this paper is to propose a model—the knowledge critical grid (KCG)—that aims at assessing the risk of knowledge loss. Applied within the Belgian TSO, this model focuses on community-of-practices and network issues. Grounded on five knowledge issues, the KCG intends to assess the knowledge volatility and vulnerability levels of an organisation and define the best relevant knowledge management actions. (author).

Operating experience with diesel generators in Belgian nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Merny, R. [Association Vincotte, Avenue du Roi 157, B-1060 Bruxelles/Brussels (Belgium)

1986-02-15

Various problems have occurred on the diesel generators in the Belgian nuclear power plants, independently of the D.G. manufacturer or from the operating crew. Furthermore no individual part of the D.G. can be incriminated as being the main cause of the incidents. The incidents reported in this paper are chosen because of the importance for the safety or for the long repair period. The unavailability of a D.G. can only be detected by periodic tests and controls. Combined with a good preventive maintenance, the risks of incidents can be reduced. (author)

The 22-Modifier in Reimbursement for Orthopedic Procedures: Hip Arthroplasty and Obesity Are Worth the Effort.

Science.gov (United States)

Smith, Eric L; Tybor, David J; Daniell, Hayley D; Naccarato, Laura A; Pevear, Mary E; Cassidy, Charles

2018-02-21

Orthopedic surgeons utilize the 22-modifier when billing for complex procedures under the American Medical Association's Current Procedural Terminology (CPT) for reasons such as excessive blood loss, anatomic abnormality, and morbid obesity, cases that would ideally be reimbursed at a higher rate to compensate for additional physician work and time. We investigated how the 22-modifier affects physician reimbursement in knee and hip arthroplasty. We queried hospital billing data from 2009 to 2016, identifying all cases performed at our urban tertiary care orthopedic center for knee arthroplasty (CPT codes 27438, 27447, 27487, and 27488) and hip arthroplasty (CPT codes 27130, 27132, 27134, 27236). We extracted patient insurance status and reimbursement data to compare the average reimbursement between cases with and without the 22-modifier. We analyzed data from 2605 procedures performed by 10 providers. There were 136 cases with 22-modifiers. For knee arthroplasty (n = 1323), the 22-modifier did not significantly increase reimbursement after adjusting for insurer, provider, and fiscal year (4.2% dollars higher on average, P = .159). For hip arthroplasty (n = 1282), cases with a 22-modifier had significantly higher reimbursement than those without the 22-modifier (6.2% dollars more, P = .049). For hip arthroplasty cases with a 22-modifier, those noting morbid obesity were reimbursed 29% higher than those cases with other etiology. The effect of the 22-modifier on reimbursement amount is differential between knee and hip arthroplasty. Hip arthroplasty procedures coded as 22-modifier are reimbursed more than those without the 22-modifier. Providers should consider these potential returns when considering submitting a 22-modifier. Copyright © 2018 Elsevier Inc. All rights reserved.

Reimbursement-Based Economics--What Is It and How Can We Use It to Inform Drug Policy Reform?

Science.gov (United States)

Coyle, Doug; Lee, Karen M; Mamdani, Muhammad; Sabarre, Kelley-Anne; Tingley, Kylie

2015-01-01

In Ontario, approximately $3.8 billion is spent annually on publicly funded drug programs. The annual growth in Ontario Public Drug Program (OPDP) expenditure has been limited to 1.2% over the course of 3 years. Concurrently, the Ontario Drug Policy Research Network (ODPRN) was appointed to conduct drug class review research relating to formulary modernization within the OPDP. Drug class reviews by ODPRN incorporate a novel methodological technique called reimbursement-based economics, which focuses on reimbursement strategies and may be particularly relevant for policy-makers. To describe the reimbursement-based economics approach. Reimbursement-based economics aims to identify the optimal reimbursement strategy for drug classes by incorporating a review of economic literature, comprehensive budget impact analyses, and consideration of cost-effectiveness. This 3-step approach is novel in its focus on the economic impact of alternate reimbursement strategies rather than individual therapies. The methods involved within the reimbursement-based approach are detailed. To facilitate the description, summary methods and findings from a recent application to formulary modernization with respect to the drug class tryptamine-based selective serotonin receptor agonists (triptans) used to treat migraine headaches are presented. The application of reimbursement-based economics in drug policy reforms allows policy-makers to consider the cost-effectiveness and budget impact of different reimbursement strategies allowing consideration of the trade-off between potential cost savings vs increased access to cost-effective treatments. © 2015 American Headache Society.

Clonal expansion of the Belgian Phytophthora ramorum populations based on new microsatellite markers

Science.gov (United States)

A. Vercauteren; I. De Dobbelaere; N. J. Grünwald; P. Bonants; E. Van Bockstaele; M. Maes; K. Heungens

2010-01-01

Co-existence of both mating types A1 and A2 within the EU1 lineage of Phytophthora ramorum has only been observed in Belgium, which begs the question whether sexual reproduction is occurring. A collection of 411 Belgian P. ramorum isolates was established during a 7-year survey. Our main objectives were genetic characterization of this population to test for sexual...

Survey of the natural radiation of Belgian territory as determined by different methods

International Nuclear Information System (INIS)

Deworm, J.P.; Slegers, W.; Gillard, J.; Flemal, J.M.; Culst, J.P.

1988-01-01

Measurement of the environmental exposure to natural radiation was performed by the Institute of Hygiene and Epidemiology and the Nuclear Research Centre in Mol. The aim of the study was the estimation of the external doses from natural radioactivity received by the Belgian population and the setting up on a map of the territory of natural exposure rates measured using different methods. (author)

30 CFR 229.109 - Reimbursement for costs incurred by a State under the delegation of authority.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Reimbursement for costs incurred by a State... Administration of Delegations § 229.109 Reimbursement for costs incurred by a State under the delegation of..., on a quarterly basis, a summary of costs incurred for which the State is seeking reimbursement. Only...

14 CFR 1214.202 - Reimbursement policy.

Science.gov (United States)

2010-01-01

... according to the reimbursement schedule plus short term call-up additional costs. The additional costs will... services. (2) The price will be based on estimated costs. (3) The price will be held constant for flights...) Subsequent to the first three years, the price will be adjusted annually to insure that total operating costs...

The Effect of Tuition Reimbursement on Turnover: A Case Study Analysis

OpenAIRE

Colleen N. Flaherty

2007-01-01

Tuition reimbursement programs provide financial assistance for direct costs of education and are a type of general skills training program commonly offered by employers in the United States. Standard human capital theory argues that investment in firm-specific skills reduces turnover, while investment in general skills training could result in increased turnover. However, firms cite increased retention as a motivation for offering tuition reimbursement programs. This rationale for offering t...

Invasive Aspergillus niger complex infections in a Belgian tertiary care hospital.

Science.gov (United States)

Vermeulen, E; Maertens, J; Meersseman, P; Saegeman, V; Dupont, L; Lagrou, K

2014-05-01

The incidence of invasive infections caused by the Aspergillus niger species complex was 0.043 cases/10 000 patient-days in a Belgian university hospital (2005-2011). Molecular typing was performed on six available A. niger complex isolates involved in invasive disease from 2010 to 2011, revealing A. tubingensis, which has higher triazole minimal inhibitory concentrations, in five out of six cases. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Do financial incentives of introducing case mix reimbursement increase feeding tube use in nursing home residents?

Science.gov (United States)

Teno, Joan M; Feng, Zhanlian; Mitchell, Susan L; Kuo, Sylvia; Intrator, Orna; Mor, Vincent

2008-05-01

To determine whether adoption of Medicaid case mix reimbursement is associated with greater prevalence of feeding tube use in nursing home (NH) residents. Secondary analysis of longitudinal administrative data about the prevalence of feeding tube insertion and surveys of states' adoption of case mix reimbursement. NHs in the United States. NH residents at the time of NH inspection between 1993 and 2004. Facility prevalence of feeding tubes reported at the state inspection of NHs reported in the Online Survey, Certification and Reporting database and interviews with state policy makers regarding the adoption of case mix reimbursement. Between 1993 and 2004, 16 states adopted Resource Utilization Group case mix reimbursement. States varied in the prevalence of feeding tubes in their NHs. Although the use of feeding tube increased substantially over the years of the study, once temporal trends and facility fixed effects were accounted for, case mix reimbursement was not associated with greater prevalence of feeding tube use. The adoption of Medicaid case mix reimbursement was not associated with an increase in the prevalence of feeding tube use.

Agglomeration of a comprehensive model for the wind-driven sand transport at the Belgian Coast

Science.gov (United States)

Strypsteen, Glenn; Rauwoens, Pieter

2016-04-01

Although a lot of research has been done in the area of Aeolian transport, it is only during the last years that attention has been drawn to Aeolian transport in coastal areas. In these areas, the physical processes are more complex, due to a large number of transport limiting parameters. In this PhD-project, which is now in its early stage, a model will be developed which relates the wind-driven sand transport at the Belgian coast with physical parameters such as the wind speed, humidity and grain size of the sand, and the slope of beach and dune surface. For the first time, the interaction between beach and dune dynamics is studied at the Belgian coast. The Belgian coastline is only 67km long, but densely populated and therefore subject to coastal protection and safety. The coast mostly consists of sandy beaches and dikes. Although, still 33km of dunes exist, whose dynamics are far less understood. The overall research approach consists of three pathways: (i) field measurements, (ii) physical model tests, and (iii) numerical simulations. Firstly and most importantly, several field campaigns will provide accurate data of meteo-marine conditions, morphology, and sand transport events on a wide beach at the Belgian Coastline. The experimental set-up consists of a monitoring station, which will provide time series of vegetation cover, shoreline position, fetch distances, surficial moisture content, wind speed and direction and transport processes. The horizontal and vertical variability of the event scale Aeolian sand transport is analyzed with 8 MWAC sand traps. Two saltiphones register the intensity and variations of grain impacts over time. Two meteo-masts, each with four anemometers and one wind vane, provide quantitative measurements of the wind flow at different locations on the beach. Surficial moisture is measured with a moisture sensor. The topography measurements are typically done with laser techniques. To start, two sites are selected for measurement

48 CFR 245.608-7 - Reimbursement of cost for transfer of contractor inventory.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Reimbursement of cost for transfer of contractor inventory. 245.608-7 Section 245.608-7 Federal Acquisition Regulations System... Reporting, Redistribution, and Disposal of Contractor Inventory 245.608-7 Reimbursement of cost for transfer...

24 CFR 5.632 - Utility reimbursements.

Science.gov (United States)

2010-04-01

... Section 8 Project-Based Assistance Family Payment § 5.632 Utility reimbursements. (a) Applicability. This... the utility supplier to pay the utility bill on behalf of the family. If the PHA elects to pay the utility supplier, the PHA must notify the family of the amount paid to the utility supplier. (3) In the...

Intake of bisphenol A from canned beverages and foods on the Belgian market.

Science.gov (United States)

Geens, Tinne; Apelbaum, Tali Zipora; Goeyens, Leo; Neels, Hugo; Covaci, Adrian

2010-11-01

Bisphenol A (BPA), a contaminant which may be present in the coating of cans, was determined in 45 canned beverages and 21 canned food items from the Belgian market. Beverages had an average BPA concentration of 1.0 ng/ml, while canned foods had a higher average concentration of 40.3 ng/g. The amount of BPA present in food items was dependent on the type of can and sterilisation conditions rather than the type of food. For example, BPA was not detected in non-canned beverages (canned food items had a very low average concentration of 0.46 ng/g. Using detailed information from the Belgian food consumption survey, the BPA intake of adults through canned foods and beverages was estimated to be 1.05 µg/day or 0.015 µg/kg body weight/day (assuming an average adult weight of 70 kg). Intake assessments, based on urinary metabolite concentrations from the literature, resulted in slightly higher BPA intakes (range 0.028-0.059 µg/kg body weight/day). This suggests that sources other than canned foods and beverages contribute to BPA exposure in humans.

76 FR 79067 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

Science.gov (United States)

2011-12-21

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN49 Payment or Reimbursement for Emergency..., authorize the Secretary of Veterans Affairs to reimburse eligible veterans for costs related to non-VA.... Specifically, section 1725 authorizes reimbursement for emergency treatment for eligible veterans with...

Two Belgian University Hospitals

Directory of Open Access Journals (Sweden)

M. Huylebrouck

2012-01-01

Full Text Available Background. Bevacizumab (BEV, a humanized immunoglobulin G1 monoclonal antibody that inhibits VEGF has demonstrated activity against recurrent high-grade gliomas (HGG in phase II clinical trials. Patients and Methods. Data were collected from patients with recurrent HGG who initiated treatment with BEV outside a clinical trial protocol at two Belgian university hospitals. Results. 19 patients (11 M/8 F were administered a total of 138 cycles of BEV (median 4, range 1–31. Tumor response assessment by MRI was available for 15 patients; 2 complete responses and 3 partial responses for an objective response rate of 26% for the intent to treat population were observed on gadolinium-enhanced T1-weighted images; significant regressions on T2/FLAIR were documented in 10 out of 15 patients (67%. A reduced uptake on PET was documented in 3 out of 4 evaluable patients. The six-month progression-free survival was 21% (95% CI 2.7–39.5. Two patients had an ongoing tumor response and remained free from progression after 12 months of BEV treatment. Conclusions. The activity and tolerability of BEV were comparable to results from previous prospective phase II trials. Reduced uptake on PET suggests a metabolic response in addition to an antiangiogenic effect in some cases with favorable clinical outcome.

Use of Information, Product Innovation and Financial Performance on Belgian Glasshouse Holdings

OpenAIRE

Taragola, Nicole; Van Huylenbroeck, Guido; Van Lierde, Dirk

2002-01-01

In order to meet the changing needs and preferences of consumers it will be important for Belgian glasshouse growers to change from a production-driven to a customer-driven strategy. More than ever, use of information and product innovation become critical factors in the changing competitive environment. The aim of the research is to analyse the relationship between business and managerial characteristics, use of information sources, product innovation and financial performance of the firm. T...

Generations and intention to leave current job : Belgian nurses in the workplace

OpenAIRE

De Vos, Nele

2016-01-01

This master thesis aims to identify work-related factors making Belgian nurses consider leaving their job voluntary and to compare the work-related factors across different generations. The purpose of this master thesis has a descriptive nature of research. The research approach chosen is a deductive approach and the research design chosen is a quantitative research design. Cluster sampling in combination with simple random sampling was used as sampling technique. 128 nurses were surveyed fro...

Drivers of Medicare Reimbursement for Thoracolumbar Fusion: An Analysis of Data From The Centers For Medicare and Medicaid Services.

Science.gov (United States)

Khanna, Krishn; Padegimas, Eric M; Zmistowski, Benjamin; Howley, Michael; Verma, Kushagra

2017-11-01

A retrospective observational study. The purpose of this study is to examine the variation in thoracolumbar fusion (TLF) payment and determine the drivers of this variation. As health care spending continues to increase, variation in surgical procedures reimbursements has come under more scrutiny. TLF is an example of a high-cost, proven-benefit procedure that is often the focus of Centers for Medicare and Medicaid Services (CMS) administrators. There is a wide variation in TLF charges, but the drivers for this variation are not clear. Claims for TLF were identified in the CMS data by analyzing Diagnosis Related Group (DRG) number 460 ("Spinal Fusion Except Cervical without Major Complications or Comorbidities"). Data on factors that may impact cost of care were collected from four sources: the United States Census Bureau, CMS, the Dartmouth Atlas, and WWAMI Rural Health Research Center. These were then grouped into seven categories: quality, supply, demand, substitute treatment availability, patient characteristics, competitive factors, and provider characteristics. Predictive reimbursement models were created from the data using multivariate linear regression to understand the factors that influence TLF reimbursement. There was significant geographic variability in reimbursement. The largest contribution to reimbursement variation came from variables in the demand (ΔR = 13.4%, P reimbursement were provider charges (β = 0.37, P reimbursement in the region (β = 0.19, P reimbursement. There was wide variation in reimbursement for TLF across the U.S. The variables that drive TLF reimbursement variation include supply, demand, and competition. Interestingly, quality of care was not associated with increased TLF reimbursement. N/A.

Euthanasia embedded in palliative care. Responses to essentialistic criticisms of the Belgian model of integral end-of-life care.

Science.gov (United States)

Bernheim, Jan L; Raus, Kasper

2017-08-01

The Belgian model of 'integral' end-of-life care consists of universal access to palliative care (PC) and legally regulated euthanasia. As a first worldwide, the Flemish PC organisation has embedded euthanasia in its practice. However, some critics have declared the Belgian-model concepts of 'integral PC' and 'palliative futility' to fundamentally contradict the essence of PC. This article analyses the various essentialistic arguments for the incompatibility of euthanasia and PC. The empirical evidence from the euthanasia-permissive Benelux countries shows that since legalisation, carefulness (of decision making) at the end of life has improved and there have been no significant adverse 'slippery slope' effects. It is problematic that some critics disregard the empirical evidence as epistemologically irrelevant in a normative ethical debate. Next, rejecting euthanasia because its prevention was a founding principle of PC ignores historical developments. Further, critics' ethical positions depart from the PC tenet of patient centeredness by prioritising caregivers' values over patients' values. Also, many critics' canonical adherence to the WHO definition of PC, which has intention as the ethical criterion is objectionable. A rejection of the Belgian model on doctrinal grounds also has nefarious practical consequences such as the marginalisation of PC in euthanasia-permissive countries, the continuation of clandestine practices and problematic palliative sedation until death. In conclusion, major flaws of essentialistic arguments against the Belgian model include the disregard of empirical evidence, appeals to canonical and questionable definitions, prioritisation of caregiver perspectives over those of patients and rejection of a plurality of respectable views on decision making at the end of life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Belgian nuclear higher education network: the evolution of an academic programme in nuclear engineering

International Nuclear Information System (INIS)

Berkvens, T.; Coeck, M.

2014-01-01

The master-after-master in nuclear engineering provided by the Belgian Nuclear higher Education Network (BNEN) is a one-year, 60 ECTS programme which combines the expertise of six Belgian universities and SCK.CEN, the Belgian Nuclear Research Centre, which participates through its Academy for Nuclear Science and Technology. It was created in close collaboration with representatives of academia, research centres, industry and other nuclear stakeholders. The BNEN consortium Due to its modular programme, BNEN is accessible for both full-time students (mainly young engineering graduates) as well as young professionals already employed in the nuclear industry. The programme is offered in English to facilitate the participation of international students. One of the important aspects of the BNEN programme is the fact that exercises and hands-on sessions in the specialised laboratories of SCK.CEN complement the theoretical classes to bring the students into contact with all facets of nuclear energy. Several of SCK.CEN's researchers provide valuable contributions to the programme through seminars and practical exercises. From their daily practices and responsibilities they give an expert view on the subjects that are being taught. In 2012, in the framework of an official accreditation process all aspects of the BNEN programme were audited by an international visitation panel. The most important outcome of this process is the current reform of the academic programme, which will be implemented in the academic year 2014-2015, taking into account the recommendations by the visitation panel. In this paper, the history of the BNEN programme will be discussed, the new BNEN programme will be presented as well as the process that has led to its implementation. (authors)

Comparing pharmaceutical pricing and reimbursement policies in Croatia to the European Union Member States.

Science.gov (United States)

Vogler, Sabine; Habl, Claudia; Bogut, Martina; Voncina, Luka

2011-04-15

To perform a comparative analysis of the pharmaceutical pricing and reimbursement systems in Croatia and the 27 European Union (EU) Member States. Knowledge about the pharmaceutical systems in Croatia and the 27 EU Member States was acquired by literature review and primary research with stakeholders. Pharmaceutical prices are controlled at all levels in Croatia, which is also the case in 21 EU Member States. Like many EU countries, Croatia also applies external price referencing, i.e., compares prices with other countries. While the wholesale remuneration by a statutorily regulated linear mark-up is applied in Croatia and in several EU countries, the pharmacy compensation for dispensing reimbursable medicines in the form of a flat rate service fee in Croatia is rare among EU countries, which usually apply a linear or regressive pharmacy mark-up scheme. Like in most EU countries, the Croatian Social Insurance reimburses specific medicines at 100%, whereas patients are charged co-payments for other reimbursable medicines. Criteria for reimbursement include the medicine's importance from the public health perspective, its therapeutic value, and relative effectiveness. In Croatia and in many EU Member States, reimbursement is based on a reference price system. The Croatian pharmaceutical system is similar to those in the EU Member States. Key policies, like external price referencing and reference price systems, which have increasingly been introduced in EU countries are also applied in Croatia and serve the same purpose: to ensure access to medicines while containing public pharmaceutical expenditure.

10 CFR 765.30 - Reimbursement of costs incurred in accordance with a plan for subsequent remedial action.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Reimbursement of costs incurred in accordance with a plan... Procedures § 765.30 Reimbursement of costs incurred in accordance with a plan for subsequent remedial action. (a) This section establishes procedures governing reimbursements of costs of remedial action incurred...

Comparison of composition and quality traits of meat from young finishing bulls from Belgian Blue, Limousin and Aberdeen Angus breeds.

Science.gov (United States)

Cuvelier, C; Clinquart, A; Hocquette, J F; Cabaraux, J F; Dufrasne, I; Istasse, L; Hornick, J L

2006-11-01

Thirty-six young finishing bulls from three breeds (Belgian Blue, Limousin and Aberdeen Angus) were fattened over five months with finishing diets based either on sugar-beet pulp or on cereals. Nutritional quality traits of meat - fat content and fatty acid composition with emphasis on the n-6 and n-3 polyunsaturated fatty acids - along with some organoleptic quality traits were measured. The Belgian Blue bulls had the lowest intramuscular fat content associated with lower saturated and monounsaturated fatty acid contents. The polyunsaturated fatty acid content did not differ to a large extent between the breeds, the Aberdeen Angus bulls showing slightly higher values. Relative to energy intake, the overall contribution of meat to the n-3 fatty acid recommended intake was small, whatever the breed. By contrast, the contribution of meat to daily fat intake was of greater importance, especially for the Aberdeen Angus bulls. The quality traits of meat varied also according to the breed: compared to the Aberdeen Angus, the Belgian Blue bull meat had the stablest colour, the highest drip and the lowest cooking losses. The meat of Limousin bulls had intermediate characteristics for all the parameters.

41 CFR 101-39.104-2 - Reimbursement.

Science.gov (United States)

2010-07-01

...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.1-Establishment, Modification, and Discontinuance of Interagency Fleet... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Reimbursement. 101-39.104-2 Section 101-39.104-2 Public Contracts and Property Management Federal Property Management...

An International Peer Review of the Safety Options Dossier of the Project for Disposal of Radioactive Waste in Deep Geological Formations (Cigéo). Final Report of the IAEA International Review Team November 2016

International Nuclear Information System (INIS)

2017-07-01

The French Nuclear Safety Authority (Autorité de sûreté nucléaire, ASN) is preparing the evaluation of a licence application for the creation of a deep geological disposal facility in 2018, called Cigéo, for intermediate level, high level and long lived radioactive waste. This licence is preceded by the submission of a Safety Options Dossier to ASN, which provides the French National Radioactive Waste Management Agency (Agence nationale pour la gestion des déchets radioactifs, Andra) the possibility to receive advice from ASN on the preparation of the licence application on the safety principles and approach. The Safety Options Dossier sets out the chosen objectives, concepts and principles for ensuring the safety of the facility. ASN requested the IAEA to organize an international peer review of the Safety Options Dossier. This publication presents the consensus view of the international group of experts convened by the IAEA to conduct the review against the relevant IAEA safety standards and proven international practice and experience. The experts acted in a personal capacity and the views expressed do not necessarily reflect those of the IAEA, the governments of the nominating Member States or the nominating organizations. The basis of this peer review is the set of documents provided by Andra, as the agency responsible for the development of the Cigéo project and for its safety. Consequently, the findings of the reviews are addressed directly to Andra. This publication, however, is primarily submitted to ASN to review the outcomes of the Andra project.

42 CFR 411.22 - Reimbursement obligations of primary payers and entities that received payment from primary payers.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Reimbursement obligations of primary payers and... Provisions § 411.22 Reimbursement obligations of primary payers and entities that received payment from... reimburse CMS for any payment if it is demonstrated that the primary payer has or had a responsibility to...

History of the Belgian nuclear power controversy

International Nuclear Information System (INIS)

Laes, E.

2009-01-01

Partly because nuclear energy technology continues to provoke profound controversy, the Flemish institute for technology assessment (viWTA) took the initiative to order a study aimed at mapping out the historical dynamics of the societal debate on nuclear energy. This study was carried out by the Belgian Nuclear Research Centre (SCK-CEN, under the research programme PISA) together with the Free university of Brussels (VUB, research group MEKO) in 2004. In 2007, the report was updated and published by Acco (Leuven) under the title Kernenergie (on)besproken. This study had three main objectives: 1) to discuss the societal debate on nuclear energy in Belgium in relation to major events (Chernobyl, TMI, etc.); 2) to elucidate the role of social actors in the controversy on both a national and international level and 3) to discuss possible alternatives for a better structuring of the debate in the future, building on existing approaches

RISCOM Applied to the Belgian Partnership Model: More and Deeper Levels

International Nuclear Information System (INIS)

Bombaerts, Gunter; Bovy, Michel; Laes, Erik

2006-01-01

Technology participation is not a new concept. It has been applied in different settings in different countries. In this article, we report a comparing analysis of the RISCOM model in Sweden and the Belgian partnership model for low and intermediate short-lived nuclear waste. After a brief description of the partnerships and the RISCOM model, we apply the latter to the first and come to recommendations for the partnership model. The strength of the partnership approach is at the community level. In one of the villages, up to one percent of the population was motivated to discuss at least once a month for four years the nuts and bolts of the repository concept. The stress on the community level and the lack of a guardian includes a weakness as well. First of all, if communities come into competition, the inter-community discussions can start resembling local politics and can become less transparent. Local actors are concerned actors but actors at the national level are concerned as well. The local decisions influence how the waste will be transported. The local decisions also determine an extra cost of electricity. We therefore recommend a broad (in terms of territory) public debate on the participation experiments preceding and concluding the local participation process in which this local process maintains an important position. The conclusions of our comparative analysis are: (1) The guardian of the process at the national level is missing. Since the Belgian nuclear regulator plays a controlling role after the process, we recommend a technology assessment institute at the federal level. (2) We state that stretching in the partnership model can happen more profoundly and recommend a 'counter institute' at the European level. The role of non-participative actors should be valued. (3) Recursion levels can be taken as a point of departure for discussion about the problem framing. If people accept them, there is no problem. If people clearly mention issues that are

RISCOM Applied to the Belgian Partnership Model: More and Deeper Levels

Energy Technology Data Exchange (ETDEWEB)

Bombaerts, Gunter; Bovy, Michel; Laes, Erik [SCKCEN, Mol (Belgium). PISA

2006-09-15

Technology participation is not a new concept. It has been applied in different settings in different countries. In this article, we report a comparing analysis of the RISCOM model in Sweden and the Belgian partnership model for low and intermediate short-lived nuclear waste. After a brief description of the partnerships and the RISCOM model, we apply the latter to the first and come to recommendations for the partnership model. The strength of the partnership approach is at the community level. In one of the villages, up to one percent of the population was motivated to discuss at least once a month for four years the nuts and bolts of the repository concept. The stress on the community level and the lack of a guardian includes a weakness as well. First of all, if communities come into competition, the inter-community discussions can start resembling local politics and can become less transparent. Local actors are concerned actors but actors at the national level are concerned as well. The local decisions influence how the waste will be transported. The local decisions also determine an extra cost of electricity. We therefore recommend a broad (in terms of territory) public debate on the participation experiments preceding and concluding the local participation process in which this local process maintains an important position. The conclusions of our comparative analysis are: (1) The guardian of the process at the national level is missing. Since the Belgian nuclear regulator plays a controlling role after the process, we recommend a technology assessment institute at the federal level. (2) We state that stretching in the partnership model can happen more profoundly and recommend a 'counter institute' at the European level. The role of non-participative actors should be valued. (3) Recursion levels can be taken as a point of departure for discussion about the problem framing. If people accept them, there is no problem. If people clearly mention issues

42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

Science.gov (United States)

2010-10-01

... Service Corps site's reimbursement obligation to the Federal Government be waived? 23.10 Section 23.10... National Health Service Corps site's reimbursement obligation to the Federal Government be waived? (a) The Secretary may waive in whole or in part the reimbursement requirements of section 334(a)(3) of the Act if he...

Nagra technical report 14-02, geological basics - Dossier II - Sediments and tectonic considerations; SGT Etappe 2: Vorschlag weiter zu untersuchender geologischer Standortgebiete mit zugehörigen Standortarealen für die Oberflächenanlage -- Geologische Grundlagen -- Dossier II -- Sedimentologische und tektonische Verhältnisse

Energy Technology Data Exchange (ETDEWEB)

Madritsch, H.; Deplazes, G.

2014-12-15

This dossier is the second of a series of eight reports concerning the safety and technical aspects of locations for the disposal of radioactive wastes in Switzerland. It considers the sediments that can be used and discusses tectonic considerations. As an introduction, the geological framework is discussed with the various sediments from the Paleozoic, Mesozoic and Cenozoic periods. The various methods used to investigate the rock, such as drilling and reflection-seismic methods along with the investigation of surface formations are discussed. A detailed discussion of the stratigraphic and sedimentological characteristics of the various formations follows. Geological structures and the tectonics in the proposed areas are discussed, as are the depth and thickness of the structures.

36 CFR 14.22 - Reimbursement of costs.

Science.gov (United States)

2010-07-01

... acceptable to the authorized officer, by bond, guaranty, cash, certificate of deposit, or other means... acceptable to the authorized officer, by bond, guaranty, cash, certificate of deposit or other means... shall reimburse the United States for costs incurred by the United States in monitoring the construction...

Part-time Work, Wages and Productivity:Evidence from Belgian Matched Panel Data

OpenAIRE

Garnero, Andrea; Kampelmann, Stephan; Rycx, François

2013-01-01

The authors use matched employer-employee panel data on Belgian private-sector firms to estimate the relationship between wage/productivity differentials and the firm’s labor composition in terms of part-time and sex. Findings suggest that the groups of women and part-timers generate employer rents, but also that the origin of these rents differs (relatively lower wages for women, relatively higher productivity for part-timers). Interactions between gender and part-time suggest that the posit...

A Regional Analysis of U.S. Insurance Reimbursement Guidelines for Massage Therapy.

Science.gov (United States)

Miccio, Robin S; Cowen, Virginia S

2018-03-01

Massage techniques fall within the scope of many different health care providers. Physical therapists, occupational therapists, and chiropractors receive insurance reimbursement for health care services, including massage. Although many patients pay out of pocket for massage services, it is unclear how the insurance company reimbursement policies factor provider qualifications into coverage. This project examined regional insurance reimbursement guidelines for massage therapy in relation to the role of the provider of massage services. A qualitative content analysis was used to explore guidelines for 26 health insurance policies across seven US companies providing coverage in the northeastern United States. Publicly available information relevant to massage was obtained from insurance company websites and extracted into a dataset for thematic analysis. Data obtained included practice guidelines, techniques, and provider requirements. Information from the dataset was coded and analyzed using descriptive statistics. Of the policies reviewed, 23% explicitly stated massage treatments were limited to 15-minute increments, 19% covered massage as one part of a comprehensive rehabilitation plan, and 27% required physician prescription. Massage techniques mentioned as qualifying for reimbursement included: Swedish, manual lymphatic drainage, mobilization/manipulation, myofascial release, and traction. Chiropractors, physical therapists, and occupational therapists could directly bill for massage. Massage therapists were specifically excluded as covered providers for seven (27%) policies. Although research supports massage for the treatment of a variety of conditions, the provider type has not been separately addressed. The reviewed policies that served the Northeastern states explicitly stated massage therapists could not bill insurance companies directly. The same insurance companies examined reimbursement for massage therapists in their western U.S. state policies. Other

Externally Acquired Radiological Data for the Clinical Routine - A Review of the Reimbursement Situation in Germany.

Science.gov (United States)

Schreyer, Andreas G; Steinhäuser, René T; Rosenberg, Britta

2018-02-07

 Interdisciplinary radiological conferences and boards can improve therapeutic pathways. Because of the reinterpretation and presentation of external image data, which already was read, an additional workload is created which is currently not considered by health care providers. In this review we discuss the ongoing basics and possibilities in health economy for a radiological second opinion for the outpatient and inpatient sector in Germany.  Based on up-to-date literature and jurisdiction, we discuss the most important questions for the reimbursement for second opinions and conference presentations of external image data in an FAQ format. Additionally, we focus on the recently introduced E-Health law accordingly.  Radiological services considering second opinion or board presentation of externally acquired image data are currently not adequately covered by health care providers. In particular, there is no reimbursement possibility for the inpatient sector. Only patients with private insurance or privately paid second opinions can be charged when these patients visit the radiologist directly.  Currently there is no adequate reimbursement possibility for a radiological second opinion or image demonstrations in clinical conferences. It will be essential to integrate adequate reimbursement by health care providers in the near future because of the importance of radiology as an essential diagnostic and therapeutic medical partner.   · Currently there is no reimbursement for image interpretation and presentation in boards.. · Second opinions can only be reimbursed for patients with private insurance or privately recompensed.. · The E-Health law allows reimbursement for tele-counsel in very complex situations.. · It will be crucial to integrate radiological second opinion in future reimbursement policies by health care providers.. · Schreyer AG, Steinhäuser RT, Rosenberg B. Externally Acquired Radiological Data for the Clinical Routine - A Review of

42 CFR 489.34 - Allowable charges: Hospitals participating in State reimbursement control systems or...

Science.gov (United States)

2010-10-01

... reimbursement control systems or demonstration projects. 489.34 Section 489.34 Public Health CENTERS FOR... CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER APPROVAL Allowable Charges § 489.34 Allowable charges: Hospitals participating in State reimbursement control systems or demonstration projects. A hospital receiving payment for...

Proof of payment for all reimbursement claims

CERN Multimedia

HR Department

2006-01-01

Members of the personnel are kindly requested to note that only documents proving that a payment has been made are accepted as proof of payment for any claims for reimbursement, including specifically the reimbursement of education fees. In particular, the following will be accepted as proof of payment: bank or post office bank statements indicating the name of the institution to which the payment was made; photocopies of cheques made out to the institution to which the payments were made together with bank statements showing the numbers of the relevant cheques; proof of payment in the form of discharged payment slips; invoices with acknowledgement of settlement, receipts, bank statements detailing operations crediting another account or similar documents. As a result, the following documents in particular will no longer be accepted as proof of payment: photocopies of cheques that are not submitted together with bank or post office bank statements showing the numbers of the relevant cheques; details of ...

Mechanical degradation processes: The Belgian experience

International Nuclear Information System (INIS)

Lafaille, J.P.; Hennart, J.C.

1998-01-01

Design life is merely used in Belgium as a requirement in the 'Design Specification' of some components subjected to known degradation processes, such as stress induced fatigue, embrittlement (irradiation or other), various types of corrosion, wear, erosion, thermal aging (electrical insulation, ...), etc. Design life is in no way directly related to the duration of the plant operation. In that sense design life for the Belgian NPP components includes the values of 20, 30 and 40 years. The oldest plant (20 years design life) has been decommissioned in 1991. The most recent units (40 years design life) have still a good time to go. The intermediate units (30 years design life) started around 1975. Consequently components of these plants need be looked at to determine whether or not deteriorations have occurred. The paper presents the various known mechanical degradation processes and how they affect various components. Emphasis is laid on prevention, mitigation or repair measures that have been or are being taken to avoid that the 'Equipment design life' be the limiting factor in the duration of the plant operation. (author)

48 CFR 528.311 - Solicitation provision and contract clause on liability insurance under cost-reimbursement...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Solicitation provision and contract clause on liability insurance under cost-reimbursement contracts. 528.311 Section 528.311 Federal...-reimbursement contracts. ...

48 CFR 28.311 - Solicitation provision and contract clause on liability insurance under cost-reimbursement...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Solicitation provision and contract clause on liability insurance under cost-reimbursement contracts. 28.311 Section 28.311 Federal...-reimbursement contracts. ...

Nursing home case-mix reimbursement in Mississippi and South Dakota.

Science.gov (United States)

Arling, Greg; Daneman, Barry

2002-04-01

To evaluate the effects of nursing home case-mix reimbursement on facility case mix and costs in Mississippi and South Dakota. Secondary data from resident assessments and Medicaid cost reports from 154 Mississippi and 107 South Dakota nursing facilities in 1992 and 1994, before and after implementation of new case-mix reimbursement systems. The study relied on a two-wave panel design to examine case mix (resident acuity) and direct care costs in 1-year periods before and after implementation of a nursing home case-mix reimbursement system. Cross-lagged regression models were used to assess change in case mix and costs between periods while taking into account facility characteristics. Facility-level measures were constructed from Medicaid cost reports and Minimum Data Set-Plus assessment records supplied by each state. Resident case mix was based on the RUG-III classification system. Facility case-mix scores and direct care costs increased significantly between periods in both states. Changes in facility costs and case mix were significantly related in a positive direction. Medicare utilization and the rate of hospitalizations from the nursing facility also increased significantly between periods, particularly in Mississippi. The case-mix reimbursement systems appeared to achieve their intended goals: improved access for heavy-care residents and increased direct care expenditures in facilities with higher acuity residents. However, increases in Medicare utilization may have influenced facility case mix or costs, and some facilities may have been unprepared to care for higher acuity residents, as indicated by increased rates of hospitalization.

Comparing pharmaceutical pricing and reimbursement policies in Croatia to the European Union Member States

Science.gov (United States)

Vogler, Sabine; Habl, Claudia; Bogut, Martina; Vončina, Luka

2011-01-01

Aim To perform a comparative analysis of the pharmaceutical pricing and reimbursement systems in Croatia and the 27 European Union (EU) Member States. Methods Knowledge about the pharmaceutical systems in Croatia and the 27 EU Member States was acquired by literature review and primary research with stakeholders. Results Pharmaceutical prices are controlled at all levels in Croatia, which is also the case in 21 EU Member States. Like many EU countries, Croatia also applies external price referencing, ie, compares prices with other countries. While the wholesale remuneration by a statutorily regulated linear mark-up is applied in Croatia and in several EU countries, the pharmacy compensation for dispensing reimbursable medicines in the form of a flat rate service fee in Croatia is rare among EU countries, which usually apply a linear or regressive pharmacy mark-up scheme. Like in most EU countries, the Croatian Social Insurance reimburses specific medicines at 100%, whereas patients are charged co-payments for other reimbursable medicines. Criteria for reimbursement include the medicine’s importance from the public health perspective, its therapeutic value, and relative effectiveness. In Croatia and in many EU Member States, reimbursement is based on a reference price system. Conclusion The Croatian pharmaceutical system is similar to those in the EU Member States. Key policies, like external price referencing and reference price systems, which have increasingly been introduced in EU countries are also applied in Croatia and serve the same purpose: to ensure access to medicines while containing public pharmaceutical expenditure. PMID:21495202

Reactor pressure vessel steels[1997 Scientific Report of the Belgian Nuclear Research Centre

Energy Technology Data Exchange (ETDEWEB)

Van De Velde, J.; Fabry, A.; Van Walle, E.; Chaouuadi, R.

1998-07-01

Research and development activities related to reactor pressure vessel steels during 1997 are reported. The objectives of activities of the Belgian Nuclear Research Centre SCK/CEN in this domain are: (1) to develop enhanced surveillance concepts by applying micromechanics and fracture-toughness tests to small specimens, and by performing damage modelling and microstructure characterization; (2) to demonstrate a methodology on a broad database; (3) to achieve regulatory acceptance and industrial use.

HEALTH INFO SANTÉ – REMINDER ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS HINTS FOR USE

CERN Multimedia

CHIS Board

2000-01-01

Information from the CHIS Board and the Human Resources Division:Annual deductible and reimbursement claims: hints for useOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and neither by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 54, 000 in 1999 - is part of the cost of our insurance.Help keep administrative costs down: do not submit reimbursement cl...

Covering and Reimbursing Telehealth Services.

Science.gov (United States)

Blackman, Kate

2016-01-01

Policymakers who are striving to achieve better health care, improved health outcomes and lower costs are considering new strategies and technologies. Telehealth is a tool that uses technology to provide health services remotely, and state leaders are looking to it now more than ever as a way to address workforce gaps and reach underserved patients. Among the challenges facing state lawmakers who are working to introduce or expand telehealth is how to handle covering patients and reimbursing providers.

48 CFR 1428.311 - Solicitation provision and contract clause on liability insurance under cost-reimbursement...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Solicitation provision and contract clause on liability insurance under cost-reimbursement contracts. 1428.311 Section 1428.311... under cost-reimbursement contracts. ...

Integration of gamma measuring equipment into an Agusta A109BA helicopter of the Belgian Armed Forces for use in emergency situations

International Nuclear Information System (INIS)

Paridaens, J.

2007-01-01

In case of a nuclear emergency, accidental releases of radioactive material might cause large scale environmental contamination. After the emergency has been brought under control, and the radioactive releases have settled on the ground, it is essential to map as quickly as possible the extent of the contaminated area and to evaluate the severity of the contamination. Airborne gamma measurements are known to be an effective means for quickly and safely mapping and evaluating large scale contaminations of gamma-emitting radio nuclides. We wanted to integrate gamma measuring equipment, based on a NaI detector, into an Agusta A109BA helicopter of the Belgian armed forces. This was done within the framework of ''Aid to the Nation'', a special program developed by the Belgian Armed Forces for facilitating cooperation between the armed forces and civilian organisations, for projects that are to the benefit of the Belgian Nation. Working in this framework, we also want to develop the necessary procedures that will allow quick and efficient deployment of the measuring capability in case of an emergency

Introduction to Dossier. International Migrations in Latin America: Critical Views on the Production of a Field of Knowledge

Directory of Open Access Journals (Sweden)

Gioconda Herrera

2017-05-01

Full Text Available This article presents a reflection from three dimensions on epistemological and political logics that crosscut the studies on migrations in Latin America: 1 the increasing heterogeneity of flows and the need to rethink the conceptual categories from which migrations are addressed; 2 the dialogue and appropriation of analytical frameworks produced in other regions in Latin American studies; and 3 the political agendas of the States in the region and in the North, and their selective influence on the production of knowledge. The objective is to offer a general reflection on the production of the field of studies on migrations in Latin America to serve as a context for the analysis of the five articles presented in this dossier of Íconos. Revista de Ciencias Sociales.

42 CFR 413.5 - Cost reimbursement: General.

Science.gov (United States)

2010-10-01

... and profit-making organizations. (6) That there should be a recognition of the need of hospitals and... fide efforts at collection). (7) Charity and courtesy allowances are not includable, although “fringe... residents in the care of individual patients) furnished in a teaching hospital may be reimbursed as a...

Surgeon Reimbursements in Maxillofacial Trauma Surgery: Effect of the Affordable Care Act in Ohio.

Science.gov (United States)

Khansa, Ibrahim; Khansa, Lara; Pearson, Gregory D

2016-02-01

Surgical treatment of maxillofacial injuries has historically been associated with low reimbursements, mainly because of the high proportion of uninsured patients. The Affordable Care Act, implemented in January of 2014, aimed to reduce the number of uninsured. If the Affordable Care Act achieves this goal, surgeons may benefit from improved reimbursement rates. The authors' purpose was to evaluate the effects of the Affordable Care Act on payor distribution and surgeon reimbursements for maxillofacial trauma surgery at their institution. A review of all patients undergoing surgery for maxillofacial trauma between January of 2012 and December of 2014 was conducted. Insurance status, and amounts billed and collected by the surgeon, were recorded. Patients treated before implementation of the Affordable Care Act were compared to those treated after. Five hundred twenty-three patients were analyzed. Three hundred thirty-four underwent surgery before implementation of the Affordable Care Act, and 189 patients underwent surgery after. After implementation of the Affordable Care Act, the proportion of uninsured decreased (27.2 percent to 11.1 percent; p reimbursement rate increased from 14.3 percent to 19.8 percent (p reimbursement rate increased. These trends should be followed over a longer term to determine the full effect of the Affordable Care Act.

Committee Representation and Medicare Reimbursements-An Examination of the Resource-Based Relative Value Scale.

Science.gov (United States)

Gao, Y Nina

2018-04-06

The Resource-Based Relative Value Scale Update Committee (RUC) submits recommended reimbursement values for physician work (wRVUs) under Medicare Part B. The RUC includes rotating representatives from medical specialties. To identify changes in physician reimbursements associated with RUC rotating seat representation. Relative Value Scale Update Committee members 1994-2013; Medicare Part B Relative Value Scale 1994-2013; Physician/Supplier Procedure Summary Master File 2007; Part B National Summary Data File 2000-2011. I match service and procedure codes to specialties using 2007 Medicare billing data. Subsequently, I model wRVUs as a function of RUC rotating committee representation and level of code specialization. An annual RUC rotating seat membership is associated with a statistically significant 3-5 percent increase in Medicare expenditures for codes billed to that specialty. For codes that are performed by a small number of physicians, the association between reimbursement and rotating subspecialty representation is positive, 0.177 (SE = 0.024). For codes that are performed by a large number of physicians, the association is negative, -0.183 (SE = 0.026). Rotating representation on the RUC is correlated with overall reimbursement rates. The resulting differential changes may exacerbate existing reimbursement discrepancies between generalist and specialist practitioners. © Health Research and Educational Trust.

Incentives for cooperation in quality improvement among hospitals--the impact of the reimbursement system.

Science.gov (United States)

Kesteloot, K; Voet, N

1998-12-01

Up to now, few analytical models have studied the incentives for cooperation in quality improvements among hospitals. Only those dealing with reimbursement systems have shown that, from the point of view of individual or competing hospitals, retrospective reimbursement is more likely to encourage quality improvements than prospective financing, while the reverse holds for efficiency improvements. This paper studies the incentives to improve the quality of hospital care, in an analytical model, taking into account the possibility of cooperative agreements, price besides non-price (quality) competition and quality improvements that may simultaneously increase demand, increase or reduce costs and spill over to rival hospitals. In this setting quality improvement efforts rise with the rate of prospective reimbursement, while the impact of the rate of retrospective reimbursement is ambiguous, but likely to be negative for quality improvements that are highly cost-reducting and create large spillovers. Cooperation may lead to more or less quality improvement than non-cooperative conduct, depending on the magnitude of spillovers and the degree of product market competition, relative to the net effect of quality on profits and the share of costs that is reimbursed retrospectively. Finally, the stability of cooperative agreements, supported by grim trigger strategies, is shown to depend upon exactly the opposite interaction between these factors.

48 CFR 1828.311 - Solicitation provision and contract clause on liability insurance under cost-reimbursement...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Solicitation provision and contract clause on liability insurance under cost-reimbursement contracts. 1828.311 Section 1828.311... insurance under cost-reimbursement contracts. ...

47 CFR 101.82 - Reimbursement and relocation expenses in the 2110-2150 MHz and 2160-2200 MHz bands.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Reimbursement and relocation expenses in the... License Transfers, Modifications, Conditions and Forfeitures § 101.82 Reimbursement and relocation expenses in the 2110-2150 MHz and 2160-2200 MHz bands. (a) Reimbursement and relocation expenses for the...

Does case-mix based reimbursement stimulate the development of process-oriented care delivery?

Science.gov (United States)

Vos, Leti; Dückers, Michel L A; Wagner, Cordula; van Merode, Godefridus G

2010-11-01

Reimbursement based on the total care of a patient during an acute episode of illness is believed to stimulate management and clinicians to reduce quality problems like waiting times and poor coordination of care delivery. Although many studies already show that this kind of case-mix based reimbursement leads to more efficiency, it remains unclear whether care coordination improved as well. This study aims to explore whether case-mix based reimbursement stimulates development of care coordination by the use of care programmes, and a process-oriented way of working. Data for this study were gathered during the winter of 2007/2008 in a survey involving all Dutch hospitals. Descriptive and structural equation modelling (SEM) analyses were conducted. SEM reveals that adoption of the case-mix reimbursement within hospitals' budgeting processes stimulates hospitals to establish care programmes by the use of process-oriented performance measures. However, the implementation of care programmes is not (yet) accompanied by a change in focus from function (the delivery of independent care activities) to process (the delivery of care activities as being connected to a chain of interdependent care activities). This study demonstrates that hospital management can stimulate the development of care programmes by the adoption of case-mix reimbursement within hospitals' budgeting processes. Future research is recommended to confirm this finding and to determine whether the establishment of care programmes will in time indeed lead to a more process-oriented view of professionals. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in “At-Risk” HMOs

Science.gov (United States)

Eggers, Paul W.; Prihoda, Ronald

1982-01-01

The Health Care Financing Administration (HCFA) has initiated several demonstration projects to encourage HMOs to participate in the Medicare program under a risk mechanism. These demonstrations are designed to test innovative marketing techniques, benefit packages, and reimbursement levels. HCFA's current method for prospective payments to HMOs is based on the Adjusted Average Per Capita Cost (AAPCC). An important issue in prospective reimbursement is the extent to which the AAPCC adequately reflects the risk factors which arise out of the selection process of Medicare beneficiaries into HMOs. This study examines the pre-enrollment reimbursement experience of Medicare beneficiaries who enrolled in the demonstration HMOs to determine whether or not a non-random selection process took place. The three demonstration HMOs included in the study are the Fallon Community Health Plan, the Greater Marshfield Community Health Plan, and the Kaiser-Permanente medical program of Portland, Oregon. The study includes 18,085 aged Medicare beneficiaries who had enrolled in the three plans as of April, 1981. We included comparison groups consisting of a 5 percent random sample of aged Medicare beneficiaries (N = 11,240) living in the same geographic areas as the control groups. The study compares the groups by total Medicare reimbursements for the years 1976 through 1979. Adjustments were made for AAPCC factor differences in the groups (age, sex, institutional status, and welfare status). In two of the HMO areas there was evidence of a selection process among the HMOs enrollees. Enrollees in the Fallon and Kaiser health plans were found to have had 20 percent lower Medicare reimbursements than their respective comparison groups in the four years prior to enrollment. This effect was strongest for inpatient services, but a significant difference also existed for use of physician and outpatient services. In the Marshfield HMO there was no statistically significant difference in pre

Different Regional Approaches to Cultural diversity Interpreting the Belgian Cultural Diversity Policy Paradox

Directory of Open Access Journals (Sweden)

Ilke Adam

2015-11-01

Full Text Available In Belgium, the authority over cultural diversity policies resulting from immigration has been devolved from the central state to the regions since 1970. Consequently, Flanders and Francophone Belgium have progressively developed divergent policy tools. By describing the divergent evolution of Francophone and Flemish cultural diversity policies, our paper demonstrates the existence of a “Belgian Cultural Diversity Paradox”, namely the existence of more multicultural minority rights in the region that has most experienced electoral success by an extreme-right anti-immigrant party (Flanders, and a more colour blind and radical secular approach in the region where anti-immigrant politicization is barely a factor (Francophone Belgium. This finding is counter-intuitive because an important strand of immigrant policy research has emphasized the relationship between the politicization of immigration and restrictive immigrant citizenship rights. Our paper demonstrates that the different degrees of politicization of immigration in Flanders and Francophone Belgium cannot fully account for divergent cultural diversity policies. By insisting on the historical path dependency of the linguistic and religious cleavages in Belgium and their overlap, this paper offers an addendum to the politicization approach. The historical linguistic and religious differences of the Belgian regions clearly mediate the impact of the politicization of immigration on both sides of the linguistic border.

Treatment trends and Medicare reimbursements for localized prostate cancer in elderly patients.

Science.gov (United States)

Dell'oglio, Paolo; Valiquette, Anne Sophie; Leyh-Bannurah, Sami-Ramzi; Tian, Zhe; Trudeau, Vincent; Larcher, Alessandro; Shariat, Shahrokh F; Capitanio, Umberto; Briganti, Alberto; Graefen, Markus; Montorsi, Francesco; Karakiewicz, Pierre I

2018-03-19

The absolute and proportional numbers of elderly patients diagnosed with localized prostate cancer (PCa) are on the rise. We examined treatment trends and reimbursement figures in localized PCa patients aged ≥80 years. Between 2000 and 2008, we identified 30 217 localized PCa patients aged ≥80 years in Surveillance, Epidemiology and End Results (SEER)-Medicare-linked database. Alternative treatment modalities consisted of conservative management (CM), radiation therapy (RT), radical prostatectomy (RP), and primary androgen-deprivation therapy (PADT). For all four modalities, utilization and reimbursements were examined. PADT was the most frequently used treatment modality between 2000 and 2005. CM became the dominant treatment modality from 2006-2008. RP rates were marginal and RT ranked third and its annual rate increased from 20.77% in 2000 to 29.13% in 2008. Median individual reimbursement of RT was highest and ranged from $29 343 in 2000 to $31 090 in 2008, followed by RP (from $20 560 in 2000 to $19 580 in 2008), PADT (from $18 901 in 2000 to $8000 in 2008) and CM (from $1824 in 2000 to $1938 in 2008). RT contributed to most of the cumulative annual reimbursements from 2003 (49.24%) to 2008 (72.97%). PADT ranked first from 2000 (54.56%) to 2002 (50.49%), but decreased by 19.40% in 2008. CM's contribution increased from 4.42% in 2000 to 6.96% in 2008. RP share of reimbursements was stable during the study period. Our results, focusing on localized PCa treatment in patients aged ≥80 years, showed an important increase in rates, median cost, and proportion of cumulative cost related to RT.

48 CFR 228.311 - Solicitation provision and contract clause on liability insurance under cost-reimbursement...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Solicitation provision and contract clause on liability insurance under cost-reimbursement contracts. 228.311 Section 228.311 Federal... liability insurance under cost-reimbursement contracts. ...

40 CFR 66.74 - Payment or reimbursement.

Science.gov (United States)

2010-07-01

....74 Payment or reimbursement. (a) Within thirty days after any adjustment of a noncompliance penalty... timely payment of a deficiency shall pay a nonpayment penalty. The nonpayment penalty shall be calculated as of the due date of the deficiency payment and shall be equal to 20% of the deficiency not paid...

The Belgian regulatory framework for NORM industries : test-case of a phosphate production plant

International Nuclear Information System (INIS)

Pepin, Stephane; Dehandschutter, Boris; Poffijn, Andre; Michel Sonck

2008-01-01

According to the Belgian radiation protection regulatory framework, some categories of NORM industries must register to the competent Belgian radiation protection authority (FANC, Federal Agency for Nuclear Control). The facilities must provide a set of information which allows the authority to assess the radiological impact of the industrial activity on the workers, the population and the environment. If the dose exceeds or is likely to exceed 1 mSv/y, corrective measures have to be implemented. FANC has issued a methodology in order to define more precisely the data needed to evaluate the radiological impact. The methodology lists also the exposure pathways which have to be taken into account and the relevant parameters for the evaluation of the doses. The case of a phosphate production plant is discussed in more details: although the exposure of the workers in the production process as such is rather limited, the specific activity of some residues (calcium fluoride sludge) reaches around 10 kBq/kg of Ra-226. This sludge is disposed off in a specific landfill for which a program of radiological monitoring has been implemented. It includes periodic measurements of dose rate and radon concentration on the landfill. (author)

The Einstein dossiers science and politics - Einstein's Berlin period with an appendix on Einstein's FBI file

CERN Document Server

Grundmann, Siegfried

2004-01-01

In 1919 the Prussian Ministry of Science, Arts and Culture opened a dossier on "Einstein's Theory of Relativity." It was rediscovered by the author in 1961 and is used in conjunction with numerous other subsequently identified 'Einstein' files as the basis of this fascinating book. In particular, the author carefully scrutinizes Einstein's FBI file from 1950-55 against mostly unpublished material from European including Soviet sources and presents hitherto unknown documentation on Einstein's alleged contacts with the German Communist Party and the Comintern. Siegfried Grundmann's thorough study of Einstein's participation on a committee of the League of Nations, based on archival research in Geneva, is also new. This book outlines Einstein's image in politics and German science policy. It covers the period from his appointment as a researcher in Berlin to his fight abroad against the "boycott of German science" after World War I and his struggle at home against attacks on "Jewish physics" of which he was made...

Towards a PSA harmonization French-Belgian comparison of the level 1 PSA for two similar PWR types

International Nuclear Information System (INIS)

Dupuy, P.; Corenwinder, F.; Lanore, J.M.; Gryffroy, D.; Gelder, P. de; Hulsmans, M.

2002-06-01

In the framework of the cooperation between French and Belgian regulatory authorities, a PSA (Probabilistic Safety Assessment) comparison exercise has been carried out for several years. This comparison deals with two PSA level 1 studies for internal events, performed for both power and shutdown states: the French PSA of the 900 MWe-series PWR, and the Belgian PSA of the Tihange 1 PWR, which both concern PWRs with a similar Framatome design. The purpose of this paper is to describe the PSA comparison methodology and to present, in a qualitative way, an overview of the insights obtained up to now. It also shows that such an 'a posteriori' benchmark exercise turns out to be a step towards PSA harmonization, and gives more confidence in the results of plant specific PSA when used for applications like precursor analysis or evaluations of importance to safety. (authors)

Cost and Reimbursement for Three Fibroid Treatments: Abdominal Hysterectomy, Abdominal Myomectomy, and Uterine Fibroid Embolization

International Nuclear Information System (INIS)

Goldberg, Jay; Bussard, Anne; McNeil, Jean; Diamond, James

2007-01-01

Purpose. To compare costs and reimbursements for three different treatments for uterine fibroids. Methods. Costs and reimbursements were collected and analyzed from the Thomas Jefferson University Hospital decision support database from 540 women who underwent abdominal hysterectomy (n 299), abdominal myomectomy (n = 105), or uterine fibroid embolization (UFE) (n = 136) for uterine fibroids during 2000-2002. We used the chi-square test and ANOVA, followed by Fisher's Least Significant Difference test, for statistical analysis. Results. The mean total hospital cost (US$) for UFE was $2,707, which was significantly less than for hysterectomy ($5,707) or myomectomy ($5,676) (p < 0.05). The mean hospital net income (hospital net reimbursement minus total hospital cost) for UFE was $57, which was significantly greater than for hysterectomy (-$572) or myomectomy (-$715) (p < 0.05). The mean professional (physician) reimbursements for UFE, hysterectomy, and myomectomy were $1,306, $979, and $1,078, respectively. Conclusion. UFE has lower hospital costs and greater hospital net income than abdominal hysterectomy or abdominal myomectomy for treating uterine fibroids. UFE may be more financially advantageous than hysterectomy or myomectomy for the insurer, hospital, and health care system. Costs and reimbursements may vary amongst different hospitals and regions

48 CFR 3028.311 - Solicitation provision and contract clause on liability insurance under cost-reimbursement...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Solicitation provision and contract clause on liability insurance under cost-reimbursement contracts. 3028.311 Section 3028.311... contract clause on liability insurance under cost-reimbursement contracts. ...

78 FR 70244 - Electronic Interim Assistance Reimbursement Program

Science.gov (United States)

2013-11-25

..., Social Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY INFORMATION: Background To be... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 416 [Docket No. SSA-2011-0104] RIN 0960-AH45 Electronic Interim Assistance Reimbursement Program AGENCY: Social Security Administration. ACTION: Notice of...

Case-mix reimbursement for nursing home services: Simulation approach

Science.gov (United States)

Adams, E. Kathleen; Schlenker, Robert E.

1986-01-01

Nursing home reimbursement based on case mix is a matter of growing interest. Several States either use or are considering this reimbursement method. In this article, we present a method for evaluating key outcomes of such a change for Connecticut nursing homes. A simulation model is used to replicate payments under the case-mix systems used in Maryland, Ohio, and West Virginia. The findings indicate that, compared with the system presently used in Connecticut, these systems would better relate dollar payments to measure patient need, and for-profit homes would benefit relative to nonprofit homes. The Ohio methodology would impose the most additional costs, the West Virginia system would actually be somewhat less expensive in terms of direct patient care payments. PMID:10311776

Case-mix reimbursement for nursing home services: simulation approach.

Science.gov (United States)

Adams, E K; Schlenker, R E

1986-01-01

Nursing home reimbursement based on case mix is a matter of growing interest. Several States either use or are considering this reimbursement method. In this article, we present a method for evaluating key outcomes of such a change for Connecticut nursing homes. A simulation model is used to replicate payments under the case-mix systems used in Maryland, Ohio, and West Virginia. The findings indicate that, compared with the system presently used in Connecticut, these systems would better relate dollar payments to measure patient need, and for-profit homes would benefit relative to nonprofit homes. The Ohio methodology would impose the most additional costs, the West Virginia system would actually be somewhat less expensive in terms of direct patient care payments.

44 CFR 208.36 - Reimbursement for Alert.

Science.gov (United States)

2010-10-01

... § 208.41 of this part. (4) Food and beverages for Task Force Members and Support Specialists when DHS does not provide meals during the Alert. DHS will limit food and beverage reimbursement to the amount... where such food and beverages were provided, multiplied by the number of personnel who received them. (b...

Nagra technical report 14-02, Geological basics - Dossier VI - Barrier properties of proposed host rock sediments and neighbouring rock; SGT Etappe 2: Vorschlag weiter zu untersuchender geologischer Standortgebiete mit zugehörigen Standortarealen für die Oberflächenanlage -- Geologische Grundlagen -- Dossier VI -- Barriereneigenschaften der Wirt- und Rahmengesteine

Energy Technology Data Exchange (ETDEWEB)

Gautschi, A.; Deplazes, G.; Traber, D.; Marschall, P. [National Cooperative for the Disposal of Radioactive Waste (NAGRA), Wettingen (Switzerland); Mazurek, M.; Gimmi, T.; Maeder, U. [Institute of Geological Sciences, University of Berne, Berne (Switzerland)

2014-12-15

This dossier is the sixth of a series of eight reports concerning the safety and technical aspects of locations for the disposal of radioactive wastes in Switzerland. It discusses the barrier properties of the proposed host rock sediments and neighbouring rock layers. The mineralogical composition of the host rocks are discussed as are their pore densities and hydrological properties. Diffusion aspects are discussed. The aquifer systems in the proposed depository areas and their classification are looked at. The barrier properties of the host rocks and those of neighbouring sediments are discussed. Finally, modelling concepts and parameters for the transport of radionuclides in the rocks are discussed.

Where is the Frame? : Victims and Intruders in the Belgian Press Coverage of the Asylum Issue

NARCIS (Netherlands)

Gorp, B. van

2005-01-01

In this article an empirically oriented conceptualization of frames is developed, using the issue of asylum and illegal immigration in the Belgian press as a test case. The methodological focus of this study is on the question of how these frames can be detected in the coverage. How can they be

Individual and environmental correlates of objectively measured sedentary time in Dutch and Belgian adults.

Directory of Open Access Journals (Sweden)

Femke van Nassau

Full Text Available As the detrimental health effects of sedentary behaviour are well established, insight into the individual and environmental factors that influence adults' sedentary behaviour is needed. Most studies to date rely on self-reported measures of sedentary time. Therefore, the aim of the current study was to examine individual and environmental correlates of objectively measured sedentary time in Dutch and Belgian adults. Between March and August 2014, Belgian (n = 133 and Dutch (n = 223 adults, recruited as sub-sample of the SPOTLIGHT survey, wore an ActiGraph accelerometer to provide objectively measured sedentary and moderate to vigorous physical activity time. Participants completed a questionnaire assessing sociodemographic (country of residence, age, gender and educational level, lifestyle (sleep, smoking, sugar-containing beverage consumption, alcohol intake, health (body mass index, self-rated health, work (employment status and type of work, happiness, physical environmental (owning a car, number of screens, socioeconomic status and residential density and social environmental factors (social network, social cohesion. Univariate and multivariable regression analyses showed that Belgian participants had a lower odds of being sedentary for at least 9 hours per day compared to Dutch participants. Women, older participants and those meeting the WHO recommendation for physical activity were also less likely to sit for 9 hours or more per day. Participants doing (heavy manual work or being in education, homemaker, unemployed had lower odds of being sedentary for at least 9 hours per day compared to participants with a sitting job. Those with a higher self-reported social network also had lower odds for sedentary time. No associations between physical and other social environmental characteristics and sedentary time were found. Our findings add to the growing evidence of factors associated with prolonged sedentary time in adults. These findings may

26 CFR 20.2205-1 - Reimbursement out of estate.

Science.gov (United States)

2010-04-01

... passing to, or in the possession of, any person other than the duly qualified executor or administrator... specific provisions giving the executor the right to reimbursement from life insurance beneficiaries and...

A Survey of Home Enteral Nutrition Practices and Reimbursement in the Asia Pacific Region

Directory of Open Access Journals (Sweden)

Alvin Wong

2018-02-01

Full Text Available Literature regarding the use of home enteral nutrition (HEN and how it is reimbursed in the Asia Pacific region is limited. This research survey aims to determine the availability of HEN, the type of feeds and enteral access used, national reimbursement policies, the presence of nutrition support teams (NSTs, and clinical nutrition education in this region. An electronic questionnaire was sent to 20 clinical nutrition societies and leaders in the Asia Pacific region in August 2017, where thirteen countries responded. Comparison of HEN reimbursement and practice between countries of different income groups based on the World Bank’s data was investigated. Financial support for HEN is only available in 40% of the countries. An association was found between availability of financial support for HEN and health expenditure (r = 0.63, p = 0.021. High and middle-upper income countries use mainly commercial supplements for HEN, while lower-middle income countries use mainly blenderized diet. The presence of NSTs is limited, and only present mainly in acute settings. Sixty percent of the countries indicated an urgent need for funding and reimbursement of HEN. This survey demonstrates the varied clinical and economic situation in the Asia Pacific region. There is a lack of reimbursement, clinical support, and inadequate educational opportunities, especially for the lower-middle income countries.

[Diagnostics and Eradication Therapy for MRSA Carriers in the Outpatient Sector: an Analysis of the Reimbursement Situation in the Light of Current Reimbursement Changes].

Science.gov (United States)

Schwendler, M; Hübner, C S; Fleßa, S

2017-10-01

Infection with methicillin-resistant Staphylococcus aureus (MRSA) occurs in both the inpatient and outpatient sector. The reimbursement for diagnostic services and eradication therapy in the outpatient sector was regulated for the first time on 01.04.2012 and after a 2-year test period, has been adopted into the standard range of care services. The aim of this retrospective study was to give an overview of the current situation in services and reimbursement in Germany and describe MRSA patients and their treatment in the outpatient sector. Secondary data, namely reimbursement data of the National Association of Statutory Health Insurance Physicians (KBV) und the Physicians' Association (KV) Mecklenburg-West Pomerania for the period 01/04/2012-31/03/2014 were analyzed. Results show that on the federal level, MRSA services amounting to € 3,235,870.18 have been reimbursed and that diagnostic costs exceed treatment costs. In Germany, 5,627 doctors invoiced services related to MRSA; 51,56% of these were general practitioners and 21,25% specialists in internal medicine working in general practice. In the KV Mecklenburg-Western Pomerania, patients were elderly (average age 69,13), cost for services were on average 27,76 €, and 76,85% of the patients were treated within one quarter. On the whole, there were regional differences in the identification and eradication of MRSA in the outpatient setting. In order to provide an extended base for a more efficient resource allocation in the health care sector, in addition to analysis of MRSA eradication from the medical point of view, attention needs to be paid to patient flow between the out- and inpatient sectors, as well as economic aspects. © Georg Thieme Verlag KG Stuttgart · New York.

Variations in Medicare Reimbursement in Radiation Oncology: An Analysis of the Medicare Provider Utilization and Payment Data Set

International Nuclear Information System (INIS)

Vu, Charles C.; Lanni, Thomas B.; Robertson, John M.

2016-01-01

Purpose: The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. Methods and Materials: The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. Results: There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (P<.001). On multivariate analysis, technical services billing (P<.001), male sex (P<.001), and rural location (P=.007) were predictive of higher Medicare reimbursement. Conclusions: The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other

Variations in Medicare Reimbursement in Radiation Oncology: An Analysis of the Medicare Provider Utilization and Payment Data Set

Energy Technology Data Exchange (ETDEWEB)

Vu, Charles C.; Lanni, Thomas B.; Robertson, John M., E-mail: JRobertson@beaumont.edu

2016-04-01

Purpose: The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. Methods and Materials: The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. Results: There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (P<.001). On multivariate analysis, technical services billing (P<.001), male sex (P<.001), and rural location (P=.007) were predictive of higher Medicare reimbursement. Conclusions: The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other

Use of unmanned aerial vehicle (UAV) for the detection and surveillance of marine oil spills in the Belgian part of the North Sea

International Nuclear Information System (INIS)

Donnay, E.

2009-01-01

This paper discussed the use of unmanned aerial vehicles (UAV) deployed by the Belgian Army in order to detect oil spills as well as for intelligence, reconnaissance and surveillance missions. The UAV are fitted with a dual sensor gyro-stabilized turret which combines a daylight camera and a thermal infrared camera. Live images of the sensors are transmitted in real time to control stations. All Belgian marine pollution surveillance platforms are coordinated by the Maritime Security Center of the Belgian Coast Guard. Satellite surveillance services provide real time information related to potential oil spills and other anomalies on the sea surface. Stand-by helicopters are also used for the rapid assessment of reported spills. The B-Hunter system is undetectable due to its small size and low noise signature, and can be used for the continuous monitoring of specific areas or for the tracking of suspect vessels. The system will also be used to monitor the progress of oil spill response operations as well as to provide information and guidance to response vessels. 6 refs., 2 figs

Use of unmanned aerial vehicle (UAV) for the detection and surveillance of marine oil spills in the Belgian part of the North Sea

Energy Technology Data Exchange (ETDEWEB)

Donnay, E. [Federal Public Service Health, Food Chain Safety and Environment, Brussels (Belgium)

2009-07-01

This paper discussed the use of unmanned aerial vehicles (UAV) deployed by the Belgian Army in order to detect oil spills as well as for intelligence, reconnaissance and surveillance missions. The UAV are fitted with a dual sensor gyro-stabilized turret which combines a daylight camera and a thermal infrared camera. Live images of the sensors are transmitted in real time to control stations. All Belgian marine pollution surveillance platforms are coordinated by the Maritime Security Center of the Belgian Coast Guard. Satellite surveillance services provide real time information related to potential oil spills and other anomalies on the sea surface. Stand-by helicopters are also used for the rapid assessment of reported spills. The B-Hunter system is undetectable due to its small size and low noise signature, and can be used for the continuous monitoring of specific areas or for the tracking of suspect vessels. The system will also be used to monitor the progress of oil spill response operations as well as to provide information and guidance to response vessels. 6 refs., 2 figs.

Results of reference pricing and reimbursement discount rate schemes of Turkey

Directory of Open Access Journals (Sweden)

Guvenc Kockaya

2013-06-01

Full Text Available OBJECTIVES: General Directorate of Pharmaceuticals and Pharmacy (IEGM is responsible for setting all prices for human medicinal products. The reference pricing system is used for setting these prices. Reference countries are reviewed annually and may be subject to certain alterations. There were 5 reference countries in 2009: Spain, Italy, Germany, France and Greece. The aim of this study is to show the distribution of reference countries which were used for reference pricing.METHODS: The price list of pharmaceuticals which was published by IEGM on 15.04.2011 was used for analysis. Distribution of reference countries and prices were evaluated.RESULTS: Prices of 6,251 generic and 3,703 original products were set according to the price list. 5,283 of generics and 3,306 of originals were in the positive list for reimbursement. Reference pricing was used for 2,352 generics and 2,281 originals. Prices of the remaining were set outside of reference pricing. 32 different countries were used for reference pricing. Italy was the most popular country for reference pricing. Even if it was not a reference country, Germany was used in some of the pharmaceuticals. The average reimbursement discount rate and price were 24.43% and 249 TL, respectively. There were no colerations between price and reimbursement discount rate, or reference country and reimbursement rate.CONCLUSION: It has been shown that Italy has the highest impact on the pricing of all pharmaceuticals in Turkey. Even if it was not a reference country, Germany showed to affect pharmaceuticals more than other countries which were also not used for reference pricing. Even if reimbursement discount rates are stated by the Social Security Institution (SGK, there are different discount rates for pharmaceuticals. The analysis stated that there were correlation between price, country and discount rates. This analysis is first for the literature. Further analysis is necessary in the light of price

78 FR 40507 - Appendix B Guidelines for Reviewing Applications for Compensation and Reimbursement of Expenses...

Science.gov (United States)

2013-07-05

... DEPARTMENT OF JUSTICE Appendix B Guidelines for Reviewing Applications for Compensation and Reimbursement of Expenses Filed Under United States Code by Attorneys in Larger Chapter 11 Cases; Correction... reviewing applications for compensation and reimbursement of expenses filed by attorneys in larger chapter...

Contamination levels observed on the Belgian territory subsequent to the Chernobyl accident

International Nuclear Information System (INIS)

Cottens, E.

1986-01-01

A summary of the data from different laboratories concerning the fallout on the Belgian territory following the Chernobyl emissions is presented. The evolution of the particulate air activity at ground level, the integrated fallout captured in water, the deposition on soil surface directly for different localities in Belgium are given. The grass contamination, the milk contamination from individual farms, the concentration levels on leafy vegetables, surface waters and water basins and the contamination of meat during the month of May are presented. (A.F.)

The implementation of DRG-based hospital reimbursement in Switzerland: A population-based perspective.

Science.gov (United States)

Busato, André; von Below, Georg

2010-10-16

Switzerland introduces a DRG (Diagnosis Related Groups) based system for hospital financing in 2012 in order to increase efficiency and transparency of Swiss health care. DRG-based hospital reimbursement is not simultaneously realized in all Swiss cantons and several cantons already implemented DRG-based financing irrespective of the national agenda, a setting that provides an opportunity to compare the situation in different cantons. Effects of introducing DRGs anticipated for providers and insurers are relatively well known but it remains less clear what effects DRGs will have on served populations. The objective of the study is therefore to analyze differences of volume and major quality indicators of care between areas with or without DRG-based hospital reimbursement from a population based perspective. Small area analysis of all hospitalizations in acute care hospitals and of all consultations reimbursed by mandatory basic health insurance for physicians in own practice during 2003-2007. The results show fewer hospitalizations and a relocation of resources to outpatient care in areas with DRG reimbursement. Overall burden of disease expressed as per capita DRG cost weights was almost identical between the two types of hospital reimbursement and no distinct temporal differences were detected in this respect. But the results show considerably higher 90-day rehospitalization rates in DRG areas. The study provides evidence of both desired and harmful effects related to the implementation of DRGs. Systematic monitoring of outcomes and quality of care are therefore essential elements to maintain in the Swiss health system after DRG's are implemented on a nationwide basis in 2012.

2005 dossier. ANDRA's researches on the geological disposal of high-level and long-lived radioactive wastes. Results and perspectives

International Nuclear Information System (INIS)

2005-06-01

This document makes a status of the researches carried out by the French national agency of radioactive wastes (ANDRA) about the geologic disposal of high-level and long-lived radioactive wastes in deep geologic formations (argilites and granites). Content: 1 - Research on deep disposal of radioactive waste: general interest task: Legislative framework, ANDRA scientific objectives, Inspections and assessments; 2 - Designing a safe and reversible disposal system: Repository safety, Reversibility: an essential requirement; 3 - Clay Research on a repository in a clay formation, A long research programme, Dossier 2005 Argile; 4 - Meuse/Haute-Marne site clay: Expected properties of the rock formation, Choice of argillite, Meuse/Haute-Marne site, Conclusions from 10 years of research at the Meuse/Haute-Marne site; 5 - Repository installations: Safe and reversible architecture, Disposal of B waste, Disposal of C waste, Possible disposal of spent fuel (CU); 6 - The disposal facility in operation: From waste packages reception to their disposal in cells, Stages of the progressive closure of engineered structures; 7 - Reversible management: Freedom of choice for future generations, Various closure stages; 8 - Long-term evolution of the repository: Apprehending the repository complexity Main evolutions expected, Slow and limited release of radioactive substances; 9 - Repository safety and impact on man: Several evolution scenarios, Normal evolution, Altered evolution; 10 - Granite Research on a repository in a granite formation: A global approach, Scientific co-operations, Dossier 2005 Granite; 11 - Characteristics of French granite formations: What properties are required for a repository?, Different types of granite formations; 12 - Repository installations: Repository design adapted to granite fractures, Clay seals to prevent water flows, Waste disposal packages ensuring long-term leak-tightness, Physical and chemical environment favourable for waste packages, Architecture

HCPCS Coding: An Integral Part of Your Reimbursement Strategy.

Science.gov (United States)

Nusgart, Marcia

2013-12-01

The first step to a successful reimbursement strategy is to ensure that your wound care product has the most appropriate Healthcare Common Procedure Coding System (HCPCS) code (or billing) for your product. The correct HCPCS code plays an essential role in patient access to new and existing technologies. When devising a strategy to obtain a HCPCS code for its product, companies must consider a number of factors as follows: (1) Has the product gone through the Food and Drug Administration (FDA) regulatory process or does it need to do so? Will the FDA code designation impact which HCPCS code will be assigned to your product? (2) In what "site of service" do you intend to market your product? Where will your customers use the product? Which coding system (CPT ® or HCPCS) applies to your product? (3) Does a HCPCS code for a similar product already exist? Does your product fit under the existing HCPCS code? (4) Does your product need a new HCPCS code? What is the linkage, if any, between coding, payment, and coverage for the product? Researchers and companies need to start early and place the same emphasis on a reimbursement strategy as it does on a regulatory strategy. Your reimbursement strategy staff should be involved early in the process, preferably during product research and development and clinical trial discussions.

"Hand surgeons probably don't starve": Patient's perceptions of physician reimbursements for performing an open carpal tunnel release.

Science.gov (United States)

Kokko, Kyle P; Lipman, Adam J; Sapienza, Anthony; Capo, John T; Barfield, William R; Paksima, Nader

2015-12-01

The purpose of this study is to evaluate patient's perceptions of physician reimbursement for the most commonly performed surgery on the hand, a carpal tunnel release (CTR). Anonymous physician reimbursement surveys were given to patients and non-patients in the waiting rooms of orthopaedic hand physicians' offices and certified hand therapist's offices. The survey consisted of 13 questions. Respondents were asked (1) what they thought a surgeon should be paid to perform a carpal tunnel release, (2) to estimate how much Medicare reimburses the surgeon, and (3) about how health care dollars should be divided among the surgeon, the anesthesiologist, and the hospital or surgery center. Descriptive subject data included age, gender, income, educational background, and insurance type. Patients thought that hand surgeons should receive $5030 for performing a CTR and the percentage of health care funds should be distributed primarily to the hand surgeon (56 %), followed by the anesthesiologist (23 %) and then the hospital/surgery center (21 %). They estimated that Medicare reimburses the hand surgeon $2685 for a CTR. Most patients (86 %) stated that Medicare reimbursement was "lower" or "much lower" than what it should be. Respondents believed that hand surgeons should be reimbursed greater than 12 times the Medicare reimbursement rate of approximately $412 and that the physicians (surgeons and anesthesiologist) should command most of the health care funds allocated to this treatment. This study highlights the discrepancy between patient's perceptions and actual physician reimbursement as it relates to federal health care. Efforts should be made to educate patients on this discrepancy.

Medical Orders: Catholic and Protestant Missionary Medicine in the Belgian Congo 1880-1940

Directory of Open Access Journals (Sweden)

Sokhieng Au

2017-03-01

Full Text Available The history of religious missions and the provisioning of western medical care in the region that was known as the Congo Free State and later the Belgian Congo reveals the complicated dynamics between competing religious missions vis à vis the Belgian colonial state. This essay highlights divisions between identities and purposes of different religious groups in medical care provisioning, focusing on the divide between the Catholic and Protestant churches. Because most Protestant missions in the Congo were American or British, the medical care provided by the Protestant church was outside of, and sometimes at odds with, the Belgian colonial state until the 1920s. In contrast, the Catholic Church served in an auxiliary role in the colonial state’s medical infrastructure. This was not an ideal situation, leading Catholic leaders to attempt to rework the church’s role in medical provisioning. Ultimately, mission, medicine, and empire were not always comfortable bedfellows. Medische Orders: katholieke en protestantse missiegeneeskunde in de Belgische Congo 1880-1940De geschiedenis van de religieuze missies en het voorzien in westerse medische gezondheidszorg in de Congo Vrijstaat – later de Belgische Congo – onthult de ingewikkelde dynamiek tussen de concurrerende religieuze missies vis à vis de Belgische koloniale staat. Dit artikel belicht verschillende religieuze groepen die medische zorg verleenden in deze regio en hun verdeeldheid inzake identiteiten en doelen. Hierbij wordt vooral gefocust op de tweedracht tussen de katholieke en protestantse kerk. Omdat de meeste protestantse missies die in de Congo gevestigd waren uit Amerika of Engeland kwamen, werd de medische zorg die zij verstrekten vaak buiten de Belgische koloniale staat om geleverd en leefden staat en protestantse kerk tot in de jaren 1920 soms op gespannen voet met elkaar. Dit staat in sterk contrast tot de katholieke kerk die wat betreft medische infrastructuur juist een

Estimating internal pelvic sizes using external body measurements in the double-muscled Belgian Bleu beef breed

NARCIS (Netherlands)

Coopman, F.; Smet, S.; Gengler, N.; Haegeman, A.; Jacobs, K.; Poucke, van M.; Laevens, H.; Zeveren, van A.; Groen, A.F.

2003-01-01

In the double-muscled (DM) Belgian Blue beef (BBB) breed, caesarean section (CS) is being applied systematically as a management tool to prevent dystocia. As a matter of fact, CS is the only possible way of calving in the breed. High birth weight and a relatively small pelvic area are the main

Prevalence of the AMHR2 mutation in Miniature Schnauzers and genetic investigation of a Belgian Malinois with persistent Müllerian duct syndrome.

Science.gov (United States)

Smit, M M; Ekenstedt, K J; Minor, K M; Lim, C K; Leegwater, Paj; Furrow, E

2018-04-01

Persistent Müllerian duct syndrome (PMDS) is a sex-limited disorder in which males develop portions of the female reproductive tract. Important consequences of PMDS are cryptorchidism and its sequelae of infertility and increased risk of testicular cancer. Anti-Müllerian hormone (AMH) and its receptor (AMHR2) induce the regression of the Müllerian ducts in male embryos. In Miniature Schnauzer dogs, the genetic basis has been identified as an autosomal recessive nonsense mutation in AMHR2, but the allele frequency of the mutation is unknown. Thus, the primary objective of this study was to estimate the prevalence of the AMHR2 mutation in North American Miniature Schnauzers, in order to ascertain the value of genetic testing in this breed. An additional objective was to determine whether mutations in AMH or AMHR2 were responsible for PMDS in a Belgian Malinois; this would aid development of a genetic test for the Belgian Malinois breed. Genomic DNA from 216 Miniature Schnauzers (including one known PMDS case) was genotyped for the AMHR2 mutation, and DNA from a single PMDS-affected Belgian Malinois was sequenced for all coding exons of AMH and AMHR2. The Miniature Schnauzer cohort had an AMHR2 mutation allele frequency of 0.16 and a carrier genotypic frequency of 0.27. The genetic basis for PMDS in the Belgian Malinois was not determined, as no coding or splicing mutations were identified in either AMH or AMHR2. These findings support a benefit to AMHR2 mutation testing Miniature Schnauzers used for breeding or with cryptorchidism. © 2017 Blackwell Verlag GmbH.

48 CFR 328.311 - Solicitation provision and contract clause on liability insurance under cost-reimbursement...

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Solicitation provision and contract clause on liability insurance under cost-reimbursement contracts. 328.311 Section 328.311 Federal... Insurance 328.311 Solicitation provision and contract clause on liability insurance under cost-reimbursement...

78 FR 56719 - Challenging Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of...

Science.gov (United States)

2013-09-13

...] Challenging Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Metabolic Diseases... announcing a public workshop entitled ``Changing Regulatory and Reimbursement Paradigms for Medical Devices... registration information on the AGA Web site. If you need special accommodations due to a disability, please...

HEALTH INFO SANTE ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS: HINTS FOR USE

CERN Multimedia

1999-01-01

Information from the CHIS Board and the Personnel DivisionOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and not by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 55, 000 in 1998 - is part of the cost of our insurance.Help keep administrative costs down : do not submit reimbursement claims for amounts less than the annual deductible unless your claims...

[Relevance of pharmacoeconomic analyses to price and reimbursement decisions in Austria].

Science.gov (United States)

Führlinger, Susanne

2006-12-01

Since the social sick funds have only limited amounts of money at their disposal, whereas the pharmaceutical market is constantly growing, thorough evaluations have to be undertaken how contributions are to be spent to get adequate value for money and especially to gain utmost benefit for the patients. When deciding on whether a pharmaceutical is listed in the Code of Reimbursement or not, pharmacoeconomic studies are obligatory in two cases: for real innovations with substantial therapeutic benefit and for applications for inclusion in the Yellow Box, when there are no alternatives listed in the Yellow Box. On the basis of the pharmacoeconomic study a comprehensible and justifiable cost/use relation of the pharmaceutical applied for should be proven in comparison with therapeutic alternatives in Austria. However, a pharmacoeconomic study is always only one aspect among others deciding on reimbursement and price. Even though the pharmaceutical applied for is not included in the Code of Reimbursement, reimbursement is possible in special cases if there is no adequate pharmaceutical listed in the Code of Reimbursement and the pharmaceutical is absolutely needed for therapeutic reasons. In these cases prior approval from a chief medical officer is required. Pharmacoeconomic studies for the purpose of section sign 25 of the Rules of Procedure for publishing the Code of Reimbursement (VO-EKO) must meet the following requirements: From a methodical point of view both cost-effectiveness analyses and--in justified cases--cost-utility analyses may be used. Due to required accuracy and traceability incremental analyses are preferred. Medical and economic data underlying the pharmacoeconomic study have to show a high degree of validity and evidence. The perspective to be taken is that of the Austrian Health Insurance. When determining the therapeutic alternatives, the most frequent indication, the most purposeful medical dosage and the main group of affected patients have to

Restrictions on the reimbursement policy with regard to retail marketing of medicinal products in Poland.

Science.gov (United States)

Zimmermann, Agnieszka

2013-01-01

On January 1, 2012, the law of 12 May 2011 on the reimbursement of medicines, food products of special nutritional purpose and medicinal products, intended to tighten up the reimbursement system, came into force in Poland. The new legislative act has significantly altered the previous principles of retail marketing of products subject to publicly financed reimbursement. First of all, the prices of reimbursed products have been unified through the introduction of fixed margins and prices and a ban--completely unknown until now--on using free market sales practices. These regulations are intended to lead to the abolition of price competition and its replacement with competition as to the quality of services provided by pharmacies. At the same time, entities engaged in retail marketing of medicinal products have been imposed a number of new obligations and highly repressive penalties for failure to fulfill them. The paper analyzes the legislative changes and points out the consequences, both those which can already be seen and the predictable ones. The assumed priority and criterion of evaluation of the reimbursement policy in question is its impact on the functioning of pharmacies which, according to the premises of Polish pharmaceutical law, should play the role of public health protection institutions.

Governance of conditional reimbursement practices in the Netherlands

NARCIS (Netherlands)

Boon, W.P.C.; Martins, Luis; Koopmanschap, Marc

When entering the market, orphan drugs are associated with substantial prices and a high degree of uncertainty regarding safety and effectiveness. This makes decision making about the reimbursement of these drugs a complex exercise. To advance on this, the Dutch government introduced a conditional

Treatment adherence in multiple sclerosis: a survey of Belgian neurologists

Directory of Open Access Journals (Sweden)

Decoo D

2015-11-01

Full Text Available Danny Decoo,1 Mathieu Vokaer2 1Department of Neurology and Neurorehab, AZ Alma, Sijsele, Belgium; 2Multiple Sclerosis Clinic, Edith Cavell Hospital, CHIREC group, Brussels, Belgium Background: Poor treatment adherence is common among patients with multiple sclerosis (MS. This survey evaluated neurologists’ perception of treatment adherence among MS patients.Materials and methods: This questionnaire-based survey of Belgian neurologists treating MS patients was conducted between June and July 2014. Face-to-face interviews with the neurologists were based on a semistructured questionnaire containing questions regarding the perception of the treatment-adherence level.Results: A total of 41 neurologists participated in the survey. Of these, 88% indicated frequent discussions about treatment adherence as beneficial for treatment efficacy. The mean time spent on the treatment-adherence discussion during the initial consultation was 11 minutes, with 24% of doctors spending 5 minutes and 24% of doctors spending 10 minutes discussing this issue. The majority of neurologists (56% perceived the adherence level in MS as good, and 12% perceived it as excellent. The majority of neurologists (64% indicated intolerance as a main cause of poor adherence, and all neurologists reported insufficient efficacy as a consequence of nonadherence. The importance of adherence in the neurologists’ practice was evaluated on a scale of 1–10, with 1= “not very important” and 10= “very important”: 44% of doctors indicated a score of 10, and the mean score was 9.0.Conclusion: Belgian neurologists consider treatment adherence in MS as essential for the benefits of therapies. However, although neurologists are aware of the consequences of nonadherence, they generally spend limited time discussing the importance of treatment adherence with their patients. Keywords: multiple sclerosis, treatment adherence, physician survey

The Impact of Medical Comorbidities on Primary Total Knee Arthroplasty Reimbursements.

Science.gov (United States)

Sabeh, Karim G; Rosas, Samuel; Buller, Leonard T; Freiberg, Andrew A; Emory, Cynthia L; Roche, Martin W

2018-05-23

Medical comorbidities have been shown to cause an increase in peri-and postoperative complications following total knee arthroplasty (TKA). However, the increase in cost associated with these complications has yet to be determined. Factors that influence cost have been of great interest particularly after the initiation of bundled payment initiatives. In this study, we present and quantify the influence of common medical comorbidities on the cost of care in patients undergoing primary TKA. A retrospective level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary TKA between 2007 and 2015. Patients were stratified by medical comorbidities and compared using analysis of variance for reimbursements for the day of surgery and over 90 days postoperatively. A cohort of 137,073 US patients was identified as having undergone primary TKA between 2007 and 2015. The mean entire episode-of-care reimbursement was $23,701 (range: $21,294-26,299; standard deviation [SD] $2,611). The highest reimbursements were seen in patients with chronic obstructive pulmonary disease (mean $26,299; SD $3,030), hepatitis C (mean $25,662; SD $2,766), morbid obesity (mean $25,450; SD $2,154), chronic kidney disease (mean $25,131, $3,361), and cirrhosis (mean $24,890; SD $2,547). Medical comorbidities significantly impact reimbursements, and therefore cost, after primary TKA. Comprehensive preoperative optimization for patients with medical comorbidities undergoing TKA is highly recommended and may reduce perioperative complications, improve patient outcome, and ultimately reduce cost. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The radiological impact of the Belgian phosphate industry

Energy Technology Data Exchange (ETDEWEB)

Vanmarcke, H.; Paridaens, J. [Belgian Nuclear Research Centre, SCK.CEN, Boeretang 200, 2400 Mol (Belgium)

2006-07-01

The Belgian phosphate industry processes huge amounts of phosphate ore (1.5 to 2 Mton/year) for a wide range of applications, the most important being the production of phosphoric acid, fertilizers and cattle food. Marine phosphate ores show high specific activities of the natural uranium decay series (usually indicated by Ra-226) (e.g. 1200 to 1500 Bq/kg for Moroccan ore). Ores of magmatic origin generally contain less of the uranium and more of the thorium decay series (up to 500 Bq/kg). These radionuclides turn up in by-products, residues or product streams depending on the processing method and the acid used for the acidulation of the phosphate rock. Sulfuric acid is the most widely used, but also hydrochloric acid and nitric acid are applied in Belgium. For Flanders, the northern part of Belgium, we already have a clear idea of the production processes and waste streams. The five Flemish phosphate plants, from 1920 to 2000, handled 54 million ton of phosphate ore containing 65 TBq of radium-226 and 2.7 TBq of thorium- 232. The total surface area of the phosphogypsum and calcium fluoride sludge deposits amounts to almost 300 ha. There is also environmental contamination along two small rivers receiving the waste waters of the hydrochloric production process: the Winterbeek (> 200 ha) and the Grote Laak (12 ha). The data on the impact of the phosphate industry in the Walloon provinces in Belgium is less complete. A large plant produced in 2004 0.8 Mton of phosphogypsum, valorizing about 70 % of the gypsum in building materials (plaster, cement), in fertilizers, and in other products such as paper. The remainder was stored on a local disposal site. The radiological impact of the Belgian phosphate industry on the local population will be discussed. At present most contaminated areas are still recognizable as waste deposits and inaccessible to the population. However as gypsum deposits and other contaminated areas quickly blend in with the landscape, it is

41 CFR 301-11.621 - Must I file a claim to be reimbursed for the additional income taxes incurred?

Science.gov (United States)

2010-07-01

... be reimbursed for the additional income taxes incurred? 301-11.621 Section 301-11.621 Public... ALLOWABLE TRAVEL EXPENSES 11-PER DIEM EXPENSES Income Tax Reimbursement Allowance (ITRA), Tax Years 1995 and Thereafter Employee Responsibilities § 301-11.621 Must I file a claim to be reimbursed for the additional...

41 CFR 301-11.521 - Must I file a claim to be reimbursed for the additional income taxes incurred?

Science.gov (United States)

2010-07-01

... be reimbursed for the additional income taxes incurred? 301-11.521 Section 301-11.521 Public... ALLOWABLE TRAVEL EXPENSES 11-PER DIEM EXPENSES Income Tax Reimbursement Allowance (ITRA), Tax Years 1993 and 1994 Employee Responsibilities § 301-11.521 Must I file a claim to be reimbursed for the additional...

Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden.

Science.gov (United States)

Sydsjö, Adam; Sydsjö, Gunilla; Bladh, Marie; Josefsson, Ann

2014-05-29

Reduction in costs of hormonal contraceptives is often proposed to reduce rates of induced abortion among young women. This study investigates the relationship between rates of induced abortion and reimbursement of dispensed hormonal contraceptives among young women in Sweden. Comparisons are made with the Nordic countries Finland, Norway and Denmark. Official statistics on induced abortion and numbers of prescribed and dispensed hormonal contraceptives presented as "Defined Daily Dose/thousand women" (DDD/T) aged 15-19 years were compiled and related to levels of reimbursement in all Swedish counties by using public official data. The Swedish numbers of induced abortion were compared to those of Finland, Norway and Denmark. The main outcome measure was rates of induced abortion and DDD/T. No correlation was observed between rates of abortion and reimbursement among Swedish counties. Nor was any correlation found between sales of hormonal contraceptives and the rates of abortion. In a Nordic perspective, Finland and Denmark, which have no reimbursement at all, and Norway all have lower rates of induced abortion than Sweden. Reimbursement does not seem to be enough in order to reduce rates of induced abortion. Evidently, other factors such as attitudes, education, religion, tradition or cultural differences in each of Swedish counties as well as in the Nordic countries may be of importance. A more innovative approach is needed in order to facilitate safe sex and to protect young women from unwanted pregnancies.

Dust control in Belgian coal mines. Position at the beginning of 1975

Energy Technology Data Exchange (ETDEWEB)

Preat, B; Vanstraelen, M

1975-01-01

A general view is given of dust control in Belgian coal mines at the beginning of 1975. The statistical data received from the mines are presented in tabular form. The length and the output of coal faces treated by the classical methods of pre-spraying of the wall, wet cutting, water infusion and wet pneumatic picks are given separately; in some cases two or more of these techniques are used together on the same coalface. The number of rock headings in which different methods of dust control are used is also given.

An evaluation of current approaches to nursing home capital reimbursement.

Science.gov (United States)

Cohen, J; Holahan, J

1986-01-01

One of the more controversial issues in reimbursement policy is how to set the capital cost component of facilities rates. In this article we examine in detail the various approaches used by states to reimburse nursing homes for capital costs. We conclude that newer approaches that recognize the increasing value of nursing home assets over time, commonly called fair rental systems, are preferable to the methodologies that have been used historically in both the Medicare and the Medicaid programs to set capital rates. When properly designed, fair rental systems should provide more rational incentives and less encouragement of property manipulation than do more traditional systems, with little or no increase in state costs.

Preventive Care Use among the Belgian Elderly Population: Does Socio-Economic Status Matter?

Directory of Open Access Journals (Sweden)

Sarah Hoeck

2013-12-01

Full Text Available Objective: To analyze the association between influenza and pneumococcus vaccination and blood cholesterol and blood sugar measurement by Belgian elderly respondents (≥65 years and socio-demographic characteristics, risk factors, health status and socio-economic status (SES. Methods: A cross-sectional study based on 4,544 non-institutionalized elderly participants of the Belgian Health Interview Surveys 2004 and 2008. Multivariate logistic regression models were constructed to examine the independent effect of socio-demographic characteristics, risk factors, health status and SES on the four preventive services. Results: After adjustment for age, sex, region, survey year, living situation, risk factors (body mass index, smoking status, physical activity and health status (self-assessed health and longstanding illness lower educated elderly were significantly less likely to report a blood cholesterol and blood sugar measurement. For instance, elderly participants with no degree or only primary education were less likely to have had a cholesterol and blood sugar measurement compared with those with higher education. Pneumococcus vaccination was not related to educational level, but lower income groups were more likely to have had a pneumococcus immunization. Influenza vaccination was not significantly related to SES. Conclusion: The results highlight the need to promote cholesterol and blood sugar measurement for lower SE groups, and pneumococcus immunization for the entire elderly population. Influenza immunization seems to be equally spread among different SE groups.

48 CFR 49.603-4 - Cost-reimbursement contracts-complete termination, with settlement limited to fee.

Science.gov (United States)

2010-10-01

... settlement limited to fee. [Insert the following in Block 14 of SF 30 for settlement of cost-reimbursement... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement contracts-complete termination, with settlement limited to fee. 49.603-4 Section 49.603-4 Federal...

43 CFR 404.36 - Will Reclamation reimburse me for the cost of an appraisal investigation or a feasibility study...

Science.gov (United States)

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Will Reclamation reimburse me for the cost... Reclamation reimburse me for the cost of an appraisal investigation or a feasibility study that was not...) or (b). Reclamation will not reimburse you or provide program funding for any expenses related to an...

The energy sources and nuclear energy - The point of view of the Belgian Catholic Church

International Nuclear Information System (INIS)

Hoenraet, Christian

2000-01-01

The problems related to the environment are reported regularly to the public by means of the newspapers, on radio and television. The story is the product of a journalistic process and in general does not bear much resemblance to the original event. The rate and type of reportage depend not only on the body of data available to the journalist but on the information sources the journalist chosen to use. The same story is reported in a positive or negative way. Finally people are overwhelmed by contradictory information and became uncertain or frightened. In order to provide the general public with objective information about nuclear energy in particular and to made a statement about the position of the Belgian Catholic Church concerning this matter, the results of the study were published in Dutch under the form of a book with the title 'The Energy Sources and Nuclear Energy - Comparative analysis and ethical thoughts written the same author. Thia paper is a short survey of the results of the study and to present the point of view of the Belgian Catholic Church in the energy debate

Risk perception of the Belgian population. Results of the public opinion survey in 2006

International Nuclear Information System (INIS)

Van Aeken, K.; Turcanu, C.; Bombaerts, G.; Carle, B.; Hardeman, F.

2007-01-01

The Belgian Nuclear Research Center SCK-CEN 2006 risk perception barometer is based on over 1000 Computer Assisted Personal Interviews, taken from persons selected to be representative for the Belgian 18+ population, and all realized in the period March 21st to April 12th 2006. Besides the classical background variables used to obtain the quota for representativity (age, language, habitat, gender and social class), we also included a series of questions assessing the sociological context and the psychological personality profile. The main topics in the survey were I) risk perception and confidence in authorities; II) acceptance of legal norms for food products; III) acceptance of countermeasures for the food chain in case of a radiological contamination and associated consumers behaviour; IV) energy; v) disposal of radioactive waste; vi) perception of the Chernobyl accident and its consequences. Some of the questions asked in 2006 are similar to those enquired in the SCK barometer of 2002, in order to study the time evolution of the risk perception associated with various issues. For the part related to acceptance of legal norms and of countermeasures for the food chain, simulated news bulletins were used in order to better reproduce the real-life context of a contamination.

Risk perception of the Belgian population. Results of the public opinion survey in 2006

Energy Technology Data Exchange (ETDEWEB)

Van Aeken, K.; Turcanu, C.; Bombaerts, G.; Carle, B.; Hardeman, F.

2007-01-15

The Belgian Nuclear Research Center SCK-CEN 2006 risk perception barometer is based on over 1000 Computer Assisted Personal Interviews, taken from persons selected to be representative for the Belgian 18+ population, and all realized in the period March 21st to April 12th 2006. Besides the classical background variables used to obtain the quota for representativity (age, language, habitat, gender and social class), we also included a series of questions assessing the sociological context and the psychological personality profile. The main topics in the survey were I) risk perception and confidence in authorities; II) acceptance of legal norms for food products; III) acceptance of countermeasures for the food chain in case of a radiological contamination and associated consumers behaviour; IV) energy; v) disposal of radioactive waste; vi) perception of the Chernobyl accident and its consequences. Some of the questions asked in 2006 are similar to those enquired in the SCK barometer of 2002, in order to study the time evolution of the risk perception associated with various issues. For the part related to acceptance of legal norms and of countermeasures for the food chain, simulated news bulletins were used in order to better reproduce the real-life context of a contamination.

All-Cause Mortality Among Belgian Military Radar Operators: A 40-Year Controlled Longitudinal Study

International Nuclear Information System (INIS)

Degrave, Etienne; Autier, Philippe; Grivegnee, Andre-Robert; Zizi, Martin

2005-01-01

Background: It has been suggested that exposure to radiofrequency/microwaves radiations could be associated with greater health hazards and higher mortality. Methods: The all-cause mortality of 27,671 Belgian militaries who served from 1963 until 1994 in battalions equipped with radars for anti-aircraft defence was studied over the period 1968-2003. End of the seventies, technical modifications brought to the shielding of the micro-wave generators resulted in a reduction in irradiations. A control group was formed by 16,128 militaries who served during the same period in the same military area but who were never exposed to radars. Administrative procedures for identifying militaries and their vital status were equivalent in the radar and the control groups. Results: The age-standardized mortality ratio (SMR) in the radar battalions was 1.05 (95% CI: 0.95-1.16) in professional militaries, and 0.80 (95% CI: 0.75-0.85) in conscripts. In professional militaries no difference in mortality was found according to duration (less than, or five years or more) or to period of service (before 1978 or after 1977). Conclusions: During a 40-year period of observation, we found no increase in all-cause mortality in Belgian militaries who were in close contact with radar equipments of anti-aircraft defence battalions

Nursing home performance under case-mix reimbursement: responding to heavy-care incentives and market changes.

Science.gov (United States)

Davis, M A; Freeman, J W; Kirby, E C

1998-10-01

To examine the effect of case mix-adjusted reimbursement policy and market factors on nursing home performance. Data from Medicaid certification inspection surveys, Medicaid cost reports, and the Kentucky State Center for Health Statistics for the years 1989 and 1991, to examine changes in nursing home performance stemming from the adoption of case mix-adjusted reimbursement in 1990. In addition to cross-sectional regressions, a first-difference approach to fixed-effects regression analyses was employed to control for facility differences that were essentially fixed during the survey years and to estimate the effects of time-varying predictors on changes in facility expenditures, efficiency, and profitability. Facilities that increased the proportion of Medicaid residents and eliminated excess capacity experienced higher profitability gains during the beginning phase of case-mix reimbursement. Having a heavy-care resident population was positively related to expenditures prior to reimbursement reform, and it was negatively related to expenditures after the case-mix reimbursement policy was introduced. While facility-level changes in case mix had no reliable influence on costs or profits, nursing homes showing an increased prevalence of poor-quality nursing practices exhibited increases in efficiency and profitability. At the market level, reductions in excess or empty nursing home beds were accompanied by a significant growth in home health services. Moreover, nursing homes located in markets with expanding home health services exhibited higher increases in costs per case-mix unit. Characteristics of the reimbursement system appear to reward a cost minimization orientation with potentially detrimental effects on quality of care. These effects, exacerbated by a supply-constrained market, may be mitigated by policies that encourage the expansion of home health service availability.

Seasonal influenza vaccination in China: Landscape of diverse regional reimbursement policy, and budget impact analysis.

Science.gov (United States)

Yang, Juan; Atkins, Katherine E; Feng, Luzhao; Pang, Mingfan; Zheng, Yaming; Liu, Xinxin; Cowling, Benjamin J; Yu, Hongjie

2016-11-11

To explore the current landscape of seasonal influenza vaccination across China, and estimate the budget of implementing a national "free-at-the-point-of-care" vaccination program for priority populations recommended by the World Health Organization. In 2014 and 2016, we conducted a survey across provincial Centers for Disease Control and Prevention to collect information on regional reimbursement policies for influenza vaccination, estimated the national uptake using distributed doses of influenza vaccines, and evaluated the budget using population size and vaccine cost obtained from official websites and literatures. Regular reimbursement policies for influenza vaccination are available in 61 mutually exclusive regions, comprising 8 provinces, 45 prefectures, and 8 counties, which were reimbursed by the local Government Financial Department or Basic Social Medical Insurance (BSMI). Finance-reimbursed vaccination was offered mainly for the elderly, and school children for free in Beijing, Dongli district in Tianjin, Karamay, Shenzhen and Xinxiang cities. BSMI-reimbursement policies were limited to specific medical insurance beneficiaries with distinct differences in the reimbursement fractions. The average national vaccination coverage was just 1.5-2.2% between 2004 and 2014. A free national vaccination program for priority populations (n=416million), would cost government US$ 757million (95% CI 726-789) annually (uptake rate=20%). An increasing number of regional governments have begun to pay, partially or fully, for influenza vaccination for selected groups. However, this small-scale policy approach has failed to increase national uptake. A free, nationwide vaccination program would require a substantial annual investment. A cost-effectiveness analysis is needed to identify the most efficient methods to improve coverage. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Lifting off towards Open Government: a report from the EU Belgian Presidency Conference

OpenAIRE

BROSTER David; MISURACA GIANLUCA; BACIGALUPO Margherita

2011-01-01

This article summarises the main messages from the Lift off towards Open Government Conference, held on 15-16 December 2010, organised by the Belgian Presidency of the EU Council. It aims to disseminate these messages to the research and practitioner communities and to contribute to the current policy debate on the prospects of e-Government, now being shaped and implemented on local, regional, national and pan-European levels. First, the article outlines the progress of the EU discourse on e-...

Restrictions for reimbursement of interferon-free direct-acting antiviral drugs for HCV infection in Europe

DEFF Research Database (Denmark)

Marshall, Alison D; Cunningham, Evan B; Nielsen, Stine

2018-01-01

for, interferon-free DAA reimbursement among countries in the European Union and European Economic Area, and Switzerland. Reimbursement documentation was reviewed between Nov 18, 2016, and Aug 1, 2017. Primary outcomes were fibrosis stage, drug or alcohol use, prescriber type, and HIV co......-infection restrictions. Among the 35 European countries and jurisdictions included, the most commonly reimbursed DAA was ombitasvir, paritaprevir, and ritonavir, with dasabuvir, and with or without ribavirin (33 [94%] countries and jurisdictions). 16 (46%) countries and jurisdictions required patients to have fibrosis...... of some countries not following the 2016 hepatitis C virus treatment guidelines by the European Association for the Study of Liver....

Mediation in the Belgian health care sector: analysis of a particular issue--the material scope of application of mediation.

Science.gov (United States)

Derèse, Marie-Noëlle

2011-06-01

In this paper, the material scope of application of mediation regulated in the Belgian Act of August 22nd, 2002 on Patient's Rights will be discussed in detail. In accordance with this Act, a mediator only has the competence to handle patients' complaints concerning the medical and care aspects of patients' rights, such as complaints relating to informed consent, access to medical files, etc. In practice, it has been observed that issues relating to administrative matters also give rise to complaints and that some patients do not know with whom they should lodge such complaints. Some clarification is necessary for a clear and proper complaints procedure that works. One possible solution is the creation of a single institution that would be in charge of handling both kinds of complaints. Such a solution has to be enacted in accordance with Belgian federalism.

41 CFR 101-39.207 - Reimbursement for services.

Science.gov (United States)

2010-07-01

... sufficient to recover applicable costs. Failure by using agencies to reimburse GSA for vehicle services will... or neglect. (e) Agencies may be charged for recovery of expenses for repairs or services to GSA IFMS... services. 101-39.207 Section 101-39.207 Public Contracts and Property Management Federal Property...

20 CFR 61.102 - Disposition of reimbursement requests.

Science.gov (United States)

2010-04-01

... STATES CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, AS AMENDED Reimbursement of...' Compensation to the disallowance or reduction of a claim within 60 days of the Office's decision. A carrier outside the United States has six months within which to file objections with the Associate Director. The...

Accidental release of iodine 131 by the IRE of the Fleurus site: return on experience by the Belgian safety authority

International Nuclear Information System (INIS)

Vandecasteele, C.M.; Sonck, M.; Degueldre, D.

2010-01-01

After a presentation of the activities of the IRE, the Belgian National Institute of Radio-elements, i.e. the production of radionuclides used in nuclear medicine, this report describes the process and chemical reaction which caused an accidental release of iodine 131. It analyzes the causes of this incident, and how the incident has been managed by the Belgian safety authority. It discusses the first assessment of radiological consequences, describes how the incident has been managed at the federal level, and how population and media have been informed. It discusses the actual radiological consequences through measurements performed on grass and vegetables (graphs and maps indicate contamination levels and contaminated areas), and through the assessment of exposure of adults and children by different ways. Lessons learned are then discussed

Variations in Medicare Reimbursement in Radiation Oncology: An Analysis of the Medicare Provider Utilization and Payment Data Set.

Science.gov (United States)

Vu, Charles C; Lanni, Thomas B; Robertson, John M

2016-04-01

The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (Preimbursement. The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other specialists. Male sex and rural practice location are independent predictors of higher total Medicare reimbursements. Copyright © 2016 Elsevier Inc. All rights reserved.

Using multicriteria decision analysis during drug development to predict reimbursement decisions.

Science.gov (United States)

Williams, Paul; Mauskopf, Josephine; Lebiecki, Jake; Kilburg, Anne

2014-01-01

Pharmaceutical companies design clinical development programs to generate the data that they believe will support reimbursement for the experimental compound. The objective of the study was to present a process for using multicriteria decision analysis (MCDA) by a pharmaceutical company to estimate the probability of a positive recommendation for reimbursement for a new drug given drug and environmental attributes. The MCDA process included 1) selection of decisions makers who were representative of those making reimbursement decisions in a specific country; 2) two pre-workshop questionnaires to identify the most important attributes and their relative importance for a positive recommendation for a new drug; 3) a 1-day workshop during which participants undertook three tasks: i) they agreed on a final list of decision attributes and their importance weights, ii) they developed level descriptions for these attributes and mapped each attribute level to a value function, and iii) they developed profiles for hypothetical products 'just likely to be reimbursed'; and 4) use of the data from the workshop to develop a prediction algorithm based on a logistic regression analysis. The MCDA process is illustrated using case studies for three countries, the United Kingdom, Germany, and Spain. The extent to which the prediction algorithms for each country captured the decision processes for the workshop participants in our case studies was tested using a post-meeting questionnaire that asked the participants to make recommendations for a set of hypothetical products. The data collected in the case study workshops resulted in a prediction algorithm: 1) for the United Kingdom, the probability of a positive recommendation for different ranges of cost-effectiveness ratios; 2) for Spain, the probability of a positive recommendation at the national and regional levels; and 3) for Germany, the probability of a determination of clinical benefit. The results from the post

Assessing cancer drugs for reimbursement: methodology, relationship between effect size and medical need.

Science.gov (United States)

de Sahb-Berkovitch, Rima; Woronoff-Lemsi, Marie-Christine; Molimard, Mathieu

2010-01-01

Reimbursement is assessed by the Transparency Commission from the Health Authority (HAS) using a medical benefit (SMR) score that gives access to reimbursement, an "improvement of medical service rendered" (ASMR) that determines the added therapeutic value, and the target population. Assessing cancer drugs for reimbursement raises the same issues as other therapeutic classes, with some key differences. Overall survival (OS) is considered by the Transparency Commission as the endpoint for assessing clinical benefit, and yet it is not an applicable primary endpoint in all types of cancer. Later lines of treatment, particularly during the development process, may make it difficult to interpret OS as the primary endpoint. Therefore, progression-free survival (PFS) for metastatic situations and disease-free survival (DFS) in adjuvant situations are wholly relevant endpoints for decisions on the reimbursement of a new cancer drug. Effect size is assessed using actuarial survival curves of the product versus the comparator, and it is difficult to summarise them into one single parameter. Results are generally interpreted based on median survival, which is fragmented because it only measures one point of the curve. The hazard ratio measures the effect of treatment throughout the duration of survival and is therefore more comprehensive in quantifying clinical benefit. Determining an effect size threshold for granting reimbursement is difficult given the diversity of cancer settings and the level of medical need, which influences assessment of the clinical relevance of the observed difference. Rapid progress in comparators (700 molecules in development) and the identification of predictive factors of efficacy (biomarkers, histology, etc.) during development may lead to different ASMR scores per population, or to the restriction of the target population to a subgroup of the marketing authorisation (MA) population in which the expected effect size is greater. To address these

Financial incentives for generic drugs: case study on a reimbursement program

Directory of Open Access Journals (Sweden)

Marcos Inocencio

2010-06-01

Full Text Available Objective: To discuss the use of financial incentives in choice of medication and to assess the economic results concerning the use of financial incentives to promote the use of genetic medication in lieu of reference drugs in a company with a reimbursement program. Methods: A case study was carried out in a large supermarket. The data was obtained in the company responsible for managing medication. The study reached 83,625 users between August 2005 and July 2007. The data was submitted to regressions in order to analyze trends and hypothesis tests to assess differences in medication consumption. The results were compared with general data regarding medication consumption of five other organizations and also with data about the national consumption of generic medication in Brazil. Results: The use of financial incentives to replace brand medications for generics, in the company studied, increased the consumption of generic drugs without reducing the company expenses with the reimbursement programs. Conclusions: This study show the occurrence of unplanned results (increase in the consumption of medications and the positive consequences of the reimbursement program concerning access to medication.

78 FR 69694 - Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity...

Science.gov (United States)

2013-11-20

...] Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity and... Administration (FDA) is announcing a public workshop entitled ``Changing Regulatory and Reimbursement Paradigms... information on the AGA Web site. If you need special accommodations due to a disability, please contact...

[Reimbursed health expenditures during the last year of life, in France, in the year 2008].

Science.gov (United States)

Ricci, P; Mezzarobba, M; Blotière, P O; Polton, D

2013-02-01

To measure the reimbursed health expenditures in the last year of life and the proportion it represents in total reimbursement costs in 2008, to analyse the structure of such expenditures and to identify costs by cause of death. Data were obtained from the French national insurance information system (SNIIRAM). Data from the national hospital discharge database were linked to the outpatient reimbursement database for patients covered by the general health insurance scheme (n=49 million persons). The cost of the last year of life was calculated for the exhaustive population (361,328 deaths in 2008). The supposed cause of death was mainly derived from the primary diagnosis of the last hospital stay during which the patient died. The average reimbursed expenses during the last year of life were estimated at 22,000 € per person in 2008, with 12,500 € accounting for public hospital costs. Reimbursed health expenditures varied according to different medical causes of death: 52,300 € for HIV disease and about 40,000 € for tumors. A negative effect of age on the expenditure during the last year of life was observed. Health care spending increased with shorter time before death, the last month of life corresponding to 28% of reimbursed expenditures during the last year of life. Health care use in the last year of life represented 10.5% of the total health expenditures in 2008. This study found results similar to those observed in the past or in other countries. Our results show in particular that the weight of health expenditures during the last year of life on total health expenditures remains stable over the years. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

[Jurisdictions on the reimbursement of new medical technologies by public health insurance: A systematic review].

Science.gov (United States)

Ex, Patricia; Felgner, Susanne; Henschke, Cornelia

2018-04-01

In Germany reimbursement for new medical technologies is often enforced before a social court. It is likely that these judicial decisions also affect the sickness funds' decisions on requests for reimbursement and thus patient access to new technologies in general. The aim of this study was to identify the technologies that have repeatedly generated court actions and whether these actions have been successful. The focus was on differences between sectors, technology groups and indications. Based on this, we analysed in a case study whether judicial decisions on the reimbursement of the same technologies vary across the years. Based on a systematic review, we identified judicial decisions of German social courts on new technologies for the years 2011 to 2016. The analysis included social court decisions on reimbursements for technologies used in the treatment of individual patients. 284 judicial decisions on new technologies were considered in the analysis. In one third of the cases, the sickness funds were required to reimburse the costs, with a higher percentage in inpatient than in outpatient care. Technologies used in treatment of diseases of the eyes and the ears were granted most frequently. In cases involving similar circumstances the social courts sometimes came to conflicting decisions; these decisions are, in part, contradictory to subsequent assessments by the Joint Federal Committee (G-BA). Decisions as to whether reimbursement for new technologies is granted or not do not appear to follow a systematic approach. In the context of the seemingly innovation-friendly policy in inpatient care, there is uncertainty with regard to the "generally accepted state of medical knowledge." It is problematic for both patients and their treating physicians that over a number of years legal proceedings are being initiated for technologies that have not been subjected to a systematic assessment of their benefit. Copyright © 2018. Published by Elsevier GmbH.

Role of centralized review processes for making reimbursement decisions on new health technologies in Europe.

Science.gov (United States)

Stafinski, Tania; Menon, Devidas; Davis, Caroline; McCabe, Christopher

2011-01-01

The purpose of this study was to compare centralized reimbursement/coverage decision-making processes for health technologies in 23 European countries, according to: mandate, authority, structure, and policy options; mechanisms for identifying, selecting, and evaluating technologies; clinical and economic evidence expectations; committee composition, procedures, and factors considered; available conditional reimbursement options for promising new technologies; and the manufacturers' roles in the process. A comprehensive review of publicly available information from peer-reviewed literature (using a variety of bibliographic databases) and gray literature (eg, working papers, committee reports, presentations, and government documents) was conducted. Policy experts in each of the 23 countries were also contacted. All information collected was reviewed by two independent researchers. Most European countries have established centralized reimbursement systems for making decisions on health technologies. However, the scope of technologies considered, as well as processes for identifying, selecting, and reviewing them varies. All systems include an assessment of clinical evidence, compiled in accordance with their own guidelines or internationally recognized published ones. In addition, most systems require an economic evaluation. The quality of such information is typically assessed by content and methodological experts. Committees responsible for formulating recommendations or decisions are multidisciplinary. While criteria used by committees appear transparent, how they are operationalized during deliberations remains unclear. Increasingly, reimbursement systems are expressing interest in and/or implementing reimbursement policy options that extend beyond the traditional "yes," "no," or "yes with restrictions" options. Such options typically require greater involvement of manufacturers which, to date, has been limited. Centralized reimbursement systems have become an

Reimbursement of licensed cell and gene therapies across the major European healthcare markets

Science.gov (United States)

Jørgensen, Jesper; Kefalas, Panos

2015-01-01

Objective The aim of this research is to identify the pricing, reimbursement, and market access (P&R&MA) considerations most relevant to advanced therapy medicinal products (ATMPs) in the Big5EU, and to inform their manufacturers about the key drivers for securing adoption at a commercially viable reimbursed price. Methodology The research was structured following three main steps: 1) Identifying the market access pathways relevant to ATMPs through secondary research; 2) Validating the secondary research findings and addressing any data gaps in primary research, by qualitative interviews with national, regional, and local-level payers and their clinical and economic advisors; 3) Collating of primary and secondary findings to compare results across countries. Results The incremental clinical benefit forms the basis for all P&R&MA processes. Budget impact is a key consideration, regardless of geography. Cost-effectiveness analyses are increasingly applied; however, only the United Kingdom has a defined threshold that links the cost per quality-adjusted life year (QALY) specifically and methodologically to the reimbursed price. Funding mechanisms to enable adoption of new and more expensive therapies exist in all countries, albeit to varying extents. Willingness to pay is typically higher in smaller patient populations, especially in populations with high disease burden. Outcomes modelling and risk-sharing agreements (RSAs) provide strategies to address the data gap and uncertainties often associated with trials in niche populations. Conclusions The high cost of ATMPs, coupled with the uncertainty at launch around their long-term claims, present challenges for their adoption at a commercially viable reimbursed price. Targeting populations of high disease burden and unmet needs may be advantageous, as the potential for improvement in clinical benefit is greater, as well as the potential for capitalising on healthcare cost offsets. Also, targeting small populations can

40 CFR 310.15 - How do I apply for reimbursement?

Science.gov (United States)

2010-07-01

... RESPONSE TO HAZARDOUS SUBSTANCE RELEASES Provisions How to Get Reimbursed § 310.15 How do I apply for... Management, Office of Solid Waste and Emergency Response, Environmental Protection Agency, 1200 Pennsylvania...

42 CFR 137.95 - May a Self-Governance Tribe purchase goods and services from the IHS on a reimbursable basis?

Science.gov (United States)

2010-10-01

... services from the IHS on a reimbursable basis? 137.95 Section 137.95 Public Health PUBLIC HEALTH SERVICE... Tribe purchase goods and services from the IHS on a reimbursable basis? Yes, a Self-Governance Tribe may...-Governance Tribe, on a reimbursable basis, including payment in advance with subsequent adjustment. Prompt...

Proposed changes to the reimbursement of pharmaceuticals and medical devices in Poland and their impact on market access and the pharmaceutical industry

Science.gov (United States)

Badora, Karolina; Caban, Aleksandra; Rémuzat, Cécile; Dussart, Claude; Toumi, Mondher

2017-01-01

ABSTRACT In Poland, two proposed amendments to the reimbursement act are currently in preparation; these are likely to substantially change the pricing and reimbursement landscape for both drugs and medical devices. Proposed changes include: alignment of medical device reimbursement with that of pharmaceuticals; relaxing the strict reimbursement criteria for ultra-orphan drugs; establishment of an additional funding category for vaccines; introduction of compassionate use, and a simplified reimbursement pathway for well-established off-label indications; appreciation of manufacturers’ innovation and research and development efforts by creating a dedicated innovation budget; introduction of a mechanism preventing excessive parallel import; prolonged duration of reimbursement decisions and reimbursement lists; and increased flexibility in defining drug programmes. Both amendments are still at a draft stage and many aspects of the new regulations remain unclear. Nonetheless, the overall direction of some of the changes is already evident and warrants discussion due to their high expected impact on pharmaceutical and device manufacturers. Here we evaluate the main changes proposed to the reimbursement of drugs, vaccines, and medical devices, and examine the impact they are likely to have on market access and pharmaceutical industry in Poland. PMID:29081924

Can medicaid reimbursement help give female condoms a second chance in the United States?

Science.gov (United States)

Witte, Susan S; Stefano, Kyle; Hawkins, Courtney

2010-10-01

The female condom is the only other barrier contraception method besides the male condom, and it is the only "woman-initiated" device for prevention of sexually transmitted infections. Although studies demonstrate high acceptability and effectiveness for this device, overall use in the United States remains low. The female condom has been available through Medicaid in many states since 1994. We provide the first published summary of data on Medicaid reimbursement for the female condom. Our findings demonstrate low rates of claims for female condoms but high rates of reimbursement. In light of the 2009 approval of a new, cheaper female condom and the recent passage of comprehensive health care reform, we call for research examining how health care providers can best promote consumer use of Medicaid reimbursement to obtain this important infection-prevention device.