Sample records for fr30ap10r medicaid program
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2010-08-11
... Parts 431, 447, and 457 Medicaid Program and Children's Health Insurance Program (CHIP); Revisions to... 431, 447, and 457 [CMS-6150-F] RIN 0938-AP69 Medicaid Program and Children's Health Insurance Program... final rule implements provisions from the Children's Health Insurance Program Reauthorization Act of...
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2012-04-18
..., 413, and 495 [CMS-0044-CN] RIN 0938-AQ84 Medicare and Medicaid Programs; Electronic Health Record... proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage... (77 FR 13698), the proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record...
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75 FR 38748 - Medicaid Program; Premiums and Cost Sharing; Correction
2010-07-06
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 447 and 457 [CMS-2244-CN] RIN 0938-AP73 Medicaid Program; Premiums and Cost Sharing; Correction AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS ACTION: Correction of final rule with comment period...
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42 CFR 1000.30 - Definitions specific to Medicaid.
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Definitions specific to Medicaid. 1000.30 Section... Medicaid. As used in connection with the Medicaid program, unless the context indicates otherwise— Applicant means an individual whose written application for Medicaid has been submitted to the agency...
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1983-05-31
The purpose of this notice is to respond to the comments we received on the Medicaid Management Information Systems Performance Standards that we published in a notice with comment period on June 30, 1981 (46 FR 33653).
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2012-12-14
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 438, 441, and 447 [CMS-2370-CN] RIN 0938-AQ63 Medicaid Program; Payments for Services Furnished by Certain...-26507 of November 6, 2012 (77 FR 66670), there were a number of technical errors that are identified and...
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77 FR 5317 - Medicaid Program; Covered Outpatient Drugs
2012-02-02
... for Medicare & Medicaid Services 42 CFR Part 447 Medicaid Program; Covered Outpatient Drugs; Proposed... Part 447 [CMS-2345-P] RIN 0938-AQ41 Medicaid Program; Covered Outpatient Drugs AGENCY: Centers for... requirements pertaining to Medicaid reimbursement for covered outpatient drugs to implement provisions of the...
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76 FR 60050 - Medicaid Program: Money Follows the Person Rebalancing Demonstration Program
2011-09-28
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Medicaid Program: Money Follows the Person Rebalancing Demonstration Program AGENCY: Centers for Medicare & Medicaid... Medicaid beneficiaries with disabling and chronic conditions from institutions into the community. The...
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77 FR 26827 - Medicaid Program; Community First Choice Option
2012-05-07
... Medicare & Medicaid Services 42 CFR Part 441 Medicaid Program; Community First Choice Option; Final Rule #0... [CMS-2337-F] RIN 0938-AQ35 Medicaid Program; Community First Choice Option AGENCY: Centers for Medicare... Affordable Care Act, which establishes a new State option to provide home and community-based attendant...
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76 FR 10735 - Medicaid Program; Community First Choice Option
2011-02-25
... for Medicare & Medicaid Services 42 CFR Part 441 Medicaid Program; Community First Choice Option... Part 441 [CMS-2337-P] RIN 0938-AQ35 Medicaid Program; Community First Choice Option AGENCY: Centers for... Section 2401 of the Affordable Care Act (ACA) which establishes a new State option to provide home and...
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75 FR 69037 - Medicaid Program; Recovery Audit Contractors
2010-11-10
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 455 [CMS-6034-P] RIN 0938-AQ19 Medicaid Program; Recovery Audit Contractors AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: This proposed rule would provide guidance to...
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2012-02-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6034-N] Medicaid Program; Announcement of Medicaid Recovery Audit Contractors (RACs) Contingency Fee Update AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This notice announces an...
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42 CFR 455.232 - Medicaid integrity audit program contractor functions.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...
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2011-08-08
... Medicare and Medicaid Services Medicare and Medicaid Programs; Quarterly Listing of Program Issuances... Centers for Medicare & Medicaid Services [CMS-9066-NC] Medicare and Medicaid Programs; Quarterly Listing... Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with comment period. SUMMARY: This quarterly notice...
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2010-12-30
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary [CMS-2420-NC] Medicaid Program: Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults AGENCY: Office of the Secretary... quality measures recommended for Medicaid-eligible adults, as required by section 2701 of the Affordable...
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42 CFR 460.168 - Reinstatement in other Medicare and Medicaid programs.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Reinstatement in other Medicare and Medicaid programs. 460.168 Section 460.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Reinstatement in other Medicare and Medicaid programs. To facilitate a participant's reinstatement in other...
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2012-02-21
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-9069-N] Medicare and Medicaid Programs; Quarterly Listing of Program Issuances--October Through December 2011 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This quarterly...
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78 FR 28551 - Medicaid Program; State Disproportionate Share Hospital Allotment Reductions
2013-05-15
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 447 [CMS-2367-P] RIN 0938-AR31 Medicaid Program; State Disproportionate Share Hospital Allotment Reductions AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: The statute...
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78 FR 57293 - Medicaid Program; State Disproportionate Share Hospital Allotment Reductions
2013-09-18
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 447 [CMS-2367-F] RIN 0938-AR31 Medicaid Program; State Disproportionate Share Hospital Allotment Reductions AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final rule. SUMMARY: The statute, as...
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77 FR 17143 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010
2012-03-23
... Medicare and Medicaid Services 42 CFR Parts 431, 435 and 457 Medicaid Program; Eligibility Changes Under... for Medicare & Medicaid Services 42 CFR Parts 431, 435, and 457 [CMS-2349-F] RIN 0938-AQ62 Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010 AGENCY: Centers for Medicare & Medicaid...
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2012-04-27
... osteopathy, dentistry, and podiatry, as required in order to become certified by the appropriate specialty...'' (January 23, 2004, 69 FR 3434). A final rule titled ``Medicare, Medicaid, and Children's Health Insurance...
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2013-12-02
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6051-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount... period entitled ``Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening...
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2013-07-15
... and 156 Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative... Secretary 45 CFR Parts 155 and 156 [CMS-2334-F] RIN 0938-AR04 Medicaid and Children's Health Insurance... Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices, delegation of appeals, and...
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2013-07-31
...] Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Temporary Moratoria on... combat fraud, waste, and abuse in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment...
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75 FR 56946 - Medicaid Program; Review and Approval Process for Section 1115 Demonstrations
2010-09-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 431 [CMS-2325-P] RIN 0938-AQ46 Medicaid Program; Review and Approval Process for Section 1115 Demonstrations AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: This...
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2011-12-19
... Parts 402 and 403 [CMS-5060-P] RIN 0938-AR33 Medicare, Medicaid, Children's Health Insurance Programs...'s Health Insurance Program (CHIP) to report annually to the Secretary certain payments or transfers... State plan under title XIX (Medicaid) or XXI of the Act (the Children's Health Insurance Program, or...
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2013-01-30
... Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430...
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2012-09-10
..., Medicaid, and CHIP Programs: Research and Analysis on Impact of CMS Programs on the Indian Health Care System AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice of Single Source Award. SUMMARY: This notice supports expansion of research on the impact of CMS programs on the Indian health...
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2013-07-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3280-FN] Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality's (CIHQ's) Hospital Accreditation Program AGENCY: Centers for Medicare and Medicaid Services, HHS. ACTION: Final...
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2013-06-03
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 433 [CMS-2327-CN] RIN 0938-AR38 Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable Care Act of 2010; Correction AGENCY: Centers for Medicare & Medicaid Services (CMS...
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75 FR 23067 - Medicaid Program; State Flexibility for Medicaid Benefit Packages
2010-04-30
... mental illness, children with serious emotional disturbance, the disabled and elderly, individuals with... that children with serious mental and/or physical disorders often qualify for Medicaid on a basis of... that brought about equitable, decent care for Medicaid-eligible individuals experiencing mental illness...
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77 FR 11677 - Medicaid Program; Review and Approval Process for Section 1115 Demonstrations
2012-02-27
... for Medicare & Medicaid Services 42 CFR Part 431 Department of the Treasury 31 CFR Part 33 Department of Health and Human Services 45 CFR Part 155 Medicaid Program; Review and Approval Process for... Regulations#0;#0; [[Page 11678
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Medicaid program; health care-related taxes. Final rule.
2009-06-30
This rule finalizes our proposal to delay enforcement of certain clarifications regarding standards for determining hold harmless arrangements in the final rule entitled, "Medicaid Program; Health Care-Related Taxes" from the expiration of a Congressional moratorium on enforcement from July 1, 2009 to June 30, 2010.
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75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program
2010-07-28
... Payment Calculation for Eligible Hospitals c. Medicare Share d. Charity Care e. Transition Factor f...), eligible hospitals and critical access hospitals (CAHs) participating in Medicare and Medicaid programs...) technology. This final rule specifies--the initial criteria EPs, eligible hospitals, and CAHs must meet in...
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2010-02-03
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1341-NC] Medicare and Medicaid Programs; Announcement of Applications From Hospitals Requesting Waiver for Organ Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with...
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75 FR 1843 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program
2010-01-13
... Payment Calculation for Eligible Hospitals c. Medicare Share d. Charity Care e. Transition Factor f...) and eligible hospitals participating in Medicare and Medicaid programs that adopt and meaningfully use... an EP and eligible hospital must meet in order to qualify for the incentive payment; calculation of...
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2010-10-15
... Children's Health Insurance Program Reauthorization Act of 2009 for Adjustments to the Federal Medical... section 614 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law... Medicaid program and required by Section 614 of the Children's Health Insurance Program Reauthorization Act...
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2013-09-20
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3287-PN] Medicare and Medicaid Programs; Application from the Compliance Team for Initial CMS-Approval of its Rural Health Clinic Accreditation Program AGENCY: Centers for Medicare and Medicaid Services, HHS. ACTION...
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2017-07-05
This final rule updates the Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) programs based on the changes to Medicaid and the Children's Health Insurance Program (CHIP) eligibility under the Patient Protection and Affordable Care Act. This rule also implements various other improvements to the PERM program.
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2013-07-09
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 431 [CMS-1450-CN] RIN 0938-AR52 Medicare and Medicaid Programs; Home Health Prospective Payment System Rate... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...
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2013-01-02
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1456-NC] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with...
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2012-08-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1452-NC] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with...
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2013-03-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1457-NC] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with...
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75 FR 16149 - Medicaid and CHIP Programs; Meeting of the CHIP Working Group-April 26, 2010
2010-03-31
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-2312-N] DEPARTMENT OF LABOR Employee Benefits Security Administration Medicaid and CHIP Programs; Meeting of the CHIP Working Group-- April 26, 2010 AGENCIES: Centers for Medicare & Medicaid Services (CMS), Department of...
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2012-05-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430, 433, 447, and 457 [CMS-2292-F] RIN 0938-AQ32 Medicaid and Children's Health Insurance Programs... Children's Health Insurance Program (CHIP) disallowance process to allow States the option to retain...
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Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs
Terry-McElrath, Yvonne M; Chriqui, Jamie F; McBride, Duane C
2011-01-01
Objective To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. Data Sources Secondary analysis of 2003–2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly available data. Study Design We used cross-sectional analyses, including state fixed effects, to assess relationships between SA treatment program Medicaid acceptance and (1) program-level factors, (2) county-level sociodemographics and treatment program density, and (3) state-level population characteristics, SA treatment-related factors, and Medicaid policy and usage. Data Extraction Methods State Medicaid policy data were compiled based on reviews of state Medicaid-related statutes/regulations and Medicaid plans. Other data were publicly available. Principal Findings Medicaid acceptance was significantly higher for programs: (a) that were publicly funded and in states with Medicaid policy allowing SA treatment coverage; (b) with accreditation/licensure and nonprofit/government ownership, as well as mental- and general-health focused programs; and (c) in counties with lower household income. Conclusions SA treatment program Medicaid acceptance related to program-, county, and state-level factors. The data suggest the importance of state policy and licensure/accreditation requirements in increasing SA program Medicaid access. PMID:21105870
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2012-05-16
... Provisions to Promote Program Efficiency, Transparency, and Burden Reduction; Final Rule #0;#0;Federal..., Transparency, and Burden Reduction AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final... on providers of care. CMS has also identified non-regulatory changes to increase transparency and to...
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2009-03-27
This action temporarily delays the effective date of the November 25, 2008 final rule entitled, Medicaid Program; Premiums and Cost Sharing" (73 FR 71828) until December 31, 2009. In addition, this action reopens the comment period on the policies set out in the November 25, 2008 final rule, and specifically solicits comments on the effect of certain provisions of the American Recovery and Reinvestment Act of 2009.
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42 CFR 495.310 - Medicaid provider incentive payments.
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Medicaid provider incentive payments. 495.310 Section 495.310 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.310 Medicaid provider incentive...
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2013-01-22
...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans...-2334-P] RIN 0938-AR04 Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health... 2010 (collectively referred to as the Affordable Care Act), and the Children's Health Insurance Program...
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2010-07-30
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-2480-NC] Medicaid Program; Request for Comments on Legislative Changes To Provide Quality of Care to Children AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with Comments. SUMMARY: This notice...
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Further stable neutron star models from f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Astashenok, Artyom V. [I. Kant Baltic Federal University, Institute of Physics and Technology, Nevskogo st. 14, Kaliningrad, 236041 (Russian Federation); Capozziello, Salvatore [Dipartimento di Fisica, Università di Napoli ' ' Federico II' ' , Via Cinthia, 9, Napoli, I–80126 (Italy); Odintsov, Sergei D., E-mail: artyom.art@gmail.com, E-mail: capozziello@na.infn.it, E-mail: odintsov@ieec.uab.es [Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona (Spain)
2013-12-01
Neutron star models in perturbative f(R) gravity are considered with realistic equations of state. In particular, we consider the FPS, SLy and other equations of state and a case of piecewise equation of state for stars with quark cores. The mass-radius relations for f(R) = R+R(e{sup −R/R{sub 0}}−1) model and for R{sup 2} models with logarithmic and cubic corrections are obtained. In the case of R{sup 2} gravity with cubic corrections, we obtain that at high central densities (ρ > 10ρ{sub ns}, where ρ{sub ns} = 2.7 × 10{sup 14} g/cm{sup 3} is the nuclear saturation density), stable star configurations exist. The minimal radius of such stars is close to 9 km with maximal mass ∼ 1.9M{sub ⊙} (SLy equation). A similar situation takes place for AP4 and BSK20 EoS. Such an effect can give rise to more compact stars than in General Relativity. If observationally identified, such objects could constitute a formidable signature for modified gravity at astrophysical level. Another interesting result can be achieved in modified gravity with only a cubic correction. For some EoS, the upper limit of neutron star mass increases and therefore these EoS can describe realistic star configurations (although, in General Relativity, these EoS are excluded by observational constraints)
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Further stable neutron star models from f(R) gravity
International Nuclear Information System (INIS)
Astashenok, Artyom V.; Capozziello, Salvatore; Odintsov, Sergei D.
2013-01-01
Neutron star models in perturbative f(R) gravity are considered with realistic equations of state. In particular, we consider the FPS, SLy and other equations of state and a case of piecewise equation of state for stars with quark cores. The mass-radius relations for f(R) = R+R(e −R/R 0 −1) model and for R 2 models with logarithmic and cubic corrections are obtained. In the case of R 2 gravity with cubic corrections, we obtain that at high central densities (ρ > 10ρ ns , where ρ ns = 2.7 × 10 14 g/cm 3 is the nuclear saturation density), stable star configurations exist. The minimal radius of such stars is close to 9 km with maximal mass ∼ 1.9M ⊙ (SLy equation). A similar situation takes place for AP4 and BSK20 EoS. Such an effect can give rise to more compact stars than in General Relativity. If observationally identified, such objects could constitute a formidable signature for modified gravity at astrophysical level. Another interesting result can be achieved in modified gravity with only a cubic correction. For some EoS, the upper limit of neutron star mass increases and therefore these EoS can describe realistic star configurations (although, in General Relativity, these EoS are excluded by observational constraints)
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42 CFR 495.304 - Medicaid provider scope and eligibility.
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Medicaid provider scope and eligibility. 495.304 Section 495.304 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.304 Medicaid provider scope and...
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Using a Classroom Response System to Improve Multiple-Choice Performance in AP[R] Physics
Bertrand, Peggy
2009-01-01
Participation in rigorous high school courses such as Advanced Placement (AP[R]) Physics increases the likelihood of college success, especially for students who are traditionally underserved. Tackling difficult multiple-choice exams should be part of any AP program because well-constructed multiple-choice questions, such as those on AP exams and…
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Medicaid Drug Rebate Program Data
U.S. Department of Health & Human Services — Product Data for Drugs in the Medicaid Drug Rebate Program. The rebate drug product data file contains the active drugs that have been reported by participating drug...
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2011-03-03
...] Medicare, Medicaid, and Children's Health Insurance Programs; Renewal, Expansion, and Renaming of the...'s Health Insurance Program (CHIP) about options for selecting health care coverage under these and... needs are for experts in health disparities, State Health Insurance Assistance Programs (SHIPs), health...
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42 CFR 460.182 - Medicaid payment.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid payment. 460.182 Section 460.182 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Payment § 460.182 Medicaid payment. (a) Under a PACE program agreement, the State administering agency...
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2013-02-08
... Parts 402 and 403 [CMS-5060-F] RIN 0938-AR33 Medicare, Medicaid, Children's Health Insurance Programs...'s Health Insurance Program (CHIP) to report annually to the Secretary certain payments or transfers... Vol. 78 Friday, No. 27 February 8, 2013 Part II Department of Health and Human Services Centers...
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42 CFR 495.320 - FFP for payments to Medicaid providers.
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false FFP for payments to Medicaid providers. 495.320 Section 495.320 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.320 FFP for payments to Medicaid...
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42 CFR 400.203 - Definitions specific to Medicaid.
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Definitions specific to Medicaid. 400.203 Section 400.203 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Medicaid. As used in connection with the Medicaid program, unless the context indicates otherwise...
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76 FR 66309 - Pilot Program for Parallel Review of Medical Products; Correction
2011-10-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare and Medicaid Services [CMS-3180-N2] Food and Drug Administration [Docket No. FDA-2010-N-0308] Pilot Program for Parallel Review of Medical... 11, 2011 (76 FR 62808). The document announced a pilot program for sponsors of innovative device...
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DiGiulio, Anne; Jump, Zach; Yu, Annie; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Yembra, Debbie; Armour, Brian S
2018-04-06
Cigarette smoking prevalence among Medicaid enrollees (25.3%) is approximately twice that of privately insured Americans (11.8%), placing Medicaid enrollees at increased risk for smoking-related disease and death (1). Medicaid spends approximately $39 billion annually on treating smoking-related diseases (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications* are effective in helping tobacco users quit (3). Although state Medicaid coverage of tobacco cessation treatments improved during 2014-2015, coverage was still limited in most states (4). To monitor recent changes in state Medicaid cessation coverage for traditional (i.e., nonexpansion) Medicaid enrollees, the American Lung Association collected data on coverage of a total of nine cessation treatments: individual counseling, group counseling, and seven FDA-approved cessation medications † in state Medicaid programs during July 1, 2015-June 30, 2017. The American Lung Association also collected data on seven barriers to accessing covered treatments, such as copayments and prior authorization. As of June 30, 2017, 10 states covered all nine of these treatments for all enrollees, up from nine states as of June 30, 2015; of these 10 states, Missouri was the only state to have removed all seven barriers to accessing these cessation treatments. State Medicaid programs that cover all evidence-based cessation treatments, remove barriers to accessing these treatments, and promote covered treatments to Medicaid enrollees and health care providers would be expected to reduce smoking, smoking-related disease, and smoking-attributable federal and state health care expenditures (5-7).
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2011-08-03
..., 433, 447, and 457 [CMS-2292-P] RIN 0938-AQ32 Medicaid and Children's Health Insurance Programs... Children's Health Insurance Program (CHIP) disallowance process to allow States the option to retain... [[Page 46685
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75 FR 46833 - 45th Anniversary of Medicare and Medicaid
2010-08-03
... Part III The President Proclamation 8544--45th Anniversary of Medicare and Medicaid #0; #0; #0..., 2010 45th Anniversary of Medicare and Medicaid By the President of the United States of America A Proclamation When President Lyndon B. Johnson signed Medicare and Medicaid into law on July 30, 1965, millions...
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The Medicaid School Program: An Effective Public School and Private Sector Partnership
Mallett, Christopher A.
2013-01-01
Privatized service delivery within Medicaid has greatly increased over the past two decades. This public program-private sector collaboration is quite common today, with a majority of Medicaid recipients receiving services in this fashion; yet controversy remains. This article focuses on just one program within Medicaid, school-based services for…
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76 FR 15105 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes
2011-03-18
... Services 42 CFR Part 488 [CMS-2435-F] Medicare and Medicaid Programs; Civil Money Penalties for Nursing... incentives for quality improvement, and to remove uncertainty for nursing homes, we proposed to set the... Vol. 76 Friday, No. 53 March 18, 2011 Part III Department of Health and Human Services Centers for...
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1980-03-05
These regulations set forth a new procedure to improve Medicaid management by explicitly authorizing HCFA to expand or revise State Medicaid Management Information Systems (MMIS) as necessary to meet program needs. Under this procedure, HCFA will publish major new requirements for comment before deciding to adopt them, and will provide increased Federal matching and reasonable phase-in time for their implementation. HCFA will also periodically review ongoing systems to determine whether all system requirements and performance standards are being met and may reduce the level of Federal matching for those MMIS systems which do not meet prescribed standards.
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30 CFR 906.10 - State regulatory program approval.
2010-07-01
... 30 Mineral Resources 3 2010-07-01 2010-07-01 false State regulatory program approval. 906.10 Section 906.10 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE COLORADO § 906.10 State...
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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.
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2009-01-27
In accordance with the memorandum of January 20, 2009, from the Assistant to the President and Chief of Staff, entitled "Regulatory Review Plan," this action temporarily delays for 60 days the effective date of the final rule entitled "Medicaid Program; Premiums and Cost Sharing" (73 FR 71828). The temporary 60-day delay in effective date is necessary to give Department officials the opportunity for further review and consideration of new regulations. In addition, this action reopens the comment period on the policies set out in the November 25, 2008 final rule.
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2013-07-26
... states may make to institutions for mental diseases (IMDs) and other mental health facilities. This... DSH payments to institutions for mental diseases (IMDs) and other mental health facilities is limited... 0938-AR91 Medicaid Program; Disproportionate Share Hospital Allotments and Institutions for Mental...
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Hartung, Daniel M; Ahmed, Sharia M; Middleton, Luke; Van Otterloo, Joshua; Zhang, Kun; Keast, Shellie; Kim, Hyunjee; Johnston, Kirbee; Deyo, Richard A
2017-09-01
Out-of-pocket payment for prescription opioids is believed to be an indicator of abuse or diversion, but few studies describe its epidemiology. Prescription drug monitoring programs (PDMPs) collect controlled substance prescription fill data regardless of payment source and thus can be used to study this phenomenon. To estimate the frequency and characteristics of prescription fills for opioids that are likely paid out-of-pocket by individuals in the Oregon Medicaid program. Cross-sectional analysis using Oregon Medicaid administrative claims and PDMP data (2012 to 2013). Continuously enrolled nondually eligible Medicaid beneficiaries who could be linked to the PDMP with two opioid fills covered by Oregon Medicaid. Patient characteristics and fill characteristics for opioid fills that lacked a Medicaid pharmacy claim. Fill characteristics included opioid name, type, and association with indicators of high-risk opioid use. A total of 33 592 Medicaid beneficiaries filled a total of 555 103 opioid prescriptions. Of these opioid fills, 74 953 (13.5%) could not be matched to a Medicaid claim. Hydromorphone (30%), fentanyl (18%), and methadone (15%) were the most likely to lack a matching claim. The 3 largest predictors for missing claims were opioid fills that overlapped with other opioids (adjusted odds ratio [aOR] 1.37; 95% confidence interval [CI], 1.34-1.4), long-acting opioids (aOR 1.52; 95% CI, 1.47-1.57), and fills at multiple pharmacies (aOR 1.45; 95% CI, 1.39-1.52). Prescription opioid fills that were likely paid out-of-pocket were common and associated with several known indicators of high-risk opioid use. Copyright © 2017 John Wiley & Sons, Ltd.
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2011-10-28
...] Medicare and Medicaid Programs; The American Association for Accreditation of Ambulatory Surgery Facilities... receipt of a deeming application from the American Association for Accreditation of Ambulatory Surgery... of Ambulatory Surgery Facilities (AAAASF's) request for deeming authority for RHCs. This notice also...
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2012-01-04
... lines was not applied correctly. We have corrected our programming logic in the OPPS data process to... made to the programming logic described in the CY 2012 OPPS/ASC final (see 76 FR 74141). The correct...
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Poor program's progress: the unanticipated politics of Medicaid policy.
Brown, Lawrence D; Sparer, Michael S
2003-01-01
Advocates of U.S. national health insurance tend to share an image that highlights universal standards of coverage, social insurance financing, and national administration--in short, the basic features of Medicare. Such an approach is said to be good (equitable and efficient) policy and equally good politics. Medicaid, by contrast, is often taken to exemplify poor policy and poorer politics: means-tested eligibility, general revenue financing, and federal/state administration, which encourage inequities and disparities of care. This stark juxtaposition fails, however, to address important counterintuitive elements in the political evolution of these programs. Medicare's benefits and beneficiaries have stayed disturbingly stable, but Medicaid's relatively broad benefits have held firm, and its categories of beneficiaries have expanded. Repeated alarms about "bankruptcy" have undermined confidence in Medicare's trust funding, while Medicaid's claims on the taxpayer's dollar have worn well. Medicare's national administration has avoided disparities, but at the price of sacrificing state and local flexibility that can ease such "reforms" as the introduction of managed care. That Medicaid has fared better than a "poor people's program" supposedly could has provocative implications for health reform debates.
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2010-11-15
..., Multiple Source Drug Definition, and Upper Limits for Multiple Source Drugs AGENCY: Centers for Medicare... withdrawing the definition of ``multiple source drug'' as it was revised in the ``Medicaid Program; Multiple Source Drug Definition'' final rule published in the October 7, 2008 Federal Register. DATES: Effective...
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Merritt, Jantraveus M.; Greenlee, Geoffrey; Bollen, Anne Marie; Scott, JoAnna M.; Chi, Donald L.
2016-01-01
Introduction We assess the relationship between race and orthodontic service utilization for Medicaid-enrolled children. Methods This cross-sectional study focused on 570,364 Washington Medicaid-enrolled children ages 6-19 years. The main predictor variable was self-reported race (White versus non-White). The outcome variable was orthodontic service utilization, defined as children who were pre-authorized for orthodontic treatment by Medicaid in 2012 and subsequently received orthodontic records and initiated treatment. Logistic regression models were used to test the hypothesis that non-Whites would be less likely to utilize orthodontic care than Whites. Results A total of 8,223 children were approved by Medicaid for orthodontic treatment and 7,313 received records and initiated treatment. Non-Whites were significantly more likely to utilize orthodontic care than Whites (Odds Ratio [OR]=1.18; 95% confidence interval [CI]=1.02, 1.36; p=.031). Hispanic non-White children were more likely to utilize orthodontic care than non-Hispanic White children (OR=1.42; 95% CI=1.18, 1.70; porthodontic care than White children. The Washington Medicaid program demonstrates a potential model for addressing racial disparities in orthodontic service utilization. Future research should identify mechanisms underlying these findings and continue to monitor orthodontic service utilization for minority children in Medicaid. PMID:27021456
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Drug Products in the Medicaid Drug Rebate Program
U.S. Department of Health & Human Services — Active drugs that have been reported by participating drug manufacturers under the Medicaid Drug Rebate Program. All drugs are identified by National Drug Code...
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2011-05-16
... partner with States, providers, beneficiaries and their caregivers, and other stakeholders to improve... conflicting Medicaid and Medicare requirements. This document represents the first step. We have compiled what.... We will then determine which issues to address and in what order and timeframe. All areas are...
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42 CFR 1002.3 - Disclosure by providers and State Medicaid agencies.
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Disclosure by providers and State Medicaid agencies... HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-STATE-INITIATED EXCLUSIONS FROM MEDICAID General Provisions § 1002.3 Disclosure by providers and State Medicaid agencies. (a) Information that must be...
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75 FR 30046 - Medicaid and CHIP Programs; Meeting of the CHIP Working Group-June 14, 2010
2010-05-28
..., Employee Benefits Security Administration, DOL at (202) 693-8335. News media representatives must contact... eligible for benefits under titles XIX or XXI of the Social Security Act (the Act) to enable them to enroll...] DEPARTMENT OF LABOR Employee Benefits Security Administration Medicaid and CHIP Programs; Meeting of the CHIP...
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42 CFR 455.21 - Cooperation with State Medicaid fraud control units.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with State Medicaid fraud control units... Detection and Investigation Program § 455.21 Cooperation with State Medicaid fraud control units. In a State with a Medicaid fraud control unit established and certified under subpart C of this part, (a) The...
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Medicaid Financial Management Data
U.S. Department of Health & Human Services — This dataset reports summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP programs. These state...
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Control of sulfate concentration by miR395-targeted APS genes in Arabidopsis thaliana
Directory of Open Access Journals (Sweden)
Qin Ai
2016-04-01
Full Text Available Sulfur nutrition is crucial for plant growth and development, as well as crop yield and quality. Inorganic sulfate in the soil is the major sulfur source for plants. After uptake, sulfate is activated by ATP sulfurylase, and then gets assimilated into sulfur-containing metabolites. However, the mechanism of regulation of sulfate levels by ATP sulfurylase is unclear. Here, we investigated the control of sulfate levels by miR395-mediated regulation of APS1/3/4. Sulfate was over-accumulated in the shoots of miR395 over-expression plants in which the expression of the APS1, APS3, and APS4 genes was suppressed. Accordingly, reduced expression of miR395 caused a decline of sulfate concentration. In agreement with these results, over-expression of the APS1, APS3, and APS4 genes led to the reduction of sulfate levels. Differential expression of these three APS genes in response to sulfate starvation implied that they have different functions. Further investigation revealed that the regulation of sulfate levels mediated by miR395 depends on the repression of its APS targets. Unlike the APS1, APS3, and APS4 genes, which encode plastid-localized ATP sulfurylases, the APS2 gene encodes a cytosolic version of ATP sulfurylase. Genetic analysis indicated that APS2 has no significant effect on sulfate levels. Our data suggest that miR395-targeted APS genes are key regulators of sulfate concentration in leaves.
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2011-07-12
... documentation must also describe how the health status of the recipient at the time of the face-to-face... [CMS 2348-P] RIN 0938-AQ36 Medicaid Program; Face-to-Face Requirements for Home Health Services; Policy... document the existence of a face-to-face encounter (including through the use of telehealth) with the...
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The Role of AP and the Composition Program.
Mahala, Daniel; Vivion, Michael
1993-01-01
Suggests that most programs have not based their acceptance of advanced placement credit on reasoned endorsement of the views of language, literature, and rhetoric that AP exams present. Criticizes the views implicit in the AP program and shows how they conflict with the goals of one particular college composition program. (RS)
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Early Childhood Caries and the Impact of Current U.S. Medicaid Program: An Overview
Directory of Open Access Journals (Sweden)
Bussma Ahmed Bugis
2012-01-01
Full Text Available Pediatric dental caries is the most common chronic disease among children. Above 40% of the U.S. children aged 2–11 years have dental caries; more than 50% of them come from low-income families. Under dental services of the Medicaid program, children enrolled in Medicaid must receive preventive dental services. However, only 1/5 of them utilize preventive dental services. The purpose of this overview is to measure the impact of Medicaid dental benefits on reducing oral health disparities among Medicaid-eligible children. This paper explains the importance of preventive dental care, children at high risk of dental caries, Medicaid dental benefits, utilization of dental preventive services by Medicaid-eligible children, dental utilization influencing factors, and outcome evaluation of Medicaid in preventing dental caries among children. In conclusion, despite the recent increase of children enrolled in Medicaid, utilizing preventive dental care is still a real challenge that faces Medicaid.
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U.S. Department of Health & Human Services — Data set merges information about the Centers for Medicare and Medicaid Services, Medicare and Medicaid EHR Incentive Programs attestations with the Office of the...
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Westinghouse AP 1000 program status
International Nuclear Information System (INIS)
Doehnert, B.
2002-01-01
The project 1000 is presented and features are discussed in the paper. Design maturity is characterized by 1300 man-year / $400 million design and testing effort, more than 12 000 design documents completed; 3D computer model developed. It includes structures, equipment, small / large pipe, cable trays, ducts etc. Licensing Maturity is determined by a very thorough and complete NRC review of AP600; 110 man-year effort (NRC) over 6 years, $30 million; independent, confirmatory plant analysis; independent, confirmatory plant testing (ROSA, OSU); over 7400 questions answered, no open items; over 380 meeting with NRC, 43 meetings with ACRS. NRC Design Certification is issued in December 1999. Reasons for developing AP 1000 and design changes are presented. Economic analysis shows an expectation for payback within 20 years. AP1000 provides 75% power uprate for 15% increment in capital cost. AP1000 meets new plant economic targets in the near term
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Grogan, Colleen M; Park, Sunggeun Ethan
2017-12-01
Policy Points: More than half of Americans are connected to the Medicaid program-either through their own coverage or that of a family member or close friend-and are significantly more likely to view Medicaid as important and to support increases in spending, even among conservatives. This finding helps explain why Affordable Care Act repeal efforts faced (and will continue to face) strong public backlash. Policymakers should be aware that although renaming programs within Medicaid may have increased enrollment take-up, this destigmatization effort might have also increased program confusion and reduced support for Medicaid even among enrollees who say the program is important to them. Since the 1980s, Medicaid enrollment has expanded so dramatically that by 2015 two-thirds of Americans had some connection to the program in which either they themselves, a family member, or a close friend is currently or was previously enrolled. Utilizing a nationally representative survey-the Kaiser Family Foundation Poll: Medicare and Medicaid at 50 (n = 1,849)-and employing ordinal and logistic regression analyses, our study examines 3 questions: (1) are individuals with a connection to Medicaid more likely to view the program as important, (2) are they more likely to support an increase in Medicaid spending, and (3) are they more likely to support adoption of the Medicaid expansion offered under the Affordable Care Act? For each of these questions we examine whether partisanship and views of stigma also impact support for Medicaid and, if so, whether these factors overwhelm the impact of connection to the program. Controlling for the strong effect of partisanship, people with any connection to the Medicaid program are more likely to view the program as important than those with no connection. However, when it comes to increasing spending or expanding the program, the type of connection to the program matters. In particular, adults with current and previous Medicaid coverage and
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A viable logarithmic f(R) model for inflation
Energy Technology Data Exchange (ETDEWEB)
Amin, M.; Khalil, S. [Center for Fundamental Physics, Zewail City of Science and Technology,6 October City, Giza (Egypt); Salah, M. [Center for Fundamental Physics, Zewail City of Science and Technology,6 October City, Giza (Egypt); Department of Mathematics, Faculty of Science, Cairo University,Giza (Egypt)
2016-08-18
Inflation in the framework of f(R) modified gravity is revisited. We study the conditions that f(R) should satisfy in order to lead to a viable inflationary model in the original form and in the Einstein frame. Based on these criteria we propose a new logarithmic model as a potential candidate for f(R) theories aiming to describe inflation consistent with observations from Planck satellite (2015). The model predicts scalar spectral index 0.9615
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Prada, Sergio I
2017-12-01
The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of
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The cost of Medicaid annuities.
Levy, Robert A; Nyman, John A; Gabay, Mary; Riley, William; Feldman, Roger
2006-01-01
Medicaid annuities are annuities that long-term care recipients use to shelter assets, thereby qualifying them early for Medicaid eligibility. As such, these annuities have the potential to increase Medicaid costs. This study estimates the cost of annuities to the Medicaid program. From a sample of Medicaid applications in five states, we found the rate at which annuities were used and simulated their cost to Medicaid. We estimated that in 2004, Medicaid annuities cost Medicaid about 197 million dollars, which represented a small proportion of Medicaid's almost 50 billion dollars cost for nursing home care.
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2011-10-24
... Efficiency, Transparency, and Burden Reduction AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS...-regulatory changes to increase transparency and to become a better business partner. As explained in the plan...
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Park, Min Gyeong; Ha, Yeongmi
2014-10-01
This study was conducted to develop a self-management program using goal setting for patients after a stroke. The program was based on a theory-based Goal setting and Action Planning framework (G-AP), and the effectiveness of the program was examined. A non-equivalent control group pretest-posttest design was used. The experimental group (n=30) received the self-management program using goal setting based on the G-AP over 7 weeks. The education was delivered individually with a specifically designed stroke workbook. The control group (n=30) received only patient information leaflets about stroke. There were significant differences between the two groups. Stroke knowledge, self-efficacy, and health behavior compliance were significantly higher (all pgoal setting based on a G-AP was found to be useful and beneficial for patients in stroke rehabilitation settings.
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Wang, Y Richard; Pauly, Mark V; Lin, Y Aileen
2003-10-01
Market penetration of HMOs affect physician practice styles for non-HMO patients. To study the impact of a restrictive Medicaid drug formulary on prescribing patterns for other patients, ie, so-called spillover effects. A before-and-after, 3-state comparison study. On January 1, 2001, Maine's Medicaid program implemented a restrictive drug formulary for the proton pump inhibitor class, with pantoprazole as the only preferred drug. The Medicaid and non-Medicaid market shares of pantoprazole in Maine (vs New Hampshire and Vermont and among Maine physicians with different Medicaid share of practice. After 3 months, the market share of pantoprazole in Maine (vs 2 control states) increased 79% among Medicaid prescriptions (vs 1%-2%), 10% among cash prescriptions (vs 3%), and 7% among other third-party payer prescriptions (vs 1%). The market shares increased more among Maine physicians with a higher Medicaid share of practice (high vs middle vs low [market]: 16% vs 8% vs 5% [cash]; 11% vs 5% vs 4% [other third-party payers]). Linear regression results indicate that practicing medicine in Maine leads to a 72% increase in pantoprazole share among Medicaid prescriptions (P markets, with somewhat stronger effects in the cash market.
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Future dynamics in f(R) theories
International Nuclear Information System (INIS)
Mueller, D.; Andrade, V.C. de; Maia, C.; Reboucas, M.J.; Teixeira, A.F.F.
2015-01-01
The f(R) gravity theories provide an alternative way to explain the current cosmic acceleration without invoking a dark energy matter component used in the cosmological modeling in the framework of general relativity. However, the freedom in the choice of the functional forms of f(R) gives rise to the problem of the degeneracy among these gravity theories on theoretical and (or) observational grounds. In this paper we examine the question as to whether the future dynamics can be used to break the degeneracy between f(R) gravity theories by investigating the dynamics of spatially homogeneous and isotropic dust flat models in two f(R) gravity theories, namely the well known f(R) = R+αR n gravity and another byAviles et al., whose motivation comes from the cosmographic approach to f(R) gravity. We perform a detailed numerical study of the dynamics of these theories taking into account the recent constraints on the cosmological parameters made by the Planck Collaboration. We demonstrate that besides being useful for discriminating between these two f(R) gravity theories, the future dynamics technique can also be used to determine the finite-time behavior as well as the fate of the Universe in the framework of these f(R) gravity theories. There also emerges from our analysis the result that one still can have a dust flat FLRWsolution with a big rip, if gravity is governed by f(R) = R+αR n . We also show that FLRW dust solutions with f'' < 0 do not necessarily lead to singularities. (orig.)
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Davidson, S M
1993-01-01
In the last few years, Medicaid has attracted more than casual attention, one reflection of which is the fact that JHPPL has published five papers on the program in its last few issues. This paper, a sixth, takes a broader view of the program than is typically the case. After a critique of the five recent articles, I discuss several questions raised by them and reach the following conclusions: First, the states do not invest enough in producing program data suitable for policy analysis and research. One lesson: Better data and analysis can help the states to avoid expensive mistakes. Second, those policy analyses that have been offered fail to give sufficient attention to the political dimension of policy. That is one reason why policy choices produce unexpected effects. Third, since Medicaid is a relatively small player in the vast medical care market, incentives adopted by Medicaid officials throughout the country rarely have the desired effects. Finally, as long as Medicaid remains the principal mechanism to provide access to health care for the poor, it must be made as efficient and effective as possible. Yet, for both political and economic reasons, Medicaid can never be what its original planners had hoped, the vehicle for providing the poor with reliable access to mainstream medical care.
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Decker, Sandra L
2015-01-01
Objective To estimate the relationship between physicians' acceptance of new Medicaid patients and access to health care. Data Sources The National Ambulatory Medical Care Survey (NAMCS) Electronic Health Records Survey and the National Health Interview Survey (NHIS) 2011/2012. Study Design Linear probability models estimated the relationship between measures of experiences with physician availability among children on Medicaid or the Children's Health Insurance Program (CHIP) from the NHIS and state-level estimates of the percent of primary care physicians accepting new Medicaid patients from the NAMCS, controlling for other factors. Principal Findings Nearly 16 percent of children with a significant health condition or development delay had a doctor's office or clinic indicate that the child's health insurance was not accepted in states with less than 60 percent of physicians accepting new Medicaid patients, compared to less than 4 percent in states with at least 75 percent of physicians accepting new Medicaid patients. Adjusted estimates and estimates for other measures of access to care were similar. Conclusions Measures of experiences with physician availability for children on Medicaid/CHIP were generally good, though better in states where more primary care physicians accepted new Medicaid patients. PMID:25683869
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AP: A Critical Examination of the Advanced Placement Program
Sadler, Philip M.; Sonnert, Gerhard; Tai, Robert; Klopfenstein, Kirstin
2016-01-01
The Advanced Placement (AP) program was created to enhance the experience of gifted students as they transition from high school to college. "AP: A Critical Examination of the Advanced Placement Program," edited by Philip M. Sadler, Gerhard Sonnert, Robert Tai, and Kirstin Klopfenstein (2010, Harvard Education Press), questions the…
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2013-12-27
... Conditions for Coverage CHAP Community Health Accreditation Program CMHC Community Mental Health Center COI... Pathology Services (Sec. 485.727) N. Emergency Preparedness Regulations for Community Mental Health Centers... Preparedness for Community Mental Health Centers (CMHCs)--Training and Testing (Sec. 485.920(d)) R. Conditions...
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Koroukian, Siran M; Bakaki, Paul M; Htoo, Phyo Than; Han, Xiaozhen; Schluchter, Mark; Owusu, Cynthia; Cooper, Gregory S; Rose, Johnie; Flocke, Susan A
2017-08-15
As an organized screening program, the national Breast and Cervical Cancer Early Detection Program (BCCEDP) was launched in the early 1990s to improve breast cancer outcomes among underserved women. To analyze the impact of the BCCEDP on breast cancer outcomes in Ohio, this study compared cancer stages and mortality across BCCEDP participants, Medicaid beneficiaries, and "all others." This study linked data across the Ohio Cancer Incidence Surveillance System, Medicaid, the BCCEDP database, death certificates, and the US Census and identified 26,426 women aged 40 to 64 years who had been diagnosed with incident invasive breast cancer during the years 2002-2008 (deaths through 2010). The study groups were as follows: BCCEDP participants (1-time or repeat users), Medicaid beneficiaries (women enrolled in Medicaid before their cancer diagnosis [Medicaid/prediagnosis] or around the time of their cancer diagnosis [Medicaid/peridiagnosis]), and all others (women identified as neither BCCEDP participants nor Medicaid beneficiaries). The outcomes included advanced-stage cancer at diagnosis and mortality. A multivariable logistic and survival analysis was conducted to examine the independent association between the BCCEDP and Medicaid status and the outcomes. The percentage of women presenting with advanced-stage disease was highest among women in the Medicaid/peridiagnosis group (63.4%) and lowest among BCCEDP repeat users (38.6%). With adjustments for potential confounders and even in comparison with Medicaid/prediagnosis beneficiaries, those in the Medicaid/peridiagnosis group were twice as likely to be diagnosed with advanced-stage disease (adjusted odds ratio, 2.20; 95% confidence interval, 1.83-2.66). Medicaid/peridiagnosis women are at particularly high risk to be diagnosed with advanced-stage disease. Efforts to reduce breast cancer disparities must target this group of women before they present to Medicaid. Cancer 2017;123:3097-106. © 2017 American Cancer Society
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77 FR 13697 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2
2012-03-07
..., decreases in length of stay, increased patient safety, and reduced medical errors. There is evidence to... Medicaid section of this proposed rule (which relate to calculations of patient volume and hospital... Building is not readily available to persons without Federal government identification, commenters are...
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Economic impacts of Medicaid in North Carolina.
Dumas, Christopher; Hall, William; Garrett, Patricia
2008-01-01
The purpose of this study is to provide estimates of the economic impacts of Medicaid program expenditures in North Carolina in state fiscal year (SFY) 2003. The study uses input-output analysis to estimate the economic impacts of Medicaid expenditures. The study uses North Carolina Medicaid program expenditure data for SFY 2003 as submitted by the North Carolina Division of Medical Assistance to the federal Centers for Medicare and Medicaid Services (CMS). Industry structure data from 2002 that are part of the IMPLAN input-output modeling software database are also used in the analysis. In SFY 2003 $6.307 billion in Medicaid program expenditures occurred within the state of North Carolina-$3.941 billion federal dollars, $2.014 billion state dollars, and $351 million in local government funds. Each dollar of state and local government expenditures brought $1.67 in federal Medicaid cost-share to the state. The economic impacts within North Carolina of the 2003 Medicaid expenditures included the following: 182,000 jobs supported (including both full-time and some part-time jobs); $6.1 billion in labor income (wages, salaries, sole proprietorship/partnership profits); and $1.9 billion in capital income (rents, interest payments, corporate dividend payments). If the Medicaid program were shut down and the funds returned to taxpayers who saved/spent the funds according to typical consumer expenditure patterns, employment in North Carolina would fall by an estimated 67,400 jobs, and labor income would fall by $2.83 billion, due to the labor-intensive nature of Medicaid expenditures. Medicaid expenditure and economic impact results do not capture the economic value of the improved health and well-being of Medicaid recipients. Furthermore, the results do not capture the savings to society from increased preventive care and reduced uncompensated care resulting from Medicaid. State and local government expenditures do not fully capture the economic consequences of Medicaid
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2010-10-05
... Airworthiness Directives; McDonnell Douglas Corporation Model DC- 10-30, DC-10-30F, DC-10-30F (KC-10A and KDC-10...-13 McDonnell Douglas Corporation: Amendment 39-16448; Docket No. FAA-2010-0553; Directorate.... Applicability (c) This AD applies to McDonnell Douglas Corporation Model DC- 10-30, DC-10-30F, DC-10-30F (KC-10A...
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46 CFR 30.10-50 - Pilot boarding equipment and point of access.
2010-10-01
... 46 Shipping 1 2010-10-01 2010-10-01 false Pilot boarding equipment and point of access. 30.10-50... Definitions § 30.10-50 Pilot boarding equipment and point of access. (a) Pilot boarding equipment means a... boarding equipment. [CGD 79-032, 49 FR 25455, June 21, 1984] ...
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Medicaid CHIP Environmental Scanning and Program Char...
U.S. Department of Health & Human Services — ESPC development is sponsored by the CMS Center for Medicare and Medicaid Innovation in partnership with the Center for Medicaid and CHIP Services (CMCS) under the...
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Medicaid Financial Management Data – National Totals
U.S. Department of Health & Human Services — This dataset reports summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP programs. These state...
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Schubart, Jane R.; Camacho, Fabian; Leslie, Douglas
2014-01-01
This study characterized psychotropic medication use among Medicaid-enrolled children and adolescents with autism spectrum disorders by examining trends over time, including length of treatment and polypharmacy using 4 years of administrative claims data from 41 state Medicaid programs (2000-2003). The data set included nearly 3 million children…
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Galaxy-galaxy weak gravitational lensing in f(R) gravity
Li, Baojiu; Shirasaki, Masato
2018-03-01
We present an analysis of galaxy-galaxy weak gravitational lensing (GGL) in chameleon f(R) gravity - a leading candidate of non-standard gravity models. For the analysis, we have created mock galaxy catalogues based on dark matter haloes from two sets of numerical simulations, using a halo occupation distribution (HOD) prescription which allows a redshift dependence of galaxy number density. To make a fairer comparison between the f(R) and Λ cold dark matter (ΛCDM) models, their HOD parameters are tuned so that the galaxy two-point correlation functions in real space (and therefore the projected two-point correlation functions) match. While the f(R) model predicts an enhancement of the convergence power spectrum by up to ˜ 30 per cent compared to the standard ΛCDM model with the same parameters, the maximum enhancement of GGL is only half as large and less than 5 per cent on separations above ˜1-2 h-1 Mpc, because the latter is a cross-correlation of shear (or matter, which is more strongly affected by modified gravity) and galaxy (which is weakly affected given the good match between galaxy autocorrelations in the two models) fields. We also study the possibility of reconstructing the matter power spectrum by combination of GGL and galaxy clustering in f(R) gravity. We find that the galaxy-matter cross-correlation coefficient remains at unity down to ˜2-3 h-1 Mpc at relevant redshifts even in f(R) gravity, indicating joint analysis of GGL and galaxy clustering can be a powerful probe of matter density fluctuations in chameleon gravity. The scale dependence of the model differences in their predictions of GGL can potentially allows us to break the degeneracy between f(R) gravity and other cosmological parameters such as Ωm and σ8.
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Effect of Medicaid disease management programs on emergency admissions and inpatient costs.
Conti, Matthew S
2013-08-01
To determine the impact of state Medicaid diabetes disease management programs on emergency admissions and inpatient costs. National InPatient Sample sponsored by the Agency for Healthcare Research and Quality Project for the years from 2000 to 2008 using 18 states. A difference-in-difference methodology compares costs and number of emergency admissions for Washington, Texas, and Georgia, which implemented disease management programs between 2000 and 2008, to states that did not undergo the transition to managed care (N = 103). Costs and emergency admissions were extracted for diabetic Medicaid enrollees diagnosed in the reform and non-reform states and collapsed into state and year cells. In the three treatment states, the implementation of disease management programs did not have statistically significant impacts on the outcome variables when compared to the control states. States that implemented disease management programs did not achieve improvements in costs or the number of emergency of admissions; thus, these programs do not appear to be an effective way to reduce the burden of this chronic disease. © Health Research and Educational Trust.
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42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).
2010-10-01
... Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b... coordination between a State child health program and other public health insurance programs. (b) Obligations...
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The Medicaid personal care services program: implications for social work practice.
Oktay, J S; Palley, H A
1991-05-01
Results of a survey of Medicaid personal care programs in 15 states and the District of Columbia in 1987 show that these programs suffer from many problems. Low wages and slow payment make recruitment and retention of qualified workers difficult. Other problems include lack of coordination among agencies, lack of adequate standards for training or supervision of workers, unequal access to programs, and inequities among states. Implications for social workers are discussed.
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2013-05-03
... general questions concerning each of the addenda published in this notice. [GRAPHIC] [TIFF OMITTED... Medicaid beneficiaries, health care providers, and the public; and (2) maintaining effective communications... 26040
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2013-11-08
... to answer general questions concerning each of the addenda published in this notice. [GRAPHIC] [TIFF... Medicaid beneficiaries, health care providers, and the public; and (2) maintaining effective communications... [[Page 67155
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Physical attributes of anisotropic compact stars in f(R, G) gravity
Energy Technology Data Exchange (ETDEWEB)
Shamir, M.F.; Zia, Saeeda [National University of Computer and Emerging Sciences, Department of Sciences and Humanities, Lahore (Pakistan)
2017-07-15
Modified gravity is one of the potential candidates to explain the accelerated expansion of the universe. Current study highlights the materialization of anisotropic compact stars in the context of f(R, G) theory of gravity. In particular, to gain insight in the physical behavior of three stars namely, Her X1, SAX J 1808-3658 and 4U 1820-30, energy density, and radial and tangential pressures are calculated. The f(R, G) gravity model is split into a Starobinsky like f(R) model and a power law f(G) model. The main feature of the work is a 3-dimensional graphical analysis in which, anisotropic measurements, energy conditions and stability attributes of these stars are discussed. It is shown that all three stars behave as usual for positive values of the f(G) model parameter n. (orig.)
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f(R) gravity solutions for evolving wormholes
Energy Technology Data Exchange (ETDEWEB)
Bhattacharya, Subhra [Presidency University, Department of Mathematics, Kolkata (India); Chakraborty, Subenoy [Jadavpur University, Department of Mathematics, Kolkata (India)
2017-08-15
The scalar-tensor f(R) theory of gravity is considered in the framework of a simple inhomogeneous space-time model. In this research we use the reconstruction technique to look for possible evolving wormhole solutions within viable f(R) gravity formalism. These f(R) models are then constrained so that they are consistent with existing experimental data. Energy conditions related to the matter threading the wormhole are analyzed graphically and are in general found to obey the null energy conditions (NEC) in regions around the throat, while in the limit f(R) = R, NEC can be violated at large in regions around the throat. (orig.)
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42 CFR 430.3 - Appeals under Medicaid.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Appeals under Medicaid. 430.3 Section 430.3 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 430.3 Appeals under Medicaid. Three distinct types of disputes may arise under Medicaid. (a...
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42 CFR 435.930 - Furnishing Medicaid.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Furnishing Medicaid. 435.930 Section 435.930 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED..., AND AMERICAN SAMOA Eligibility in the States and District of Columbia Furnishing Medicaid § 435.930...
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Oregon state university's advanced plant experiment (APEX) AP1000 integral facility test program
International Nuclear Information System (INIS)
Reyes, J.N.; Groome, J.T.; Woods, B.G.; Young, E.; Abel, K.; Wu, Q.
2005-01-01
Oregon State University (OSU) has recently completed a three year study of the thermal hydraulic behavior of the Westinghouse AP1000 passive safety systems. Eleven Design Basis Accident (DBA) scenarios, sponsored by the U.S. Department of Energy (DOE) with technical support from Westinghouse Electric, were simulated in OSU's Advanced Plant Experiment (APEX)-1000. The OSU test program was conducted within the purview of the requirements of 10CFR50 Appendix B, NQA-1 and 10 CFR 21 and the test data was used to provide benchmarks for computer codes used in the final design approval of the AP1000. In addition to the DOE certification testing, OSU conducted eleven confirmatory tests for the U.S. Nuclear Regulatory Commission. This paper presents the test program objectives, a description of the APEX-1000 test facility and an overview of the test matrix that was conducted in support of plant certification. (authors)
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45 CFR 162.1901 - Medicaid pharmacy subrogation transaction.
2010-10-01
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Medicaid pharmacy subrogation transaction. 162... STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1901 Medicaid pharmacy subrogation transaction. The Medicaid pharmacy subrogation transaction is the...
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AP1000, a nuclear central of advanced design; AP1000, una central nuclear de diseno avanzado
Energy Technology Data Exchange (ETDEWEB)
Hernandez M, N.; Viais J, J. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)]. e-mail: nhm@nuclear.inin.mx
2005-07-01
The AP1000 is a design of a nuclear reactor of pressurized water (PWR) of 1000 M We with characteristic of safety in a passive way; besides presenting simplifications in the systems of the plant, the construction, the maintenance and the safety, the AP1000 is a design that uses technology endorsed by those but of 30 years of operational experience of the PWR reactors. The program AP1000 of Westinghouse is focused to the implementation of the plant to provide improvements in the economy of the same one and it is a design that is derived directly of the AP600 designs. On September 13, 2004 the US-NRC (for their initials in United States- Nuclear Regulatory Commission) approved the final design of the AP1000, now Westinghouse and the US-NRC are working on the whole in a complete program for the certification. (Author)
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AP1000R licensing and deployment in the United States
International Nuclear Information System (INIS)
Jordan, R. P.; Russ, P. A.; Filiak, P. P.; Castiglione, L. L.
2012-01-01
In recent years, both domestic and foreign utilities have turned to the standardized Westinghouse AP1000 plant design in satisfying their near - and long-term - sustainable energy needs. As direct support to these actions, licensing the AP1000 design has played a significant role by providing one of the fundamental bases in clearing regulatory hurdles leading to the start of new plant construction. Within the U.S. alone, Westinghouse AP1000 licensing activities have reached unprecedented milestones with the approvals of both AP1000 Design Certification and Southern Company's combined construction permit and operating license (COL) application directly supporting the construction of two new nuclear plants in Georgia. Further COL application approvals are immediately pending for an additional two AP1000 plants in South Carolina. And, across the U.S. nuclear industry spectrum, there are 10 other COL applications under regulatory review representing some 16 new plants at 10 sites. In total, these actions represent the first wave of new plant licensing under the regulatory approval process since 1978. Fundamental to the Nuclear Regulatory Commission's AP1000 Design Certification is the formal recognition of the AP1000 passive safety design through regulatory acceptance rulemaking. Through recognition and deployment of the AP1000 Design Certification, the utility licensee / operator of this reactor design are now offered an opportunity to use a simplified 'one-step' combined license process, thereby managing substantial back-end construction schedule risk from regulatory and intervention delays. Application of this regulatory philosophy represents both acceptance and encouragement of standardized reactor designs like the AP1000. With the recent AP1000 Design Certification and utility COL acceptances, the fundamental licensing processes of this philosophy have successfully proven the attainment of significant milestones with the next stage licensing actions directed
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Understanding the recent growth in Medicaid spending, 2000-2003.
Holahan, John; Ghosh, Arunabh
2005-01-01
Growth in Medicaid spending averaged 10.2 percent per year between 2000 and 2003, resulting in a one-third increase in program spending. Spending growth was lower from 2002 to 2003 because of slower growth in enrollment and in spending per enrollee, particularly for acute care services, and declines in disproportionate-share hospital (DSH) payments and upper payment limit (UPL) programs. For the entire 2000-2003 period, Medicaid spending increases were largely driven by enrollment growth, much of which was attributable to the economic downturn. Increases in spending per enrollee over the period were faster than inflation but slower than increases in private insurance spending.
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Pediatric Dentist Density and Preventive Care Utilization for Medicaid Children.
Heidenreich, James F; Kim, Amy S; Scott, JoAnna M; Chi, Donald L
2015-01-01
The purpose of this study was to evaluate county-level pediatric dentist density and dental care utilization for Medicaid-enrolled children. This was a cross-sectional analysis of 604,885 zero- to 17-year-olds enrolled in the Washington State Medicaid Program for 11-12 months in 2012. The relationship between county-level pediatric dentist density, defined as the number of pediatric dentists per 10,000 Medicaid-enrolled children, and preventive dental care utilization was evaluated using linear regression models. In 2012, 179 pediatric dentists practiced in 16 of the 39 counties in Washington. County-level pediatric dentist density varied from zero to 5.98 pediatric dentists per 10,000 Medicaid-enrolled children. County-level preventive dental care utilization ranged from 32 percent to 81 percent, with 62 percent of Medicaid-enrolled children utilizing preventive dental services. County-level density was significantly associated with county-level dental care utilization (Slope equals 1.67, 95 percent confidence interval equals 0.02, 3.32, Pchildren who utilize preventive dental care services. Policies aimed at improving pediatric oral health disparities should include strategies to increase the number of oral health care providers, including pediatric dentists, in geographic areas with large proportions of Medicaid-enrolled children.
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Exploring plane-symmetric solutions in f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Shamir, M. F., E-mail: farasat.shamir@nu.edu.pk [National University of Computer and Emerging Sciences, Department of Sciences and Humanities (Pakistan)
2016-02-15
The modified theories of gravity, especially the f(R) gravity, have attracted much attention in the last decade. This paper is devoted to exploring plane-symmetric solutions in the context of metric f(R) gravity. We extend the work on static plane-symmetric vacuum solutions in f(R) gravity already available in the literature [1, 2]. The modified field equations are solved using the assumptions of both constant and nonconstant scalar curvature. Some well-known solutions are recovered with power-law and logarithmic forms of f(R) models.
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2011-07-18
...) 786-4533, and Jana Lindquist, (410) 786-4533, Partial hospitalization and community mental health... Laboratory Fee Schedule CMHC Community Mental Health Center CMS Centers for Medicare & Medicaid Services CPT... community mental health centers (CMHCs)) and hospital outpatient services that are furnished to inpatients...
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Medicaid Enrollment Gap Length and Number of Medicaid Enrollment Periods Among US Children
Schoendorf, Kenneth C.
2014-01-01
Objectives. We examined gap length, characteristics associated with gap length, and number of enrollment periods among Medicaid-enrolled children in the United States. Methods. We linked the 2004 National Health Interview Survey to Medicaid Analytic eXtract files for 1999 through 2008. We examined linkage-eligible children aged 5 to 13 years in the 2004 National Health Interview Survey who disenrolled from Medicaid. We generated Kaplan-Meier curves of time to reenrollment. We used Cox proportional hazards models to assess the effect of sociodemographic variables on time to reenrollment. We compared the percentage of children enrolled 4 or more times across sociodemographic groups. Results. Of children who disenrolled from Medicaid, 35.8%, 47.1%, 63.5%, 70.8%, and 79.1% of children had reenrolled in Medicaid by 6 months, 1, 3, 5, and 10 years, respectively. Children who were younger, poorer, or of minority race/ethnicity or had lower educated parents had shorter gaps in Medicaid and were more likely to have had 4 or more Medicaid enrollment periods. Conclusions. Nearly half of US children who disenrolled from Medicaid reenrolled within 1 year. Children with traditionally high-risk demographic characteristics had shorter gaps in Medicaid enrollment and were more likely to have more periods of Medicaid enrollment. PMID:25033135
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Bian, Boyang; Kelton, Christina M L; Guo, Jeff J; Wigle, Patricia R
2010-01-01
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are widely prescribed for the treatment of hypertension and heart failure, as well as for kidney disease prevention in patients with diabetes mellitus and the management of patients after myocardial infarction. To (a) describe ACE inhibitor and ARB utilization and spending in the Medicaid fee-for-service program from 1991 through 2008, and (b) estimate the potential cost savings for the collective Medicaid programs from a higher ratio of generic ACE inhibitor utilization. A retrospective, descriptive analysis was performed using the National Summary Files from the Medicaid State Drug Utilization Data, which are composed of pharmacy claims that are subject to federally mandated rebates from pharmaceutical manufacturers. For the years 1991-2008, quarterly claim counts and expenditures were calculated by summing data for individual ACE inhibitors and ARBs. Quarterly per-claim expenditure as a proxy for drug price was computed for all brand and generic drugs. Market shares were calculated based on the number of pharmacy claims and Medicaid expenditures. In the Medicaid fee-for-service program, ACE inhibitors accounted for 100% of the claims in the combined market for ACE inhibitors and ARBs in 1991, 80.6% in 2000, and 64.7% in 2008. The Medicaid expenditure per ACE inhibitor claim dropped from $37.24 in 1991 to $24.03 in 2008 when generics accounted for 92.5% of ACE inhibitor claims; after adjusting for inflation for the period from 1991 to 2008, the real price drop was 59.2%. Brand ACE inhibitors accounted for only 7.5% of the claims in 2008 for all ACE inhibitors but 32.1% of spending; excluding the effects of manufacturer rebates, Medicaid spending would have been reduced by $28.7 million (9%) in 2008 if all ACE inhibitor claims were generic. The average price per ACE inhibitor claim in 2008 was $24.03 ($17.64 per generic claim vs. $103.45 per brand claim) versus $81.98 per ARB
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AP1000{sup R} severe accident features and post-Fukushima considerations
Energy Technology Data Exchange (ETDEWEB)
Scobel, J. H.; Schulz, T. L.; Williams, M. G. [Westinghouse Electric Company, LLC, 1000 Westinghouse Dr., Cranberry Township, PA 16066 (United States)
2012-07-01
The AP1000{sup R} passive nuclear power plant is uniquely equipped to withstand an extended station blackout scenario such as the events following the earthquake and tsunami at Fukushima without compromising core and containment integrity. The AP1000 plant shuts down the reactor, cools the core, containment and spent fuel pool for more than 3 days using passive systems that do not require AC or DC power or operator actions. Following this passive coping period, minimal operator actions are needed to extend the operation of the passive features to 7 days using installed equipment. To provide defense-in-depth for design extension conditions, the AP1000 plant has engineered features that mitigate the effects of core damage. Engineered features retain damaged core debris within the reactor vessel as a key feature. Other aspects of the design protect containment integrity during severe accidents, including unique features of the AP1000 design relative to passive containment cooling with water and air, and hydrogen management. (authors)
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Tumin, Dmitry; Beal, Eliza W; Mumtaz, Khalid; Hayes, Don; Tobias, Joseph D; Pawlik, Timothy M; Washburn, W Kenneth; Black, Sylvester M
2017-08-01
The 2014 Medicaid expansion in participating states increased insurance coverage among people with chronic health conditions, but its implications for access to surgical care remain unclear. We investigated how Medicaid expansion influenced the insurance status of candidates for liver transplantation (LT) and transplant center payor mix. Data on LT candidates aged 18 to 64 years, in 2012 to 2013 (pre-expansion) and 2014 to 2015 (post-expansion), were obtained from the United Network for Organ Sharing registry. Change between the 2 periods in the percent of LT candidates using Medicaid was compared between expansion and nonexpansion states. Multivariable logistic regression was used to determine how Medicaid expansion influenced individual LT candidates' likelihood of using Medicaid insurance. The study included 33,017 LT candidates, of whom 29,666 had complete data for multivariable analysis. Medicaid enrollment increased by 4% after Medicaid expansion in participating states. One-quarter of the transplant centers in these states experienced ≥10% increase in the proportion of LT candidates using Medicaid insurance. Multivariable analysis confirmed that Medicaid expansion was associated with increased odds of LT candidates using Medicaid insurance (odds ratio 1.49; 95% CI 1.34, 1.66; p Medicaid expansion states during the post-expansion period. Candidates for LT became more likely to use Medicaid after the 2014 Medicaid expansion policy came into effect. Enactment of this policy did not appear to increase access to LT or address socioeconomic and demographic disparities in access to the LT wait list. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
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2013-04-02
... Care Act expanded Medicaid eligibility from 100 percent of the Federal Poverty Level (FPL) to 133... FMAP. Although some commenters supported flexibility in concept, the overall position favored in the...
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2010-04-23
... within a reasonable distance of the facility; Assures that an adequate environment exists for operating... final rule on these operational issues, we will work with all interested stakeholders to develop the..., Health Records, Medicaid, Medicare, Nursing [[Page 21179
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Medicaid provider reimbursement policy for adult immunizations.
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.
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Medicaid provider reimbursement policy for adult immunizations☆
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
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Barriers to Medicaid Participation among Florida Dentists
Logan, Henrietta L.; Catalanotto, Frank; Guo, Yi; Marks, John; Dharamsi, Shafik
2015-01-01
Background Finding dentists who treat Medicaid-enrolled children is a struggle for many parents. The purpose of this study was to identify non-reimbursement factors that influence the decision by dentists about whether or not to participate in the Medicaid program in Florida. Methods Data from a mailed survey was analyzed using a logistic regression model to test the association of Medicaid participation with the Perceived Barriers and Social Responsibility variables. Results General and pediatric dentists (n=882) who identified themselves as either Medicaid (14%) or Non-Medicaid (86%) participants responded. Five items emerged as significant predictors of Medicaid participation, with a final concordance index of 0.905. Two previously unreported barriers to participation in Medicaid emerged: 1) dentists’ perception of social stigma from other dentists for participating in Medicaid, and 2) the lack of specialists to whom Medicaid patients can be referred. Conclusions This study provides new information about non-reimbursement barriers to Medicaid participation. PMID:25702734
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75 FR 39641 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes
2010-07-12
... law judge (ALJ) reverses the civil money penalty determination in whole or in part, the escrowed..., widespread harm, or resulting in a resident's death is not eligible for the civil money penalty reduction... Penalties for Nursing Homes AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed...
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Disentangling the f(R). Duality
International Nuclear Information System (INIS)
Broy, Benedict J.; Westphal, Alexander; Pedro, Francisco G.; Univ. Autonoma de Madrid
2014-11-01
Motivated by UV realisations of Starobinsky-like inflation models, we study generic exponential plateau-like potentials to understand whether an exact f(R)-formulation may still be obtained when the asymptotic shift-symmetry of the potential is broken for larger field values. Potentials which break the shift symmetry with rising exponentials at large field values only allow for corresponding f(R)-descriptions with a leading order term R n with 1 2 -term survives as part of a series expansion of the function f(R) and thus cannot maintain a plateau for all field values. We further find a lean and instructive way to obtain a function f(R) describing m 2 φ 2 -inflation which breaks the shift symmetry with a monomial, and corresponds to effectively logarithmic corrections to an R+R 2 model. These examples emphasise that higher order terms in f(R)-theory may not be neglected if they are present at all. Additionally, we relate the function f(R) corresponding to chaotic inflation to a more general Jordan frame set-up. In addition, we consider f(R)-duals of two given UV examples, both from supergravity and string theory. Finally, we outline the CMB phenomenology of these models which show effects of power suppression at low-l.
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Geodesic congruences in the Palatini f(R) theory
International Nuclear Information System (INIS)
Shojai, Fatimah; Shojai, Ali
2008-01-01
We shall investigate the properties of a congruence of geodesics in the framework of Palatini f(R) theories. We shall evaluate the modified geodesic deviation equation and the Raychaudhuri's equation and show that f(R) Palatini theories do not necessarily lead to attractive forces. Also, we shall study energy condition for f(R) Palatini gravity via a perturbative analysis of the Raychaudhuri's equation.
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Single women and the dynamics of Medicaid.
Short, P F; Freedman, V A
1998-01-01
OBJECTIVE: To investigate transitions in and out of Medicaid for a cohort of single adult women of childbearing age in order to address questions that arise as policymakers try to encourage transitions from welfare to work. DATA SOURCES: Longitudinal data from Waves 2 through 8 of the 1990 panel of the Survey of Income and Program Participation, a nationally representative survey of American adults covering May 1990-1992. STUDY DESIGN: We estimate a series of discrete-time logit models with duration dependence to obtain transition probabilities among Medicaid, privately insured, and uninsured spells. Explanatory variables in the models include prior insurance history, income limits on Medicaid by state, and important socioeconomic and demographic characteristics. We use these models to characterize insurance spells for a cohort of single women. PRINCIPAL FINDINGS: Most Medicaid spells are relatively short. Over half end in a year or less; only one spell out of seven lasts longer than five years. Two-thirds of Medicaid disenrollees become uninsured. Former welfare recipients are prone to frequent changes in insurance status. In states with more generous income limits for AFDC, women stay on Medicaid longer, but they do not move into the program at a faster rate. CONCLUSIONS: Imposing time limits on Medicaid eligibility would affect only a small proportion of Medicaid spells but would eliminate a significant proportion of the caseload at a point in time. In considering changes in Medicaid that would encourage transitions from welfare to work and would alter the dynamics of Medicaid, policymakers need to consider how transitions both in and out of private insurance and Medicaid would be affected. Images Figure 2 Figure 3 Figure 4 PMID:9865222
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Clustering of galaxies with f(R) gravity
Capozziello, Salvatore; Faizal, Mir; Hameeda, Mir; Pourhassan, Behnam; Salzano, Vincenzo; Upadhyay, Sudhaker
2018-02-01
Based on thermodynamics, we discuss the galactic clustering of expanding Universe by assuming the gravitational interaction through the modified Newton's potential given by f(R) gravity. We compute the corrected N-particle partition function analytically. The corrected partition function leads to more exact equations of state of the system. By assuming that the system follows quasi-equilibrium, we derive the exact distribution function that exhibits the f(R) correction. Moreover, we evaluate the critical temperature and discuss the stability of the system. We observe the effects of correction of f(R) gravity on the power-law behaviour of particle-particle correlation function also. In order to check the feasibility of an f(R) gravity approach to the clustering of galaxies, we compare our results with an observational galaxy cluster catalogue.
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Nonlinear evolution of f(R) cosmologies. I. Methodology
International Nuclear Information System (INIS)
Oyaizu, Hiroaki
2008-01-01
We introduce the method and the implementation of a cosmological simulation of a class of metric-variation f(R) models that accelerate the cosmological expansion without a cosmological constant and evade solar-system bounds of small-field deviations to general relativity. Such simulations are shown to reduce to solving a nonlinear Poisson equation for the scalar degree of freedom introduced by the f(R) modifications. We detail the method to efficiently solve the nonlinear Poisson equation by using a Newton-Gauss-Seidel relaxation scheme coupled with the multigrid method to accelerate the convergence. The simulations are shown to satisfy tests comparing the simulated outcome to analytical solutions for simple situations, and the dynamics of the simulations are tested with orbital and Zeldovich collapse tests. Finally, we present several static and dynamical simulations using realistic cosmological parameters to highlight the differences between standard physics and f(R) physics. In general, we find that the f(R) modifications result in stronger gravitational attraction that enhances the dark matter power spectrum by ∼20% for large but observationally allowed f(R) modifications. A more detailed study of the nonlinear f(R) effects on the power spectrum are presented in a companion paper.
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Solar System constraints to general f(R) gravity
International Nuclear Information System (INIS)
Chiba, Takeshi; Smith, Tristan L.; Erickcek, Adrienne L.
2007-01-01
It has been proposed that cosmic acceleration or inflation can be driven by replacing the Einstein-Hilbert action of general relativity with a function f(R) of the Ricci scalar R. Such f(R) gravity theories have been shown to be equivalent to scalar-tensor theories of gravity that are incompatible with Solar System tests of general relativity, as long as the scalar field propagates over Solar System scales. Specifically, the parameterized post-Newtonian (PPN) parameter in the equivalent scalar-tensor theory is γ=1/2, which is far outside the range allowed by observations. In response to a flurry of papers that questioned the equivalence of f(R) theory to scalar-tensor theories, it was recently shown explicitly, without resorting to the scalar-tensor equivalence, that the vacuum field equations for 1/R gravity around a spherically symmetric mass also yield γ=1/2. Here we generalize this analysis to f(R) gravity and enumerate the conditions that, when satisfied by the function f(R), lead to the prediction that γ=1/2
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f(R) gravity and chameleon theories
International Nuclear Information System (INIS)
Brax, Philippe; Bruck, Carsten van de; Davis, Anne-Christine; Shaw, Douglas J.
2008-01-01
We analyze f(R) modifications of Einstein's gravity as dark energy models in the light of their connection with chameleon theories. Formulated as scalar-tensor theories, the f(R) theories imply the existence of a strong coupling of the scalar field to matter. This would violate all experimental gravitational tests on deviations from Newton's law. Fortunately, the existence of a matter dependent mass and a thin-shell effect allows one to alleviate these constraints. The thin-shell condition also implies strong restrictions on the cosmological dynamics of the f(R) theories. As a consequence, we find that the equation of state of dark energy is constrained to be extremely close to -1 in the recent past. We also examine the potential effects of f(R) theories in the context of the Eoet-wash experiments. We show that the requirement of a thin shell for the test bodies is not enough to guarantee a null result on deviations from Newton's law. As long as dark energy accounts for a sizeable fraction of the total energy density of the Universe, the constraints that we deduce also forbid any measurable deviation of the dark energy equation of state from -1. All in all, we find that both cosmological and laboratory tests imply that f(R) models are almost coincident with a ΛCDM model at the background level.
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2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Approval of the State Medicaid HIT plan, the HIT PAPD and update, the HIT IAPD and update, and the annual HIT IAPD. 495.344 Section 495.344 Public... Requirements Specific to the Medicaid Program § 495.344 Approval of the State Medicaid HIT plan, the HIT PAPD...
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Stellar equilibrium configurations of white dwarfs in the f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Carvalho, G.A.; Moraes, P.H.R.S.; Marinho, R.M.; Malheiro, M. [Instituto Tecnologico de Aeronautica, Departamento de Fisica, Sao Jose dos Campos, SP (Brazil); Lobato, R.V. [Instituto Tecnologico de Aeronautica, Departamento de Fisica, Sao Jose dos Campos, SP (Brazil); Sapienza Universita di Roma, Dipartimento di Fisica, Rome (Italy); ICRANet, Pescara (Italy); Arbanil, Jose D.V. [Universidad Privada del Norte, Departamento de Ciencias, Lima (Peru); Otoniel, E. [Universidade Federal do Cariri, Instituto de Formacao de Professores, Brejo Santo, CE (Brazil)
2017-12-15
In this work we investigate the equilibrium configurations of white dwarfs in a modified gravity theory, namely, f(R, T) gravity, for which R and T stand for the Ricci scalar and trace of the energy-momentum tensor, respectively. Considering the functional form f(R, T) = R+2λT, with λ being a constant, we obtain the hydrostatic equilibrium equation for the theory. Some physical properties of white dwarfs, such as: mass, radius, pressure and energy density, as well as their dependence on the parameter λ are derived. More massive and larger white dwarfs are found for negative values of λ when it decreases. The equilibrium configurations predict a maximum mass limit for white dwarfs slightly above the Chandrasekhar limit, with larger radii and lower central densities when compared to standard gravity outcomes. The most important effect of f(R, T) theory for massive white dwarfs is the increase of the radius in comparison with GR and also f(R) results. By comparing our results with some observational data of massive white dwarfs we also find a lower limit for λ, namely, λ > -3 x 10{sup -4}. (orig.)
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AP190L and PDP-KI10: a hardware/software measurement report
International Nuclear Information System (INIS)
Maron, N.; Sutherland, G.G.
1979-01-01
This report discusses an AP190L array processor (manufactured by Floating Point Systems of Beaverton, Oregon) interfaced to a PDP-10 (Digital Equipment Corporation, Maynard, Mass.). After AP software installation, an analysis of the overhead was performed. The results of these measurements and some conclusions are presented. An AP monitor and software interface were written to minimize the overhead from the PDP-10. A vector extension to the FORTRAN language called FIVE was developed to increase user access to the AP. Some of the problems associated with defining and implementing FIVE are discussed. Its successes and limitations are reviewed. 2 figures, 2 tables
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2010-04-01
.... Sales Practice Standards. In 1982, Congress reaffirmed the importance of minimum sales practice... the sharing of information. Marketing Activities by Firms Granted Rule 30.10 Relief FR date and...
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Dynamics of anisotropic power-law f(R) cosmology
International Nuclear Information System (INIS)
Shamir, M. F.
2016-01-01
Modified theories of gravity have attracted much attention of the researchers in the recent years. In particular, the f(R) theory has been investigated extensively due to important f(R) gravity models in cosmological contexts. This paper is devoted to exploring an anisotropic universe in metric f(R) gravity. A locally rotationally symmetric Bianchi type I cosmological model is considered for this purpose. Exact solutions of modified field equations are obtained for a well-known f(R) gravity model. The energy conditions are also discussed for the model under consideration. The viability of the model is investigated via graphical analysis using the present-day values of cosmological parameters. The model satisfies null energy, weak energy, and dominant energy conditions for a particular range of the anisotropy parameter while the strong energy condition is violated, which shows that the anisotropic universe in f(R) gravity supports the crucial issue of accelerated expansion of the universe.
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Dynamics of anisotropic power-law f(R) cosmology
Energy Technology Data Exchange (ETDEWEB)
Shamir, M. F., E-mail: farasat.shamir@nu.edu.pk [National University of Computer and Emerging Sciences, Lahore Campus, Department of Sciences and Humanities (Pakistan)
2016-12-15
Modified theories of gravity have attracted much attention of the researchers in the recent years. In particular, the f(R) theory has been investigated extensively due to important f(R) gravity models in cosmological contexts. This paper is devoted to exploring an anisotropic universe in metric f(R) gravity. A locally rotationally symmetric Bianchi type I cosmological model is considered for this purpose. Exact solutions of modified field equations are obtained for a well-known f(R) gravity model. The energy conditions are also discussed for the model under consideration. The viability of the model is investigated via graphical analysis using the present-day values of cosmological parameters. The model satisfies null energy, weak energy, and dominant energy conditions for a particular range of the anisotropy parameter while the strong energy condition is violated, which shows that the anisotropic universe in f(R) gravity supports the crucial issue of accelerated expansion of the universe.
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Kahn, J G; Haile, B; Kates, J; Chang, S
2001-09-01
OBJECTIVES. This study modeled the health and federal fiscal effects of expanding Medicaid for HIV-infected people to improve access to highly active antiretroviral therapy. A disease state model of the US HIV epidemic, with and without Medicaid expansion, was used. Eligibility required a CD4 cell count less than 500/mm3 or viral load greater than 10,000, absent or inadequate medication insurance, and annual income less than $10,000. Two benefits were modeled, "full" and "limited" (medications, outpatient care). Federal spending for Medicaid, Medicare, AIDS Drug Assistance Program, Supplemental Security Income, and Social Security Disability Insurance were assessed. An estimated 38,000 individuals would enroll in a Medicaid HIV expansion. Over 5 years, expansion would prevent an estimated 13,000 AIDS diagnoses and 2600 deaths and add 5,816 years of life. Net federal costs for all programs are $739 million (full benefits) and $480 million (limited benefits); for Medicaid alone, the costs are $1.43 and $1.17 billion, respectively. Results were sensitive to awareness of serostatus, highly active antiretroviral therapy cost, and participation rate. Strategies for federal cost neutrality include Medicaid HIV drug price reductions as low as 9% and private insurance buy-ins. Expansion of the Medicaid eligibility to increase access to antiretroviral therapy would have substantial health benefits at affordable costs.
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Divergent Synthesis of Revised Apratoxin E, 30-epi-Apratoxin E, and 30S/30R-Oxoapratoxin E.
Mao, Zhuo-Ya; Si, Chang-Mei; Liu, Yi-Wen; Dong, Han-Qing; Wei, Bang-Guo; Lin, Guo-Qiang
2017-10-20
In this report, originally proposed apratoxin E (30S-7), revised apratoxin E (30R-7), and (30S)/(30R)-oxoapratoxin E (30S)-38/(30R)-38 were efficiently prepared by two synthetic methods. The chiral lactone 10, recycled from the degradation of saponin glycosides, was utilized to prepare the key nonpeptide fragment 9. Our alternative convergent assembly strategy was applied to the divergent synthesis of revised apratoxin E and its three analogues. Moreover, ring-closing metathesis (RCM) was for the first time found to be an efficient strategy for the macrocyclization of apratoxins.
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42 CFR 430.45 - Reduction of Federal Medicaid payments.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Reduction of Federal Medicaid payments. 430.45 Section 430.45 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Federal Medicaid Payments § 430.45 Reduction of Federal Medicaid payments. (a) Methods of reduction. CMS...
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45 CFR 400.94 - Determination of eligibility for Medicaid.
2010-10-01
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Determination of eligibility for Medicaid. 400.94... Determination of eligibility for Medicaid. (a) The State must determine Medicaid and SCHIP eligibility under its Medicaid and SCHIP State plans for each individual member of a family unit that applies for medical...
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Improving access for Medicaid-insured children: focus on front-office personnel.
Lam, M; Riedy, C A; Milgrom, P
1999-03-01
Access to dental services for low-income children is limited. Front-office personnel play a role regarding dentists' participation in the Medicaid program. Subjects (N = 24) represented general dental offices in Spokane County, Wash., and included participants and nonparticipants in the Access to Baby and Child Dentistry, or ABCD, program, a dental society/community program aimed at expanding dental services provided to Medicaid-insured children. The authors stratified the participants according to the number of claims their practices submitted to Medicaid for ABCD children: non-ABCD, low-ABCD and high-ABCD. Five two-hour focus group sessions were conducted to determine participants' beliefs about, attitudes toward and experiences in serving this population. The authors' data analysis consisted of a comprehensive content review of participants' responses from transcripted audiotapes. They synthesized frequently mentioned concepts and ideas into relevant themes. The major factors affecting practices' participation in Medicaid were office policy on seeing Medicaid-insured patients; staff members' personal connection to Medicaid-insured patients; staff members' attitudes about Medicaid-insured patients; and staff members' perceptions of Medicaid-insured patients' barriers to care. The data suggest that factors affecting dentists' participation in the Medicaid program are more complex than the often-stated dissatisfactions with low reimbursement fees and hassles with paperwork. Efforts to increase dentist participation in serving Medicaid-insured patients will continue to be relatively ineffective until many of the concerns raised by this study's subjects are better understood and addressed.
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Do Medicaid home and community based service waivers save money?
Harrington, Charlene; Ng, Terence; Kitchener, Martin
2011-10-01
This article estimates the potential savings to the Medicaid program of using 1915c Home and Community Based Services (HCBS) waivers rather than institutional care. For Medicaid HCBS waiver expenditures of $25 billion in 2006, we estimate the national savings to be over $57 billion, or $57,338 per waiver participant in 2006 compared with the cost of Medicaid institutional care (for which all waiver participants are eligible). When taking into account a potential 50% "woodwork effect" (for people who might have refused institutional services), the saving would be $21 billion. This analysis demonstrates that HCBS waiver programs present significant direct financial savings to Medicaid long-term care (LTC) programs.
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Wilk, Adam S; Evans, Leigh C; Jones, David K
2018-02-01
Six states that have rejected the Patient Protection and Affordable Care Act's (ACA) Medicaid expansion nonetheless extended the primary care "fee bump," by which the federal government increased Medicaid fees for primary care services up to 100 percent of Medicare fees during 2013-14. We conducted semistructured interviews with leaders in five of these states, as well as in three comparison states, to examine why they would continue a provision of the ACA that moderately expands access at significant state expense while rejecting the expansion and its large federal match, focusing on relevant economic, political, and procedural factors. We found that fee bump extension proposals were more successful where they were dissociated from major national policy debates, actionable with the input of relatively few stakeholder entities, and well aligned with preexisting policy-making structures and decision trends. Republican proposals to cap or reduce federal funding for Medicaid, if enacted, would compel states to contain program costs. In this context, states' established decision-making processes for updating Medicaid fee schedules, which we elucidate in this study, may shape the future of the Medicaid program. Copyright © 2018 by Duke University Press 2018.
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2016-03-30
This final rule will address the application of certain requirements set forth in the Public Health Service Act, as amended by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, to coverage offered by Medicaid managed care organizations, Medicaid Alternative Benefit Plans, and Children’s Health Insurance Programs.
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AP1000{sup R} licensing and deployment in the United States
Energy Technology Data Exchange (ETDEWEB)
Jordan, R. P.; Russ, P. A.; Filiak, P. P.; Castiglione, L. L. [Westinghouse Electric Company LLC, 1000 Westinghouse Drive, Cranberry Township, PA 16066 (United States)
2012-07-01
In recent years, both domestic and foreign utilities have turned to the standardized Westinghouse AP1000 plant design in satisfying their near - and long-term - sustainable energy needs. As direct support to these actions, licensing the AP1000 design has played a significant role by providing one of the fundamental bases in clearing regulatory hurdles leading to the start of new plant construction. Within the U.S. alone, Westinghouse AP1000 licensing activities have reached unprecedented milestones with the approvals of both AP1000 Design Certification and Southern Company's combined construction permit and operating license (COL) application directly supporting the construction of two new nuclear plants in Georgia. Further COL application approvals are immediately pending for an additional two AP1000 plants in South Carolina. And, across the U.S. nuclear industry spectrum, there are 10 other COL applications under regulatory review representing some 16 new plants at 10 sites. In total, these actions represent the first wave of new plant licensing under the regulatory approval process since 1978. Fundamental to the Nuclear Regulatory Commission's AP1000 Design Certification is the formal recognition of the AP1000 passive safety design through regulatory acceptance rulemaking. Through recognition and deployment of the AP1000 Design Certification, the utility licensee / operator of this reactor design are now offered an opportunity to use a simplified 'one-step' combined license process, thereby managing substantial back-end construction schedule risk from regulatory and intervention delays. Application of this regulatory philosophy represents both acceptance and encouragement of standardized reactor designs like the AP1000. With the recent AP1000 Design Certification and utility COL acceptances, the fundamental licensing processes of this philosophy have successfully proven the attainment of significant milestones with the next stage licensing
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76 FR 51147 - Medicaid Program; Eligibility Changes Under the Affordable Care Act of 2010
2011-08-17
.../MedicaidEligibility/downloads/CMS-2349-P-PreliminaryRegulatoryImpactAnalysis.pdf . A summary of the... Opportunity Reconciliation Act of 1996 QI Qualifying Individuals QMB Qualified Medicare Beneficiaries SHO... eligibility criteria, such as citizenship or satisfactory immigration status. Children and, in some States...
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Association Between Health Plan Exit From Medicaid Managed Care and Quality of Care, 2006-2014.
Ndumele, Chima D; Schpero, William L; Schlesinger, Mark J; Trivedi, Amal N
2017-06-27
State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences. To determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality. Retrospective cohort of all comprehensive Medicaid managed care plans (N = 390) during the interval 2006-2014. Plan exit, defined as the withdrawal of a managed care plan from a state's Medicaid program. Eight measures from the Healthcare Effectiveness Data and Information Set were used to construct 3 composite indicators of quality (preventive care, chronic disease care management, and maternity care). Four measures from the Consumer Assessment of Healthcare Providers and Systems were combined into a composite indicator of patient experience, reflecting the proportion of beneficiaries rating experiences as 8 or above on a 0-to-10-point scale. Outcome data were available for 248 plans (68% of plans operating prior to 2014, representing 78% of beneficiaries). Of the 366 comprehensive Medicaid managed care plans operating prior to 2014, 106 exited Medicaid. These exiting plans enrolled 4 848 310 Medicaid beneficiaries, with a mean of 606 039 beneficiaries affected by plan exits annually. Six states had a mean of greater than 10% of Medicaid managed care recipients enrolled in plans that exited, whereas 10 states experienced no plan exits. Plans that exited from a state's Medicaid market performed significantly worse prior to exiting than those that remained in terms of preventive care (57.5% vs 60.4%; difference, 2.9% [95% CI, 0.3% to 5.5%]), maternity care (69.7% vs 73.6%; difference, 3.8% [95% CI, 1.7% to 6.0%]), and patient experience (73.5% vs 74.8%; difference, 1.3% [95% CI, 0.6% to 1
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Cosmology of f(R) gravity in the metric variational approach
Li, Baojiu; Barrow, John D.
2007-04-01
We consider the cosmologies that arise in a subclass of f(R) gravity with f(R)=R+μ2n+2/(-R)n and n∈(-1,0) in the metric (as opposed to the Palatini) variational approach to deriving the gravitational field equations. The calculations of the isotropic and homogeneous cosmological models are undertaken in the Jordan frame and at both the background and the perturbation levels. For the former, we also discuss the connection to the Einstein frame in which the extra degree of freedom in the theory is associated with a scalar field sharing some of the properties of a “chameleon” field. For the latter, we derive the cosmological perturbation equations in general theories of f(R) gravity in covariant form and implement them numerically to calculate the cosmic microwave background (CMB) temperature and matter power spectra of the cosmological model. The CMB power is shown to reduce at low l’s, and the matter power spectrum is almost scale independent at small scales, thus having a similar shape to that in standard general relativity. These are in stark contrast with what was found in the Palatini f(R) gravity, where the CMB power is largely amplified at low l’s and the matter spectrum is strongly scale dependent at small scales. These features make the present model more adaptable than that arising from the Palatini f(R) field equations, and none of the data on background evolution, CMB power spectrum, or matter power spectrum currently rule it out.
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10 CFR 712.30 - Applicability.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Applicability. 712.30 Section 712.30 Energy DEPARTMENT OF ENERGY HUMAN RELIABILITY PROGRAM Medical Standards § 712.30 Applicability. This subpart establishes standards and procedures for conducting medical assessments of DOE and DOE contractor individuals in HRP...
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2011-06-06
... 1995 (Pub. L. 104-04, enacted on March 22, 1995) UTI Urinary tract infection I. Background Title XIX of.... + Secondary Diabetes with Hyperosmolarity. Catheter-Associated Urinary Tract Infection (UTI). Vascular... of Children's Hospitals, the Joint Commission, and State Medicaid Medical Directors. Most of these...
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42 CFR 493.1809 - Limitation on Medicaid payment.
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Limitation on Medicaid payment. 493.1809 Section 493.1809 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Limitation on Medicaid payment. As provided in section 1902(a)(9)(C) of the Act, payment for laboratory...
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2013-09-06
... millions) (2) change (3) Total $3,625 1% Eye and ocular adnexa 1,496 -3 Digestive system 743 8 Nervous... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 405...: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality...
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Medicaid Contradictions: Adding, Subtracting, and Redeterminations in Illinois.
Koetting, Michael
2016-04-01
States are required to conduct annual Medicaid redeterminations. How these redeterminations are undertaken is crucial to determining the nature of Medicaid coverage. There can be wide variations in the proportion of clients disenrolled, with potentially large numbers of people disenrolled each year. This case study of Illinois Medicaid shows how, as the Affordable Care Act added people, redeterminations were taking people off the rolls-about 25 percent of all Medicaid clients were disenrolled in one year. Many of these people were no longer eligible, but it appears that a larger number were in fact eligible but simply failed to comply with administrative requirements in a timely way. Balancing between the two imperatives of program integrity and continuity of care is a difficult act for Medicaid programs. The Illinois experience also illustrates impacts on information technology and outsourcing of eligibility functions, not to mention budget considerations. Copyright © 2016 by Duke University Press.
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AP1000, a nuclear central of advanced design
International Nuclear Information System (INIS)
Hernandez M, N.; Viais J, J.
2005-01-01
The AP1000 is a design of a nuclear reactor of pressurized water (PWR) of 1000 M We with characteristic of safety in a passive way; besides presenting simplifications in the systems of the plant, the construction, the maintenance and the safety, the AP1000 is a design that uses technology endorsed by those but of 30 years of operational experience of the PWR reactors. The program AP1000 of Westinghouse is focused to the implementation of the plant to provide improvements in the economy of the same one and it is a design that is derived directly of the AP600 designs. On September 13, 2004 the US-NRC (for their initials in United States- Nuclear Regulatory Commission) approved the final design of the AP1000, now Westinghouse and the US-NRC are working on the whole in a complete program for the certification. (Author)
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48 CFR 30.202-5 - Filing disclosure statements.
2010-10-01
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Filing disclosure... GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.202-5 Filing disclosure statements. See 48 CFR 9903.202-5 (FAR appendix). [61 FR 18917, Apr. 29, 1996...
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Development of a Medicaid Behavioral Health Case-Mix Model
Robst, John
2009-01-01
Many Medicaid programs have either fully or partially carved out mental health services. The evaluation of carve-out plans requires a case-mix model that accounts for differing health status across Medicaid managed care plans. This article develops a diagnosis-based case-mix adjustment system specific to Medicaid behavioral health care. Several…
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Closed string tachyon driving f(R) cosmology
Wang, Peng; Wu, Houwen; Yang, Haitang
2018-05-01
To study quantum effects on the bulk tachyon dynamics, we replace R with f(R) in the low-energy effective action that couples gravity, the dilaton, and the bulk closed string tachyon of bosonic closed string theory and study properties of their classical solutions. The α' corrections of the graviton-dilaton-tachyon system are implemented in the f(R). We obtain the tachyon-induced rolling solutions and show that the string metric does not need to remain fixed in some cases. In the case with H( t=‑∞ ) = , only the R and R2 terms in f(R) play a role in obtaining the rolling solutions with nontrivial metric. The singular behavior of more classical solutions are investigated and found to be modified by quantum effects. In particular, there could exist some classical solutions, in which the tachyon field rolls down from a maximum of the tachyon potential while the dilaton expectation value is always bounded from above during the rolling process.
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Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials
Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M
2013-01-01
Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369
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Botti, Mari; Khaw, Damien; Jørgensen, Emmy Brandt; Rasmussen, Bodil; Hunter, Susan; Redley, Bernice
2015-08-01
This study investigated the cross-cultural factor stability and internal consistency of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R), a measure of the quality of postoperative pain management used internationally. We conducted exploratory factor analysis (EFA) of APS-POQ-R data from 2 point prevalence studies comprising 268 and 311 surveys of Danish and Australian medical-surgical patients, respectively. Parallel analysis indicated 4- and 3-factor solutions for Danish and Australian patients, respectively, which accounted for 58.1% and 52.9% of variance. Internal consistency was unsatisfactory among both Danish (Cronbach α = .54) and Australian (Cronbach α = .63) cohorts. There was a high degree of between-group similarity in item-factor loadings of variables coded as "pain experience," but not "pain management." This finding reflected cross-cultural differences in ratings of treatment satisfaction. For Danish patients, satisfaction was associated with the degree of pain severity and activity interference, whereas for Australian patients, satisfaction was associated with their perceived ability to participate in treatment. To facilitate further cross-cultural comparison, we compared our findings with past research conducted in the United States and Iceland. EFA supported the construct validity of the APS-POQ-R as a measure of "pain experience" but indicated that items measuring "pain management" may vary cross-culturally. Findings highlighted the need for further validation of the APS-POQ-R internationally. This study revealed the APS-POQ-R as a valid measure of postoperative pain experience for Danish and Australian patients. Measures of patients' perception of pain management were not robust to group differences in treatment expectations and demonstrated cross-cultural instability. Results highlighted the difficulties in establishing stable cross-cultural, cross-population subscales for the APS-POQ-R. Copyright © 2015
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f(R) gravity, torsion and non-metricity
International Nuclear Information System (INIS)
Sotiriou, Thomas P
2009-01-01
For both f(R) theories of gravity with an independent symmetric connection (no torsion), usually referred to as Palatini f(R) gravity theories, and for f(R) theories of gravity with torsion but no non-metricity, called U4 theories, it has been shown that the independent connection can actually be eliminated algebraically, as long as this connection does not couple to matter. Remarkably, the outcome in both cases is the same theory, which is dynamically equivalent with an ω 0 = -3/2 Brans-Dicke theory. It is shown here that even for the most general case of an independent connection with both non-metricity and torsion, one arrives at exactly the same theory as in the more restricted cases. This generalizes the previous results and explains why assuming that either the torsion or the non-metricity vanishing ultimately leads to the same theory. It also demonstrates that f(R) actions cannot support an independent connection which carries dynamical degrees of freedom, irrespective of how general this connection is, at least as long as there is no connection-matter coupling. (fast track communication)
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Reducing Early Childhood Tooth Decay: Strategies for State Medicaid and CHIP Dental Program Managers
Colin Reusch; Meg Booth; Leslie Foster
2015-01-01
Young children who are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) can be at risk for developing early childhood caries (ECC). ECC is a chronic bacterial infection that causes severe tooth decay and can begin to develop before baby teeth erupt.
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Standard cosmological evolution in the f(R) model to Kaluza-Klein cosmology
International Nuclear Information System (INIS)
Aghmohammadi, A; Abolhassani, M R; Saaidi, Kh; Vajdi, A
2009-01-01
In this paper, using f(R) theory of gravity we explicitly calculate cosmological evolution in the presence of a perfect fluid source in four- and five-dimensional space-time in which this cosmological evolution in self-creation is presented by Reddy et al (2009 Int. J. Theor. Phys. 48 10). An exact cosmological model is presented using a relation between Einstein's gravity field equation components due to a metric with the same component from f(R) theory of gravity. Some physics and kinematical properties of the model are also discussed.
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Effective Dark Matter Halo Catalog in f(R) Gravity.
He, Jian-Hua; Hawken, Adam J; Li, Baojiu; Guzzo, Luigi
2015-08-14
We introduce the idea of an effective dark matter halo catalog in f(R) gravity, which is built using the effective density field. Using a suite of high resolution N-body simulations, we find that the dynamical properties of halos, such as the distribution of density, velocity dispersion, specific angular momentum and spin, in the effective catalog of f(R) gravity closely mimic those in the cold dark matter model with a cosmological constant (ΛCDM). Thus, when using effective halos, an f(R) model can be viewed as a ΛCDM model. This effective catalog therefore provides a convenient way for studying the baryonic physics, the galaxy halo occupation distribution and even semianalytical galaxy formation in f(R) cosmologies.
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Constraints on perturbative f(R) gravity via neutron stars
Energy Technology Data Exchange (ETDEWEB)
Arapoğlu, Savaş; Ekşi, K. Yavuz [İstanbul Technical University, Faculty of Science and Letters, Physics Engineering Department, Maslak 34469, İstanbul (Turkey); Deliduman, Cemsinan, E-mail: arapoglu@itu.edu.tr, E-mail: cemsinan@msgsu.edu.tr, E-mail: eksi@itu.edu.tr [Mimar Sinan Fine Arts University, Department of Physics, Beşiktaş 34349, İstanbul (Turkey)
2011-07-01
We study the structure of neutron stars in perturbative f(R) gravity models with realistic equations of state. We obtain mass-radius relations in a gravity model of the form f(R) = R+αR{sup 2}. We find that deviations from the results of general relativity, comparable to the variations due to using different equations of state (EoS'), are induced for |α| ∼ 10{sup 9} cm{sup 2}. Some of the soft EoS' that are excluded within the framework of general relativity can be reconciled with the 2 solar mass neutron star recently observed for certain values of α within this range. For some of the EoS' we find that a new solution branch, which allows highly massive neutron stars, exists for values of α greater than a few 10{sup 9} cm{sup 2}. We find constraints on α for a variety of EoS' using the recent observational constraints on the mass-radius relation. These are all 5 orders of magnitude smaller than the recent constraint obtained via Gravity Probe B for this gravity model. The associated length scale √(alpha)approx 10{sup 5} cm is only an order of magnitude smaller than the typical radius of a neutron star, the probe used in this test. This implies that real deviations from general relativity can be even smaller.
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42 CFR 431.630 - Coordination of Medicaid with QIOs.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Coordination of Medicaid with QIOs. 431.630 Section 431.630 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... With Other Agencies § 431.630 Coordination of Medicaid with QIOs. (a) The State plan may provide for...
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Wormholes in R{sup 2}-gravity within the f(R, T) formalism
Energy Technology Data Exchange (ETDEWEB)
Sahoo, P.K.; Sahoo, Parbati [Birla Institute of Technology and Science-Pilani, Department of Mathematics, Hyderabad (India); Moraes, P.H.R.S. [ITA-Instituto Tecnologico de Aeronautica, Departamento de Fisica, Sao Jose dos Campos, Sao Paulo (Brazil)
2018-01-15
We propose, as a novelty in the literature, the modeling of wormholes within a particular case of f(R, T) gravity, namely f(R, T) = R + αR{sup 2} + λT, with R and T being the Ricci scalar and trace of the energy-momentum tensor, respectively, while α and λ are constants. Although such a functional form application can be found in the literature, those concern compact astrophysical objects, such that no wormhole analysis has been done so far. The quadratic geometric and linear material corrections of this theory render the matter content of the wormhole remarkably able to obey the energy conditions. (orig.)
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42 CFR 456.506 - Waiver options for Medicaid agency.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Waiver options for Medicaid agency. 456.506 Section 456.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... options for Medicaid agency. (a) The agency may apply for a waiver at any time it has the procedures...
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Existence of relativistic stars in f(R) gravity
International Nuclear Information System (INIS)
Upadhye, Amol; Hu, Wayne
2009-01-01
We refute recent claims in the literature that stars with relativistically deep potentials cannot exist in f(R) gravity. Numerical examples of stable stars, including relativistic (GM * /r * ∼0.1), constant density stars, are studied. As a star is made larger, nonlinear 'chameleon' effects screen much of the star's mass, stabilizing gravity at the stellar center. Furthermore, we show that the onset of this chameleon screening is unrelated to strong gravity. At large central pressures P>ρ/3, f(R) gravity, like general relativity, does have a maximum gravitational potential, but at a slightly smaller value: GM * /r * | max =0.345<4/9 for constant density and one choice of parameters. This difference is associated with negative central curvature R under general relativity not being accessed in the f(R) model, but does not apply to any known astrophysical object.
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45 CFR 162.1902 - Standard for Medicaid pharmacy subrogation transaction.
2010-10-01
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standard for Medicaid pharmacy subrogation... DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1902 Standard for Medicaid pharmacy subrogation transaction. The Secretary adopts the Batch Standard...
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42 CFR 456.372 - Medicaid agency review of need for admission.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid agency review of need for admission. 456.372 Section 456.372 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Medicaid agency review of need for admission. Medical and other professional personnel of the Medicaid...
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f(R) gravity: scalar perturbations in the late Universe
Czech Academy of Sciences Publication Activity Database
Eingorn, M.; Novák, Jan; Zhuk, A.
2014-01-01
Roč. 74, č. 8 (2014), s. 3005 ISSN 1434-6044 Institutional support: RVO:67985840 Keywords : nonlinear f(R) gravity * scalar cosmological perturbations * scalaron Subject RIV: BA - General Mathematics Impact factor: 5.084, year: 2014 http://link.springer.com/article/10.1140/epjc/s10052-014-3005-1
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Models of f(R) cosmic acceleration that evade solar system tests
International Nuclear Information System (INIS)
Hu, Wayne; Sawicki, Ignacy
2007-01-01
We study a class of metric-variation f(R) models that accelerates the expansion without a cosmological constant and satisfies both cosmological and solar-system tests in the small-field limit of the parameter space. Solar-system tests alone place only weak bounds on these models, since the additional scalar degree of freedom is locked to the high-curvature general-relativistic prediction across more than 25 orders of magnitude in density, out through the solar corona. This agreement requires that the galactic halo be of sufficient extent to maintain the galaxy at high curvature in the presence of the low-curvature cosmological background. If the galactic halo and local environment in f(R) models do not have substantially deeper potentials than expected in ΛCDM, then cosmological field amplitudes |f R | > or approx.10 -6 will cause the galactic interior to evolve to low curvature during the acceleration epoch. Viability of large-deviation models therefore rests on the structure and evolution of the galactic halo, requiring cosmological simulations of f(R) models, and not directly on solar-system tests. Even small deviations that conservatively satisfy both galactic and solar-system constraints can still be tested by future, percent-level measurements of the linear power spectrum, while they remain undetectable to cosmological-distance measures. Although we illustrate these effects in a specific class of models, the requirements on f(R) are phrased in a nearly model-independent manner
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... State Guides Rural Data Visualizations Rural Data Explorer Chart Gallery Maps Case Studies & Conversations Rural Health Models & ... services provided by state Medicaid programs might include dental care, physical therapy, home and community-based services, ...
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U.S. Department of Health & Human Services — The Environmental Scanning and Program Characteristic (ESPC) Database is in a Microsoft (MS) Access format and contains Medicaid and CHIP data, for the 50 states and...
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The impact of changing medicaid enrollments on New Mexico's Immunization Program.
Directory of Open Access Journals (Sweden)
Michael A Schillaci
Full Text Available Immunizations are an important component to pediatric primary care. New Mexico is a relatively poor and rural state which has sometimes struggled to achieve and maintain its childhood immunization rates. We evaluated New Mexico's immunization rates between 1996 and 2006. Specifically, we examined the increase in immunization rates between 2002 and 2004, and how this increase may have been associated with Medicaid enrollment levels, as opposed to changes in government policies concerning immunization practices.This study examines trends in childhood immunization coverage rates relative to Medicaid enrollment among those receiving Temporary Assistance for Needy Families (TANF in New Mexico. Information on health policy changes and immunization coverage was obtained from state governmental sources and the National Immunization Survey. We found statistically significant correlations varying from 0.86 to 0.93 between immunization rates and Medicaid enrollment.New Mexico's improvement and subsequent deterioration in immunization rates corresponded with changing Medicaid coverage, rather than the state's efforts to change immunization practices. Maintaining high Medicaid enrollment levels may be important for achieving high childhood immunization levels.
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The Impact of Changing Medicaid Enrollments on New Mexico's Immunization Program
Schillaci, Michael A.; Waitzkin, Howard; Sharmen, Tom; Romain, Sandra J.
2008-01-01
Background Immunizations are an important component to pediatric primary care. New Mexico is a relatively poor and rural state which has sometimes struggled to achieve and maintain its childhood immunization rates. We evaluated New Mexico's immunization rates between 1996 and 2006. Specifically, we examined the increase in immunization rates between 2002 and 2004, and how this increase may have been associated with Medicaid enrollment levels, as opposed to changes in government policies concerning immunization practices. Methods and Findings This study examines trends in childhood immunization coverage rates relative to Medicaid enrollment among those receiving Temporary Assistance for Needy Families (TANF) in New Mexico. Information on health policy changes and immunization coverage was obtained from state governmental sources and the National Immunization Survey. We found statistically significant correlations varying from 0.86 to 0.93 between immunization rates and Medicaid enrollment. Conclusions New Mexico's improvement and subsequent deterioration in immunization rates corresponded with changing Medicaid coverage, rather than the state's efforts to change immunization practices. Maintaining high Medicaid enrollment levels may be important for achieving high childhood immunization levels. PMID:19107189
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f(R) gravity cosmology in scalar degree of freedom
International Nuclear Information System (INIS)
Goswami, Umananda Dev; Deka, Kabita
2014-01-01
The models of f(R) gravity belong to an important class of modified gravity models where the late time cosmic accelerated expansion is considered as the manifestation of the large scale modification of the force of gravity. f(R) gravity models can be expressed in terms of a scalar degree of freedom by explicit redefinition of model's variable. Here we report about the study of the features of cosmological parameters and hence the cosmological evolution using the scalar degree of freedom of the f(R) = ξR n gravity model in the Friedmann-Lemaître-Robertson-Walker (FLRW) background
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Kibicho, Jennifer; Pinkerton, Steven D
2012-04-01
Michigan's Medicaid program implemented four cost containment policies--preferred drug lists, joint and multistate purchasing arrangements, and maximum allowable cost--during 2002-04. The goal was to control growth of drug spending for beneficiaries who were enrolled in both Medicaid and Medicare and taking antihypertensive or antihyperlipidemic prescription drugs. We analyzed the impact of each policy while holding the effect of all other policies constant. Preferred drug lists increased both preferred and generic drugs' market share and reduced daily cost--the cost per day for each prescription provided to a beneficiary. In contrast, the maximum allowable cost policy increased daily cost and was the only policy that did not generate cost savings. The joint and multistate arrangements did not affect daily cost. Despite these policy trade-offs, the cumulative effect was a 10 percent decrease in daily cost and a total cost savings of $46,195 per year. Our findings suggest that policy makers need to evaluate the impact of multiple policies aimed at restraining drug spending, and further evaluate the policy trade-offs, to ensure that scarce public dollars achieve the greatest return for money spent.
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Constraint propagation equations of the 3+1 decomposition of f(R) gravity
International Nuclear Information System (INIS)
Paschalidis, Vasileios; Shapiro, Stuart L; Halataei, Seyyed M H; Sawicki, Ignacy
2011-01-01
Theories of gravity other than general relativity (GR) can explain the observed cosmic acceleration without a cosmological constant. One such class of theories of gravity is f(R). Metric f(R) theories have been proven to be equivalent to Brans-Dicke (BD) scalar-tensor gravity without a kinetic term (ω = 0). Using this equivalence and a 3+1 decomposition of the theory, it has been shown that metric f(R) gravity admits a well-posed initial value problem. However, it has not been proven that the 3+1 evolution equations of metric f(R) gravity preserve the (Hamiltonian and momentum) constraints. In this paper, we show that this is indeed the case. In addition, we show that the mathematical form of the constraint propagation equations in BD-equilavent f(R) gravity and in f(R) gravity in both the Jordan and Einstein frames is exactly the same as in the standard ADM 3+1 decomposition of GR. Finally, we point out that current numerical relativity codes can incorporate the 3+1 evolution equations of metric f(R) gravity by modifying the stress-energy tensor and adding an additional scalar field evolution equation. We hope that this work will serve as a starting point for relativists to develop fully dynamical codes for valid f(R) models.
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Intergenerational enrollment and expenditure changes in Medicaid: trends from 1991 to 2005
Directory of Open Access Journals (Sweden)
Patrick Stephen W
2012-09-01
Full Text Available Abstract Background From its inception, Medicaid was aimed at providing insurance coverage for low income children, elderly, and disabled. Since this time, children have become a smaller proportion of the US population and Medicaid has expanded to additional eligibility groups. We sought to evaluate relative growth in spending in the Medicaid program between children and adults from 1991-2005. We hypothesize that this shifting demographic will result in fewer resources being allocated to children in the Medicaid program. Methods We utilized retrospective enrollment and expenditure data for children, adults and the elderly from 1991 to 2005 for both Medicaid and Children’s Health Insurance Program Medicaid expansion programs. Data were obtained from the Centers for Medicare and Medicaid Services using their Medicaid Statistical Information System. Results From 1991 to 2005, the number of enrollees increased by 83% to 58.7 million. This includes increases of 33% for children, 100% for adults and 50% for the elderly. Concurrently, total expenditures nationwide rose 150% to $273 billion. Expenditures for children increased from $23.4 to $65.7 billion, adults from $46.2 to $123.6 billion, and elderly from $39.2 to $71.3 billion. From 1999 to 2005, Medicaid spending on long-term care increased by 31% to $84.3 billion. Expenditures on the disabled grew by 61% to $119 billion. In total, the disabled account for 43% and long-term care 31%, of the total Medicaid budget. Conclusion Our study did not find an absolute decrease in the overall resources being directed toward children. However, increased spending on adults on a per-capita and absolute basis, particularly disabled adults, is responsible for much of the growth in spending over the past 15 years. Medicaid expenditures have grown faster than inflation and overall national health expenditures. A national strategy is needed to ensure adequate coverage for Medicaid recipients while dealing with the
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Medicare-Medicaid Enrollee Profiles (State and National)
U.S. Department of Health & Human Services — Today there are over 10 million Medicare-Medicaid enrollees in the United States.To provide a greater understanding of the Medicare-Medicaid enrollee population, the...
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Robust approach to f(R) gravity
International Nuclear Information System (INIS)
Jaime, Luisa G.; Patino, Leonardo; Salgado, Marcelo
2011-01-01
We consider metric f(R) theories of gravity without mapping them to their scalar-tensor counterpart, but using the Ricci scalar itself as an ''extra'' degree of freedom. This approach avoids then the introduction of a scalar-field potential that might be ill defined (not single valued). In order to explicitly show the usefulness of this method, we focus on static and spherically symmetric spacetimes and deal with the recent controversy about the existence of extended relativistic objects in certain class of f(R) models.
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76 FR 14637 - State Medicaid Fraud Control Units; Data Mining
2011-03-17
...] State Medicaid Fraud Control Units; Data Mining AGENCY: Office of Inspector General (OIG), HHS. ACTION... and analyzing State Medicaid claims data, known as data mining. To support and modernize MFCU efforts... (FFP) in the costs of defined data mining activities under specified conditions. In addition, we...
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Travaille, Peter; Mueller, Roland; Thornton, Dallas; van Hillegersberg, Jos
2011-01-01
It is estimated that between $600 and $850 billion annually is lost to fraud, waste, and abuse in the US healthcare system,with $125 to $175 billion of this due to fraudulent activity (Kelley 2009). Medicaid, a state-run, federally-matchedgovernment program which accounts for roughly one-quarter of
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Serious Infection Rates Among Children With Systemic Lupus Erythematosus Enrolled in Medicaid.
Hiraki, Linda T; Feldman, Candace H; Marty, Francisco M; Winkelmayer, Wolfgang C; Guan, Hongshu; Costenbader, Karen H
2017-11-01
To investigate the nationwide prevalence and incidence of serious infections among children with systemic lupus erythematosus (SLE) enrolled in Medicaid, the US health insurance program for low-income patients. From Medicaid claims (2000-2006) we identified children ages 5 to 30 days apart) and lupus nephritis (LN; ≥2 ICD-9 codes for kidney disease on/after SLE codes). From hospital discharge diagnoses, we identified infection subtypes (bacterial, fungal, and viral). We calculated incidence rates (IRs) per 100 person-years, mortality rates, and hazard ratios adjusted for sociodemographic factors, medications, and preventive care. Among 3,500 children with identified SLE, 1,053 serious infections occurred over 10,108 person-years; the IR was 10.42 per 100 person-years (95% confidence interval [95% CI] 9.80-11.07) among all those with SLE and 17.65 per 100 person-years (95% CI 16.29-19.09) among those with LN. Bacterial infections were most common (87%, of which 39% were bacterial pneumonias). In adjusted models, African Americans and American Indians had higher rates of infections compared with white children, and those with comorbidities or receiving corticosteroids had higher infection rates than those without. Males had lower rates of serious infections compared to females. The 30-day postdischarge mortality rate was 4.4%. Overall, hospitalized infections were very common in children with SLE, with bacterial pneumonia being the most common infection. Highest infection risks were among African American and American Indian children, those with LN, comorbidities, and those taking corticosteroids. © 2017, American College of Rheumatology.
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Possible antigravity regions in F(R) theory?
Energy Technology Data Exchange (ETDEWEB)
Bamba, Kazuharu, E-mail: bamba@kmi.nagoya-u.ac.jp [Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya 464-8602 (Japan); Nojiri, Shin' ichi, E-mail: nojiri@phys.nagoya-u.ac.jp [Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya 464-8602 (Japan); Department of Physics, Nagoya University, Nagoya 464-8602 (Japan); Odintsov, Sergei D., E-mail: odintsov@ieec.uab.es [Department of Physics, Nagoya University, Nagoya 464-8602 (Japan); Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona (Spain); Institut de Ciencies de l' Espai (CSIC-IEEC), Campus UAB, Facultat de Ciencies, Torre C5-Par-2a pl, E-08193 Bellaterra (Barcelona) (Spain); Tomsk State Pedagogical University, Kievskaya Avenue, 60, 634061, Tomsk (Russian Federation); Sáez-Gómez, Diego, E-mail: diego.saezgomez@uct.ac.za [Astrophysics, Cosmology and Gravity Centre (ACGC) and Department of Mathematics and Applied Mathematics, University of Cape Town, Rondebosch 7701, Cape Town (South Africa); Fisika Teorikoaren eta Zientziaren Historia Saila, Zientzia eta Teknologia Fakultatea, Euskal Herriko Unibertsitatea, 644 Posta Kutxatila, 48080 Bilbao (Spain)
2014-03-07
We construct an F(R) gravity theory corresponding to the Weyl invariant two scalar field theory. We investigate whether such F(R) gravity can have the antigravity regions where the Weyl curvature invariant does not diverge at the Big Bang and Big Crunch singularities. It is revealed that the divergence cannot be evaded completely but can be much milder than that in the original Weyl invariant two scalar field theory.
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Holographic dark energy and f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Aghamohammadi, A [Faculty of Science, Islamic Azad University of Sanandaj, Sanandaj (Iran, Islamic Republic of); Saaidi, Kh, E-mail: ksaaidi@uok.ac.ir, E-mail: agha35484@yahoo.com [Department of Physics, Faculty of Science, University of Kurdistan, Sanandaj (Iran, Islamic Republic of)
2011-02-15
We investigate the corresponding relation between f(R) gravity and holographic dark energy. We introduce a type of energy density from f(R) that has the same role as holographic dark energy. We obtain the differential equation that specifies the evolution of the introduced energy density parameter based on a varying gravitational constant. We discover the relation for the equation of state parameter for low redshifts that contains varying G correction.
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Possible antigravity regions in F(R) theory?
Bamba, Kazuharu; Nojiri, Shin'ichi; Odintsov, Sergei D.; Sáez-Gómez, Diego
2014-03-01
We construct an F(R) gravity theory corresponding to the Weyl invariant two scalar field theory. We investigate whether such F(R) gravity can have the antigravity regions where the Weyl curvature invariant does not diverge at the Big Bang and Big Crunch singularities. It is revealed that the divergence cannot be evaded completely but can be much milder than that in the original Weyl invariant two scalar field theory.
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Possible antigravity regions in F(R) theory?
International Nuclear Information System (INIS)
Bamba, Kazuharu; Nojiri, Shin'ichi; Odintsov, Sergei D.; Sáez-Gómez, Diego
2014-01-01
We construct an F(R) gravity theory corresponding to the Weyl invariant two scalar field theory. We investigate whether such F(R) gravity can have the antigravity regions where the Weyl curvature invariant does not diverge at the Big Bang and Big Crunch singularities. It is revealed that the divergence cannot be evaded completely but can be much milder than that in the original Weyl invariant two scalar field theory.
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Energy Technology Data Exchange (ETDEWEB)
Motohashi, Hayato [Universidad de Valencia-CSIC, Instituto de Fisica Corpuscular (IFIC), Valencia (Spain); Starobinsky, Alexei A. [L.D. Landau Institute for Theoretical Physics, RAS, Moscow (Russian Federation); National Research University Higher School of Economics, Moscow (Russian Federation)
2017-08-15
The previously introduced class of two-parametric phenomenological inflationary models in general relativity in which the slow-roll assumption is replaced by the more general, constant-roll condition is generalized to the case of f(R) gravity. A simple constant-roll condition is defined in the original Jordan frame, and exact expressions for a scalaron potential in the Einstein frame, for a function f(R) (in the parametric form) and for inflationary dynamics are obtained. The region of the model parameters permitted by the latest observational constraints on the scalar spectral index and the tensor-to-scalar ratio of primordial metric perturbations generated during inflation is determined. (orig.)
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2013-06-27
.... The LTC facility regulations clearly specify what services the facility is required to provide to... professional caregivers and are often paid by third-party payers, such as Medicaid. These facilities are... benefit. In regulations at 42 CFR 418.112(c), we specify what must be included in a written agreement...
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AP Geography, Environmental Science Thrive
Robelen, Erik W.
2012-01-01
Geography may not be particularly known as a hot topic among today's students--even some advocates suggest it suffers from an image problem--but by at least one measure, the subject is starting to come into its own. Across more than 30 topics covered in the Advanced Placement (AP) program, participation in geography is rising faster than any…
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42 CFR 441.206 - Documentation needed by the Medicaid agency.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Documentation needed by the Medicaid agency. 441.206 Section 441.206 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... SPECIFIC SERVICES Abortions § 441.206 Documentation needed by the Medicaid agency. FFP is not available in...
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2012-01-11
...-0117; Airspace Docket No. 09-AGL-31] RIN 2120-AI92 Proposed Establishment of Restricted Areas R-5402, R-5403A, R- 5403B, R-5403C, R-5403D, R-5403E, R-5403F; Devils Lake, ND AGENCY: Federal Aviation... Restricted Areas R-5402, R-5403A, R-5403B, R- 5403C, R-5403D, R-5403E, R-5403F; Devils Lake, ND (76 FR 72869...
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42 CFR 460.90 - PACE benefits under Medicare and Medicaid.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false PACE benefits under Medicare and Medicaid. 460.90 Section 460.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) PACE Services § 460.90 PACE benefits under Medicare and Medicaid. If a Medicare...
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Medicaid Managed Care Enrollment Report
U.S. Department of Health & Human Services — This report is composed annually and profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. This report also provides...
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42 CFR 1007.9 - Relationship to, and agreement with, the Medicaid agency.
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Relationship to, and agreement with, the Medicaid... AND HUMAN SERVICES OIG AUTHORITIES STATE MEDICAID FRAUD CONTROL UNITS § 1007.9 Relationship to, and agreement with, the Medicaid agency. (a) The unit must be separate and distinct from the Medicaid agency. (b...
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Stellar configurations in f(R) theories of gravity
International Nuclear Information System (INIS)
Henttunen, K.; Multamaeki, T.; Vilja, I.
2008-01-01
We study stellar configurations and the space-time around them in metric f(R) theories of gravity. In particular, we focus on the polytropic model of the Sun in two specific cases: the f(R)=R-μ 4 /R model and a model with a stabilizing higher order term f(R)=R-μ 4 /R+βR 3 /(3μ 4 ). We show how the stellar configuration in the f(R) theory can, by appropriate initial conditions, be selected to be equal to that described by the Lane-Emden equation and how a simple scaling relation exists between the solutions. We also derive the correct solution analytically near the center of the star in f(R) theory. Previous analytical and numerical results are confirmed, indicating that the space-time around the Sun is incompatible with solar system constraints in the f(R)=R-μ 4 /R model. Numerical work shows that stellar configurations, with a regular metric at the center, lead to γ PPN ≅1/2 outside the star for both models, i.e., the Schwarzschild-de Sitter space-time is not the correct vacuum solution for such configurations. This shows that even when one fine-tunes the initial conditions inside a star such that the mass of the effective scalar in the equivalent scalar-tensor theory is large, γ PPN is still 1/2 outside the star. Conversely, by selecting the Schwarzschild-de Sitter metric as the outside solution, or equivalently setting the mass of the effective scalar to be large outside the star, we find that the stellar configuration is unchanged but the metric is irregular at the center. The possibility of constructing a f(R) theory compatible with the solar system experiments and possible new constraints arising from the radius-mass relation of stellar objects is discussed
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Cosmological reconstruction of realistic modified F(R) gravities
International Nuclear Information System (INIS)
Nojiri, Shin'ichi; Odintsov, Sergei D.; Saez-Gomez, Diego
2009-01-01
The cosmological reconstruction scheme for modified F(R) gravity is developed in terms of e-folding (or, redshift). It is demonstrated how any FRW cosmology may emerge from specific F(R) theory. The specific examples of well-known cosmological evolution are reconstructed, including ΛCDM cosmology, deceleration with transition to phantom superacceleration era which may develop singularity or be transient. The application of this scheme to viable F(R) gravities unifying inflation with dark energy era is proposed. The additional reconstruction of such models leads to non-leading gravitational correction mainly relevant at the early/late universe and helping to pass the cosmological bounds (if necessary). It is also shown how cosmological reconstruction scheme may be generalized in the presence of scalar field.
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2012-04-13
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP) Interagency Center for... (HTS) Assays for the Tox21 Initiative AGENCY: Division of the National Toxicology Program (DNTP...: April 5, 2012. John R. Bucher, Associate Director, National Toxicology Program. [FR Doc. 2012-8942 Filed...
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Health Care Expenditures for Children with Autism Spectrum Disorders in Medicaid
Wang, Li; Leslie, Douglas L.
2010-01-01
Objective: To study trends in health care expenditures associated with autism spectrum disorders (ASDs) in state Medicaid programs. Method: Using Medicaid data from 42 states from 2000 to 2003, patients aged 17 years and under who were continuously enrolled in fee-for-service Medicaid were studied. Patients with claims related to autistic disorder…
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77 FR 61326 - Indiana: Final Authorization of State Hazardous Waste Management Program Revision
2012-10-09
...: Final Authorization of State Hazardous Waste Management Program Revision AGENCY: Environmental... RCRA hazardous waste management program. We granted authorization for changes to their program on... 202. Hazardous Waste Management July 30, 2003; 68 329 IAC 3.1-6-2(16); System; Identification and FR...
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42 CFR 457.350 - Eligibility screening and facilitation of Medicaid enrollment.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Eligibility screening and facilitation of Medicaid enrollment. 457.350 Section 457.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Eligibility screening and facilitation of Medicaid enrollment. (a) State plan requirement. The State plan must...
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Medicaid is government health insurance that helps many low-income people in the United States to pay ... You have to meet certain requirements to get Medicaid help. These might involve Your age Whether you ...
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Federal Funding Insulated State Budgets From Increased Spending Related To Medicaid Expansion.
Sommers, Benjamin D; Gruber, Jonathan
2017-05-01
As states weigh whether to expand Medicaid under the Affordable Care Act (ACA) and Medicaid reform remains a priority for some federal lawmakers, fiscal considerations loom large. As part of the ACA's expansion of eligibility for Medicaid, the federal government paid for 100 percent of the costs for newly eligible Medicaid enrollees for the period 2014-16. In 2017 states will pay some of the costs for new enrollees, with each participating state's share rising to 10 percent by 2020. States continue to pay their traditional Medicaid share (roughly 25-50 percent, depending on the state) for previously eligible enrollees. We used data for fiscal years 2010-15 from the National Association of State Budget Officers and a difference-in-differences framework to assess the effects of the expansion's first two fiscal years. We found that the expansion led to an 11.7 percent increase in overall spending on Medicaid, which was accompanied by a 12.2 percent increase in spending from federal funds. There were no significant increases in spending from state funds as a result of the expansion, nor any significant reductions in spending on education or other programs. States' advance budget projections were also reasonably accurate in the aggregate, with no significant differences between the projected levels of federal, state, and Medicaid spending and the actual expenses as measured at the end of the fiscal year. Project HOPE—The People-to-People Health Foundation, Inc.
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International Nuclear Information System (INIS)
Gibson, J.M.; Fenner, R.B.; Long, G.; Borland, M.; Decker, G.
2007-01-01
In my five years as the Director of the Advanced Photon Source (APS), I have been fortunate to see major growth in the scientific impact from the APS. This year I am particularly enthusiastic about prospects for our longer-term future. Every scientific instrument must remain at the cutting edge to flourish. Our plans for the next generation of APS--an APS upgrade--got seriously in gear this year with strong encouragement from our users and sponsors. The most promising avenue that has emerged is the energy-recovery linac (ERL) (see article on page xx), for which we are beginning serious R and D. The ERL(at)APS would offer revolutionary performance, especially for x-ray imaging and ultrafast science, while not seriously disrupting the existing user base. I am very proud of our accelerator physics and engineering staff, who not only keep the current APS at the forefront, but were able to greatly impress our international Machine Advisory Committee with the quality of their work on the possible upgrade option (see page xx). As we prepare for long-term major upgrades, our plans to develop and optimize all the sectors at APS in the near future are advancing. Several new beamlines saw first light this year, including a dedicated powder diffraction beamline (11-BM), two instruments for inelastic x-ray scattering at sector 30, and the Center for Nanoscale Materials (CNM) Nanoprobe beamline at sector 26. Our partnership in the first x-ray free-electron laser (LCLS) to be built at Stanford contributes to revolutionary growth in ultrafast science (see page xx), and we are developing a pulse chirping scheme to get ps pulses at sector 7 of the APS within a year or so. In this report, you will find selected highlights of scientific research at the APS from calendar year 2006. The highlighted work covers diverse disciplines, from fundamental to applied science. In the article on page xx you can see the direct impact of APS research on technology. Several new products have emerged
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Energy Technology Data Exchange (ETDEWEB)
Gibson, J. M.; Fenner, R. B.; Long, G.; Borland, M.; Decker, G.
2007-05-24
In my five years as the Director of the Advanced Photon Source (APS), I have been fortunate to see major growth in the scientific impact from the APS. This year I am particularly enthusiastic about prospects for our longer-term future. Every scientific instrument must remain at the cutting edge to flourish. Our plans for the next generation of APS--an APS upgrade--got seriously in gear this year with strong encouragement from our users and sponsors. The most promising avenue that has emerged is the energy-recovery linac (ERL) (see article on page xx), for which we are beginning serious R&D. The ERL{at}APS would offer revolutionary performance, especially for x-ray imaging and ultrafast science, while not seriously disrupting the existing user base. I am very proud of our accelerator physics and engineering staff, who not only keep the current APS at the forefront, but were able to greatly impress our international Machine Advisory Committee with the quality of their work on the possible upgrade option (see page xx). As we prepare for long-term major upgrades, our plans to develop and optimize all the sectors at APS in the near future are advancing. Several new beamlines saw first light this year, including a dedicated powder diffraction beamline (11-BM), two instruments for inelastic x-ray scattering at sector 30, and the Center for Nanoscale Materials (CNM) Nanoprobe beamline at sector 26. Our partnership in the first x-ray free-electron laser (LCLS) to be built at Stanford contributes to revolutionary growth in ultrafast science (see page xx), and we are developing a pulse chirping scheme to get ps pulses at sector 7 of the APS within a year or so. In this report, you will find selected highlights of scientific research at the APS from calendar year 2006. The highlighted work covers diverse disciplines, from fundamental to applied science. In the article on page xx you can see the direct impact of APS research on technology. Several new products have emerged from
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State Medicaid Coverage, ESRD Incidence, and Access to Care
Goldstein, Benjamin A.; Hall, Yoshio N.; Mitani, Aya A.; Winkelmayer, Wolfgang C.
2014-01-01
The proportion of low-income nonelderly adults covered by Medicaid varies widely by state. We sought to determine whether broader state Medicaid coverage, defined as the proportion of each state’s low-income nonelderly adult population covered by Medicaid, associates with lower state-level incidence of ESRD and greater access to care. The main outcomes were incidence of ESRD and five indicators of access to care. We identified 408,535 adults aged 20–64 years, who developed ESRD between January 1, 2001, and December 31, 2008. Medicaid coverage among low-income nonelderly adults ranged from 12.2% to 66.0% (median 32.5%). For each additional 10% of the low-income nonelderly population covered by Medicaid, there was a 1.8% (95% confidence interval, 1.0% to 2.6%) decrease in ESRD incidence. Among nonelderly adults with ESRD, gaps in access to care between those with private insurance and those with Medicaid were narrower in states with broader coverage. For a 50-year-old white woman, the access gap to the kidney transplant waiting list between Medicaid and private insurance decreased by 7.7 percentage points in high (>45%) versus low (Medicaid coverage states. Similarly, the access gap to transplantation decreased by 4.0 percentage points and the access gap to peritoneal dialysis decreased by 3.8 percentage points in high Medicaid coverage states. In conclusion, states with broader Medicaid coverage had a lower incidence of ESRD and smaller insurance-related access gaps. PMID:24652791
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42 CFR 456.171 - Medicaid agency review of need for admission.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid agency review of need for admission. 456.171 Section 456.171 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Hospitals Medical, Psychiatric, and Social Evaluations and Admission Review § 456.171 Medicaid agency review...
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The Role of Activator Protein-1 (AP-1) Family Members in CD30-Positive Lymphomas
Garces de los Fayos Alonso, Ines; Lagger, Sabine; Merkel, Olaf; Kenner, Lukas
2018-01-01
The Activator Protein-1 (AP-1) transcription factor (TF) family, composed of a variety of members including c-JUN, c-FOS and ATF, is involved in mediating many biological processes such as proliferation, differentiation and cell death. Since their discovery, the role of AP-1 TFs in cancer development has been extensively analysed. Multiple in vitro and in vivo studies have highlighted the complexity of these TFs, mainly due to their cell-type specific homo- or hetero-dimerization resulting in diverse transcriptional response profiles. However, as a result of the increasing knowledge of the role of AP-1 TFs in disease, these TFs are being recognized as promising therapeutic targets for various malignancies. In this review, we focus on the impact of deregulated expression of AP-1 TFs in CD30-positive lymphomas including Classical Hodgkin Lymphoma and Anaplastic Large Cell Lymphoma. PMID:29597249
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Cosmology of Horava-Lifshitz f(R) gravity
International Nuclear Information System (INIS)
Chakrabarti, Sayan K.; Sen, Anjan A.
2011-08-01
We discuss the cosmology of recently proposed Horava-Lifshitz f(R) gravity. In particular, we derive the modified Hubble equation that reduces to the standard HL gravity case in appropriate limit. We show how the bounce solutions in this theory are modified due to nonlinear effect of f(R) gravity. In addition we find that the solutions exist when the Universe can make turn around for large scale-factor. Therefore, in principle, the Universe in this set-up can show cyclic behavior. (orig.)
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Cosmology of Horava-Lifshitz f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Chakrabarti, Sayan K. [Univ. Tecnica de Lisboa (Portugal). Inst. Superior Tecnico; Dutta, Koushik [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Sen, Anjan A. [Centre of Theoretical Physics, Jamia Millia Islamia, New Dehli (India)
2011-08-15
We discuss the cosmology of recently proposed Horava-Lifshitz f(R) gravity. In particular, we derive the modified Hubble equation that reduces to the standard HL gravity case in appropriate limit. We show how the bounce solutions in this theory are modified due to nonlinear effect of f(R) gravity. In addition we find that the solutions exist when the Universe can make turn around for large scale-factor. Therefore, in principle, the Universe in this set-up can show cyclic behavior. (orig.)
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2012-04-20
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1442-N... regulatory philosophy and principles identified in Executive Order 12866 and 13563, the RFA, and section 1102.... Kathleen Sebelius, Secretary, Department of Health and Human Services. [FR Doc. 2012-9598 Filed 4-19-12; 8...
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30 CFR 746.10 - Information collection.
2010-07-01
... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Information collection. 746.10 Section 746.10... LANDS PROGRAM REVIEW AND APPROVAL OF MINING PLANS § 746.10 Information collection. The information... U.S.C. 3507 and assigned clearance number 1029-0026. The information is being collected to determine...
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2013-05-31
... health coverage options available. The Advisory Panel on Outreach and Education allows us to consider a... Education (APOE) and Request for Nominations AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... Education (APOE) has been renewed. It also requests nominations for individuals to serve on the APOE. DATES...
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42 CFR 460.124 - Additional appeal rights under Medicare or Medicaid.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Additional appeal rights under Medicare or Medicaid. 460.124 Section 460.124 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... or Medicaid. A PACE organization must inform a participant in writing of his or her appeal rights...
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Medical Expenditures Associated With Diabetes Among Youth With Medicaid Coverage.
Shrestha, Sundar S; Zhang, Ping; Thompson, Theodore J; Gregg, Edward W; Albright, Ann; Imperatore, Giuseppina
2017-07-01
Information on diabetes-related excess medical expenditures for youth is important to understand the magnitude of financial burden and to plan the health care resources needed for managing diabetes. However, diabetes-related excess medical expenditures for youth covered by Medicaid program have not been investigated recently. To estimate excess diabetes-related medical expenditures among youth aged below 20 years enrolled in Medicaid programs in the United States. We analyzed data from 2008 to 2012 MarketScan multistate Medicaid database for 6502 youths with diagnosed diabetes and 6502 propensity score matched youths without diabetes, enrolled in fee-for-service payment plans. We stratified analysis by Medicaid eligibility criteria (poverty or disability). We used 2-part regression models to estimate diabetes-related excess medical expenditures, adjusted for age, sex, race/ethnicity, year of claims, depression status, asthma status, and interaction terms. For poverty-based Medicaid enrollees, estimated annual diabetes-related total medical expenditure was $9046 per person [$3681 (no diabetes) vs. $12,727 (diabetes); PMedicaid enrollees, the estimated annual diabetes-related total medical expenditure was $9944 per person ($14,149 vs. $24,093; PMedicaid programs are substantial, which is larger among those with disabilities than without disabilities. Identifying cost-effective ways of managing diabetes in this vulnerable segment of the youth population is needed.
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Kabiri, Mina; Chhatwal, Jagpreet; Donohue, Julie M; Roberts, Mark S; James, A Everette; Dunn, Michael A; Gellad, Walid F
2017-09-01
Several highly effective but costly therapies for hepatitis C virus (HCV) are available. As a consequence of their high price, 36 state Medicaid programs limited treatment coverage to patients with more advanced HCV stages. States have only limited information available to predict the long-term impact of these decisions. We adapted a validated hepatitis C microsimulation model to the Pennsylvania Medicaid population to estimate the existing HCV prevalence in Pennsylvania Medicaid and estimate the impact of various HCV drug coverage policies on disease outcomes and costs. Outcome measures included rates of advanced-stage HCV outcomes and treatment and disease costs in both Medicaid and Medicare. We estimated that 46,700 individuals in Pennsylvania Medicaid were infected with HCV in 2015, 33% of whom were still undiagnosed. By expanding treatment to include mild fibrosis stage (Metavir F2), Pennsylvania Medicaid will spend an additional $273 million on medications in the next decade with no substantial reduction in the incidence of liver cancer or liver-related death. Medicaid patients who are not eligible for treatment under restricted policies would get treatment once they transition to the Medicare program, which would incur 10% reduction in HCV-related costs due to early treatment in Medicaid. Further expanding treatment to patients with early fibrosis stages (F0 or F1) would cost Medicaid an additional $693 million during the next decade but would reduce the number of individuals in need of treatment in Medicare by 46% and decrease Medicare treatment costs by 23%. In some scenarios, outcomes could worsen with eligibility expansion if there is inadequate capacity to treat all patients. Expansion of HCV treatment coverage to less severe stages of liver disease may not substantially improve liver related outcomes for patients in Pennsylvania Medicaid in scenarios in which coverage through Medicare is widely available. Published by Elsevier Inc.
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An overview of Medicaid managed care litigation.
Rosenbaum, S; Teitelbaum, J; Kirby, C; Priebe, L; Klement, T
1998-11-01
Since the enactment of Medicaid in 1965, states have had the option of offering beneficiaries enrollment in managed care arrangements. With the advent of mandatory managed care reaching millions of beneficiaries (including a growing proportion of disabled recipients), the amount and scope of litigation involving Medicaid managed care plans can be expected to grow. A review of the current litigation regarding Medicaid managed care reveals two basic types of lawsuits: (1) those that challenge the practices of managed care companies under various federal and state laws that safeguard consumer rights, protect health care quality, and prohibit discrimination; and (2) suits that assert claims arising directly under the Medicaid statute and implementing regulations, as well as claims related to Constitutional safeguards that undergird the program. Lawsuits asserting claims arising under Medicaid tend to raise two basic questions: (1) the extent to which enrollment in a Medicaid managed care plan alters existing Medicaid beneficiary rights and state agency duties under federal or state Medicaid law; and (2) the extent to which managed care companies, as agents of the state, act under "color of law" (i.e., undertaking to perform official duties or acting with the imprimatur of state authority). Additionally, states might see an increase in litigation brought by prospective and current contractors who assert that they have been wrongfully denied contracts or improperly penalized for poor performance. These assertions may involve claims that are grounded in federal and state law, the Medicaid statute, and the Constitution. Moreover, in light of the consumer protection elements of the managed care reforms contained in the Balanced Budget Act, future managed care litigation may focus on the manner in which companies carry out states' obligations toward managed care enrollees. Resolution of Medicaid managed care cases involves the application of general principles of
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2012-05-11
... the Social Security Act, as amended by the Patient Protection and Affordable Care Act of 2010 (the...: CMS-2370-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. 4. By hand or... & Medicaid Services, Department of Health and Human Services, 7500 Security Boulevard, Baltimore, MD 21244...
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30 CFR 902.10 - State regulatory program approval.
2010-07-01
... Mining and Water Management, 3601 C Street, Suite 800, Anchorage, AK 99503-5925, Telephone: (907) 762... Section 902.10 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE ALASKA § 902.10 State...
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Medicaid and the politics of groups: recipients, providers, and policy making.
Kronebusch, K
1997-06-01
There is a substantial heterogeneity of interests within the Medicaid program. Its major beneficiary groups include the elderly, people with disabilities, children in low-income families, and adults receiving Aid to Families with Dependent Children. Providers who deliver medical services to these recipients represent another set of potential claimants. These groups are likely to be treated differently by the politics that affect the design and management of the Medicaid program. The Medicaid recipient groups vary in several important dimensions: First, the groups differ politically, a dimension that includes their political participation, their relationships to parties and electoral coalitions, the images they present to other political actors, and the legacy of public policies that affect them. Second, the groups have different medical and social needs. Third, the groups differ with respect to economic constraints, including the political economy of labor markets and of government spending programs, and they have differing relationships to the various types of medical providers. The medical providers are themselves political actors with a variety of characteristics that create political advantages relative to recipients, although there is also diversity among providers. The politics of the Medicaid program involves more than simply technical decisions about eligibility, coverage of medical services, reimbursement, and the implementation of managed care initiatives. Instead the differences between the program's multiple claimants are an important element of current Medicaid politics and the likely path of future reforms.
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2010-07-07
...-0672; Directorate Identifier 2010-NM-047-AD] RIN 2120-AA64 Airworthiness Directives; McDonnell Douglas...: McDonnell Douglas Corporation: Docket No. FAA-2010-0672; Directorate Identifier 2010-NM-047-AD. Comments Due... applies to McDonnell Douglas Corporation Model DC- 10-10, DC-10-10F, DC-10-30, DC-10-30F (KDC-10), DC-10...
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Medicaid program choice, inertia and adverse selection.
Marton, James; Yelowitz, Aaron; Talbert, Jeffery C
2017-12-01
In 2012, Kentucky implemented Medicaid managed care statewide, auto-assigned enrollees to three plans, and allowed switching. Using administrative data, we find that the state's auto-assignment algorithm most heavily weighted cost-minimization and plan balancing, and placed little weight on the quality of the enrollee-plan match. Immobility - apparently driven by health plan inertia - contributed to the success of the cost-minimization strategy, as more than half of enrollees auto-assigned to even the lowest quality plans did not opt-out. High-cost enrollees were more likely to opt-out of their auto-assigned plan, creating adverse selection. The plan with arguably the highest quality incurred the largest initial profit margin reduction due to adverse selection prior to risk adjustment, as it attracted a disproportionate share of high-cost enrollees. The presence of such selection, caused by differential degrees of mobility, raises concerns about the long run viability of the Medicaid managed care market without such risk adjustment. Copyright © 2017 Elsevier B.V. All rights reserved.
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2010-10-14
... Airworthiness Directives; McDonnell Douglas Corporation Model DC- 10-10, DC-10-10F, DC-10-30, DC-10-30F (KDC-10... following new airworthiness directive (AD): 2010-21-13 McDonnell Douglas Corporation: Amendment 39-16473... November 18, 2010. Affected ADs (b) None. Applicability (c) This AD applies to McDonnell Douglas...
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10 CFR 905.30 - Purpose and applicability.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Purpose and applicability. 905.30 Section 905.30 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.30 Purpose and applicability. (a) The Power Marketing Initiative (PMI) provides a framework for marketing Western's long-term...
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Late-time cosmological approach in mimetic f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Baffou, E.H. [Institut de Mathematiques et de Sciences Physiques (IMSP), Porto-Novo (Benin); Houndjo, M.J.S. [Institut de Mathematiques et de Sciences Physiques (IMSP), Porto-Novo (Benin); Faculte des Sciences et Techniques de Natitingou, Natitingou (Benin); Hamani-Daouda, M. [Universite de Niamey, Departement de Physique, Niamey (Niger); Alvarenga, F.G. [Universidade Federal do Espirito Santo, Departamento de Engenharia e Ciencias Naturais, CEUNES, Sao Mateus, ES (Brazil)
2017-10-15
In this paper, we investigate the late-time cosmic acceleration in mimetic f(R, T) gravity with the Lagrange multiplier and potential in a Universe containing, besides radiation and dark energy, a self-interacting (collisional) matter. We obtain through the modified Friedmann equations the main equation that can describe the cosmological evolution. Then, with several models from Q(z) and the well-known particular model f(R, T), we perform an analysis of the late-time evolution. We examine the behavior of the Hubble parameter, the dark energy equation of state and the total effective equation of state and in each case we compare the resulting picture with the non-collisional matter (assumed as dust) and also with the collisional matter in mimetic f(R, T) gravity. The results obtained are in good agreement with the observational data and show that in the presence of the collisional matter the dark energy oscillations in mimetic f(R, T) gravity can be damped. (orig.)
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Medicare and Medicaid programs; advance directives--HCFA. Final rule.
1995-06-27
This final rule responds to public comments on the March 6, 1992 interim final rule with comment period that amended the Medicare and Medicaid regulations governing provider agreements and contracts to establish requirements for States, hospitals, nursing facilities, skilled nursing facilities, providers of home health care or personal care services, hospice programs and managed care plans concerning advance directives. An advance directive is a written instruction, such as a living will or durable power of attorney for health care, recognized under State law, relating to the provision of health care when an individual's condition makes him or her unable to express his or her wishes. The intent of the advance directives provisions is to enhance an adult individual's control over medical treatment decisions. This rule confirms the interim final rule with several minor changes based on our review and consideration of public comments.
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AP1000R pressurised water reactor project in china advances toward completion
International Nuclear Information System (INIS)
Harrop, G.
2014-01-01
The AP1000 R pressurised water reactor (PWR) project in China is the first deployment of its first-of-a-kind Generation III+ technology, making it one of most internationally important and industry-significant new build projects. The innovative AP1000 PWR design contains advanced passive safety and performance features that involve fewer active safety components than a traditional plant, thereby reducing the site footprint. The AP1000 reactor is the first and only Generation III+ nuclear power plant to be granted design certification by the United States Nuclear Regulatory Commission, and it has received an Interim Design Acceptance Confirmation from the Office for Nuclear Regulation and an Interim Statement of Design Acceptability from the Environment Agency in the United Kingdom. Construction and testing of dual AP1000 PWR units is currently in progress in each of two coastal sites in the People's Republic of China: Sanmen (Zhejiang Province) and Haiyang (Shandong Province). Since the initial contract award in 2007, the Westinghouse Consortium has worked in concert with the owners to construct the plants using innovative structural and mechanical modules. Uniquely designed plant components and essential instrumentation and control systems have been manufactured, delivered, and installed at the plants. Numerous personnel, including future reactor operators, have been trained at both the Sanmen and Haiyang sites, and technology transfer of technical documents and computer codes is well underway. The commercial operation dates are now nearing for Sanmen Unit 1 and Haiyang Unit 1, the first two units scheduled for completion. Consequently, these units are now in advanced stages of completion and present activities include planning and preparation for pre-operational testing, system turnover, and commissioning leading to fuel load, and eventual commercial operation. These activities are pioneering, in that they have never before been performed for a new build of
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State Variation in Medicaid Reimbursements for Orthopaedic Surgery.
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.
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Generation of spherically symmetric metrics in f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Amirabi, Z.; Halilsoy, M.; Mazharimousavi, S.H. [Eastern Mediterranean University, Department of Physics, Gazimagusa (Turkey)
2016-06-15
In D-dimensional spherically symmetric f(R) gravity there are three unknown functions to be determined from the fourth order differential equations. It is shown that the system remarkably may be integrated to relate two functions through the third one to provide a reduction to second order equations accompanied with a large class of potential solutions. The third function, which acts as the generator of the process, is F(R) = (df(R))/(dR). We recall that our generating function has been employed as a scalar field with an accompanying self-interacting potential previously, which is entirely different from our approach. Reduction of f(R) theory into a system of equations seems to be efficient enough to generate a solution corresponding to each generating function. As particular examples, besides the known ones, we obtain new black hole solutions in any dimension D. We further extend our analysis to cover non-zero energy-momentum tensors. Global monopole and Maxwell sources are given as examples. (orig.)
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Directory of Open Access Journals (Sweden)
Jennifer Kahende
Full Text Available To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes.We used the linked National Health Interview Survey (survey years 1995, 1997-2005 and the Medicaid Analytic eXtract files (1999-2008 to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare. Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage, individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding.In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01. Cessation medication utilization was greater among older individuals (≥ 25 years, females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization.Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999-2008 and varied by individual and state-level characteristics. Given that the
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Rational approximations of f(R) cosmography through Pad'e polynomials
Capozziello, Salvatore; D'Agostino, Rocco; Luongo, Orlando
2018-05-01
We consider high-redshift f(R) cosmography adopting the technique of polynomial reconstruction. In lieu of considering Taylor treatments, which turn out to be non-predictive as soon as z>1, we take into account the Pad&apose rational approximations which consist in performing expansions converging at high redshift domains. Particularly, our strategy is to reconstruct f(z) functions first, assuming the Ricci scalar to be invertible with respect to the redshift z. Having the so-obtained f(z) functions, we invert them and we easily obtain the corresponding f(R) terms. We minimize error propagation, assuming no errors upon redshift data. The treatment we follow naturally leads to evaluating curvature pressure, density and equation of state, characterizing the universe evolution at redshift much higher than standard cosmographic approaches. We therefore match these outcomes with small redshift constraints got by framing the f(R) cosmology through Taylor series around 0zsimeq . This gives rise to a calibration procedure with small redshift that enables the definitions of polynomial approximations up to zsimeq 10. Last but not least, we show discrepancies with the standard cosmological model which go towards an extension of the ΛCDM paradigm, indicating an effective dark energy term evolving in time. We finally describe the evolution of our effective dark energy term by means of basic techniques of data mining.
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F(R Gravity’s Rainbow and Its Einstein Counterpart
Directory of Open Access Journals (Sweden)
S. H. Hendi
2016-01-01
Full Text Available Motivated by UV completion of general relativity with a modification of a geometry at high energy scale, it is expected to have an energy dependent geometry. In this paper, we introduce charged black hole solutions with power Maxwell invariant source in the context of gravity’s rainbow. In addition, we investigate two classes of F(R gravity’s rainbow solutions. At first, we study energy dependent F(R gravity without energy-momentum tensor, and then we obtain F(R gravity’s rainbow in the presence of conformally invariant Maxwell source. We study geometrical properties of the mentioned solutions and compare their results. We also give some related comments regarding thermodynamical behavior of the obtained solutions and discuss thermal stability of the solutions.
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Reforming Access: Trends in Medicaid Enrollment for New Medicare Beneficiaries, 2008-2011.
Keohane, Laura M; Rahman, Momotazur; Mor, Vincent
2016-04-01
To evaluate whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. Medicare enrollment records for years 2007-2011. We used a multinomial logistic model with state fixed effects to examine the annual change in limited and full Medicaid enrollment among new Medicare beneficiaries for 2 years before and after the reforms (2008-2011). We identified new Medicare beneficiaries in the years 2008-2011 and their participation in Medicaid based on Medicare enrollment records. The percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability (p < .001). There was no significant difference in the size of enrollment increases between states with and without concurrent limited Medicaid eligibility expansions. Our findings suggest that streamlining financial assistance programs may improve Medicare beneficiaries' access to benefits. © Health Research and Educational Trust.
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Exploring the liminality: properties of haloes and subhaloes in borderline f(R) gravity
Shi, Difu; Li, Baojiu; Han, Jiaxin; Gao, Liang; Hellwing, Wojciech A.
2015-09-01
We investigate the properties of dark matter haloes and subhaloes in an f(R) gravity model with |fR0| = 10-6, using a very-high-resolution N-body simulation. The model is a borderline between being cosmologically interesting and yet still consistent with current data. We find that the halo mass function in this model has a maximum 20 per cent enhancement compared with the Λ-cold-dark-matter (ΛCDM) predictions between z = 1 and 0. Because of the chameleon mechanism which screens the deviation from standard gravity in dense environments, haloes more massive than 1013 h-1 M⊙ in this f(R) model have very similar properties to haloes of similar mass in ΛCDM, while less massive haloes, such as that of the Milky Way, can have steeper inner density profiles and higher velocity dispersions due to their weaker screening. The halo concentration is remarkably enhanced for low-mass haloes in this model due to a deepening of the total gravitational potential. Contrary to the naive expectation, the halo formation time zf is later for low-mass haloes in this model, a consequence of these haloes growing faster than their counterparts in ΛCDM at late times and the definition of zf. Subhaloes, especially those less massive than 1011 h-1 M⊙, are substantially more abundant in this f(R) model for host haloes less massive than 1013 h-1 M⊙. We discuss the implications of these results for the Milky Way satellite abundance problem. Although the overall halo and subhalo properties in this borderline f(R) model are close to their ΛCDM predictions, our results suggest that studies of the Local Group and astrophysical systems, aided by high-resolution simulations, can be valuable for further tests of it.
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30 CFR 402.10 - Research-project applications.
2010-07-01
... project title, project objectives, background information, research tasks, methodology to conduct the... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Research-project applications. 402.10 Section... PROGRAM AND THE WATER-RESOURCES TECHNOLOGY DEVELOPMENT PROGRAM Application, Evaluation, and Management...
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The holographic bound in the scalar-tensor and f(R) gravities
International Nuclear Information System (INIS)
Firouzjaee, J.T.
2013-01-01
The holographic bound has been extended to the different theory of gravities such as scalar-tensor gravity and f(R) gravity according to the Noether charge definition of the entropy for a black hole surface. We have introduced some popular examples of the flat FRW cosmology in order to investigate holographic bound in scalar-tensor and f(R) gravity. Using the holographic bound, we put an additional constraint on scalar-tensor gravity and the f(R) gravity parameters. We also discuss the transformation from Jordan frame to Einstein frame. (orig.)
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2010-02-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1566-CN... 22, 2010 (75 FR 3743), there were a number of technical errors that are identified and corrected in... telephone at the number listed in the FOR FURTHER INFORMATION CONTACT section of this notice by the date...
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Directory of Open Access Journals (Sweden)
Pilon D
2017-03-01
Full Text Available Dominic Pilon,1 Kruti Joshi,2 Neeta Tandon,2 Marie-Hélène Lafeuille,1 Rhiannon L Kamstra,1 Bruno Emond,1 Patrick Lefebvre2 1Groupe d’analyse, Ltée, Montréal, QC, Canada; 2Janssen Scientific Affairs, LLC, Titusville, NJ, USA Background: Poor antipsychotic (AP adherence is a key issue in patients with schizophrenia. First-generation antipsychotic (FGA and second-generation antipsychotic (SGA long-acting injectable therapies (LAI may improve adherence compared to oral antipsychotics (OAP. The objective of the study was to compare treatment adherence and persistence in Medicaid patients with schizophrenia initiated on first-generation long-acting injectable therapies (FGA-LAI or second-generation long-acting injectable therapies (SGA-LAI versus OAP.Methods: Adults with schizophrenia initiated on FGA-LAI, SGA-LAI, or OAP on or after January 2010 were identified using a six-state Medicaid database (January 2009– March 2015. Outcomes were assessed during the 12 months following treatment initiation. Index medication adherence was assessed using the proportion of days covered ≥80%, while persistence was assessed as no gap of ≥30, ≥60, or ≥90 days between days of supply. Outcomes were compared between FGA/SGA-LAI and OAP cohorts using chi-squared tests and adjusted odds ratios (OR.Results: During follow-up, AP polypharmacy was more common in FGA-LAI patients (N=1,089; 36%; P=0.029 and less common in SGA-LAI patients (N=2,209; 27%; P<0.001 versus OAP patients (N=20,478; 33%. After adjustment, SGA-LAI patients had 24% higher odds of adherence at 12 months (OR: 1.24; P<0.001, in contrast to FGA-LAI patients who had 48% lower odds of adherence (OR: 0.52; P<0.001 relative to OAP patients. SGA-LAI patients were more likely to be persistent (no gap ≥60 days at 12 months than OAP patients (37% vs 30%; P<0.001, but not FGA-LAI patients (31% vs 30%; P=0.776. In comparison to OAP patients, SGA-LAI patients had 46% higher adjusted odds of
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Lanese, Bethany G; Oglesby, Willie H
2016-01-01
Title X of the Public Health Service Act provides funding for a range of reproductive health services, with a priority given to low-income persons. Now that many of these services are provided to larger numbers of people with low-income since the passage of the Affordable Care Act and Medicaid expansion, questions remain on the continued need for the Title X program. The current project highlights the importance of these safety net programs. To help inform this policy issue, research was conducted to examine the revenue and service changes for Title X per state and compare those findings to the states' Medicaid expansion and demographics. The dataset include publicly available data from 2013 and 2014 Family Planning Annual Reports (FPAR). Paired samples differences of means t-tests were then used to compare the means of family planning participation rates for 2013 and 2014 across the different categories for Medicaid expansion states and non-expansion states. The ACA has had an impact on Title X services, but the link is not as direct as previously thought. The findings indicate that all states' Title X funded clinics lost revenue; however, expansion states fared better than non-expansion states. While the general statements from the FPAR National surveys certainly are supported in that Title X providers have decreased in number and scope of services, which has led to the decrease in total clients, these variations are not evenly applied across the states. The ACA has very likely had an impact on Title X services, but the link is not as obvious as previously thought. Title X funded clinics have helped increase access to health insurance at a greater rate in expansion states than non-expansion states. There was much concern from advocates that with the projected increased revenue from Medicaid and private insurance, that Title X programs could be deemed unnecessary. However, this revenue increase has yet to actually pan out. Title X still helps fill a much needed
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Ibrahim, Alshaymaa Ahmed; El-Lebedy, Dalia; Ashmawy, Ingy; Hady, Maha Abdel
2017-06-01
Paraoxonase-1 (PON1) is involved in the oxidative stress process that cause tissue damage observed in systemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APS). The aim of the present study was to investigate the association of PON1 Q192R and L55M polymorphisms with risk of SLE and associated APS among Egyptian sample. The study included 120 SLE patients (45 without APS and 75 with APS) and 120 healthy subjects. PON1 Q192R and L55M polymorphisms were genotyped by real-time PCR. No significant differences in Q192R genotypes or allele frequencies were found between patients and controls (p = 0.5 and 0.1, respectively). The frequency of the 55M allele was significantly higher in SLE patients than in controls (66.6 vs. 43.3%), while the 55L allele was more frequent in controls (56.6%) than in patients (33.3%) (p = 0.03). The LL genotype was more frequent in controls (21.6%) than in patients (10%) while M allele carrier genotypes (LM + MM) were more frequent among patients (90%) than controls (78.3%), p = 0.04. Also, the 55M allele was more frequent in APS patients (73.3%) than in patients without APS (55.6%), p = 0.004. M allele carrier genotypes (LM + MM) was significantly higher among APS patients (95.4%) than in non-APS patients (80%), p = 0.008. Our results indicated that the PON1 L55M polymorphism associated with SLE and associated APS in a population from Cairo of Egypt, while the Q192R polymorphism plays no role in disease susceptibility. A large scale study to assess PON1 polymorphisms, PON1 activity, and markers of oxidative stress interaction is needed to clarify the role of PON-1 polymorphisms in the pathogenesis of SLE and associated APS.
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Medicaid. Will the public program neglect the poor to pay for the elderly?
Hudson, T
1995-05-20
If the policy-makers trying to fix Medicaid think they've thought of every angle, they should think about the situation of Peggy, a middle-class Illinois widow stricken with Alzheimer's disease, who's being forced to spend down her savings to get Medicaid coverage for her nursing home care. In fact, there are several million Peggys out there, and balancing their needs against those of the hard-core Medicaid poor may break a system that was never resource-blessed to begin with.
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30 CFR 884.13 - Content of proposed State reclamation plan.
2010-07-01
... reclamation program, the Rural Abandoned Mine Program administered by the Soil Conservation Service, the... wildlife and their habitat. [47 FR 28600, June 30, 1982, as amended at 73 FR 67642, Nov. 14, 2008] ...
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Le developpement de Limacella glioderma (Fr.) R. Maire
Reijnders, A.F.M.
1979-01-01
A comparison of the development of Limacella guttata (Fr.) Konrad & Maublanc with that of L. glioderma (Fr.) R. Maire shows clearly that the latter is of a more primitive type. This conclusion is based on the following observations: a. Limacella guttata has a pileocarpic development: the first
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45 CFR 235.70 - Prompt notice to child support or Medicaid agency.
2010-10-01
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Prompt notice to child support or Medicaid agency... Medicaid agency. (a) A State plan under title IV-A of the Social Security Act must provide for prompt.... Prompt notice must also include all relevant information as prescribed by the State medicaid agency for...
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APS Education and Diversity Efforts
Prestridge, Katherine; Hodapp, Theodore
2015-11-01
American Physical Society (APS) has a wide range of education and diversity programs and activities, including programs that improve physics education, increase diversity, provide outreach to the public, and impact public policy. We present the latest programs spearheaded by the Committee on the Status of Women in Physics (CSWP), with highlights from other diversity and education efforts. The CSWP is working to increase the fraction of women in physics, understand and implement solutions for gender-specific issues, enhance professional development opportunities for women in physics, and remedy issues that impact gender inequality in physics. The Conferences for Undergraduate Women in Physics, Professional Skills Development Workshops, and our new Professional Skills program for students and postdocs are all working towards meeting these goals. The CSWP also has site visit and conversation visit programs, where department chairs request that the APS assess the climate for women in their departments or facilitate climate discussions. APS also has two significant programs to increase participation by underrepresented minorities (URM). The newest program, the APS National Mentoring Community, is working to provide mentoring to URM undergraduates, and the APS Bridge Program is an established effort that is dramatically increasing the number of URM PhDs in physics.
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2013-03-07
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 412... philosophy and principles identified in Executive Order 12866 and 13563, the RFA, and section 1102(b) of the.... Approved: March 1, 2013. Kathleen Sebelius, Secretary, Department of Health and Human Services. [FR Doc...
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The relationship of post-acute home care use to Medicaid utilization and expenditures.
Payne, Susan M C; DiGiuseppe, David L; Tilahun, Negussie
2002-06-01
To describe the use of post-acute home care (PAHC) and total Medicaid expenditures among hospitalized nonelderly adult Medicaid eligibles and to test whether health services utilization rates or total Medicaid expenditures were lower among Medicaid eligibles who used PAHC compared to those who did not. 5,299 Medicaid patients aged 18-64 discharged in 1992-1996 from 29 hospitals in the Cleveland Health Quality Choice (CHQC) project. Linked Ohio Medicaid claims and CHQC medical record abstract data. One stay per patient was randomly selected. Observational study. To control for treatment selection bias, we developed a model predicting the probability (propensity) a patient would be referred to PAHC, as a proxy for the patient's need for PAHC. We matched 430 patients who used Medicaid-covered PAHC ("USE") to patients who did not ("NO USE") by their propensity scores. Study outcomes were inpatient re-admission rates and days of stay (DOS), nursing home admission rates and DOS, and mean total Medicaid expenditures 90 and 180 days after discharge. Of 3,788 medical patients, 12.1 percent were referred to PAHC; 64 percent of those referred used PAHC. Of 1,511 surgical patients, 10.9 percent were referred; 99 percent of those referred used PAHC. In 430 pairs of patients matched by propensity score, mean total Medicaid expenditures within 90 days after discharge were $7,649 in the USE group and $5,761 in the NO USE group. Total Medicaid expenditures were significantly higher in the USE group compared to the NO USE group for medical patients after 180 days (p analysis indicates the results may be influenced by unmeasured variables, most likely functional status and/or care-giver support. Thirty-six percent of the medical patients referred to PAHC did not receive Medicaid-covered services. This suggests potential underuse among medical patients. The high post-discharge expenditures suggest opportunities for reducing costs through coordinating utilization or diverting it to
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Synthesis and properties of ApA analogues with shortened phosphonate internucleotide linkage
Czech Academy of Sciences Publication Activity Database
Králíková, Šárka; Buděšínský, Miloš; Barvík, I.; Masojídková, Milena; Točík, Zdeněk; Rosenberg, Ivan
2011-01-01
Roč. 30, 7/9 (2011), s. 524-543 ISSN 1525-7770 R&D Projects: GA ČR GA202/09/0193; GA AV ČR KAN200520801; GA MŠk(CZ) LC06061 Institutional research plan: CEZ:AV0Z40550506 Keywords : alpha-hydroxy-phosphonate linkage * ApA analogues * phosphonate internucleotide bond * NMR conformational study Subject RIV: CC - Organic Chemistry Impact factor: 0.899, year: 2011
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High-Expenditure Pharmaceutical Use Among Children in Medicaid.
Cohen, Eyal; Hall, Matt; Lopert, Ruth; Bruen, Brian; Chamberlain, Lisa J; Bardach, Naomi; Gedney, Jennifer; Zima, Bonnie T; Berry, Jay G
2017-09-01
Medication use may be a target for quality improvement, cost containment, and research. We aimed to identify medication classes associated with the highest expenditures among pediatric Medicaid enrollees and to characterize the demographic, clinical, and health service use of children prescribed these medications. Retrospective, cross-sectional study of 3 271 081 Medicaid-enrolled children. Outpatient medication spending among high-expenditure medication classes, defined as the 10 most expensive among 261 mutually exclusive medication classes, was determined by using transaction prices paid to pharmacies by Medicaid agencies and managed care plans among prescriptions filled and dispensed in 2013. Outpatient medications accounted for 16.6% of all Medicaid expenditures. The 10 most expensive medication classes accounted for 63.9% of all medication expenditures. Stimulants (amphetamine-type) accounted for both the highest proportion of expenditures (20.6%) and days of medication use (14.0%) among medication classes. Users of medications in the 10 highest-expenditure classes were more likely to have a chronic condition of any complexity (77.9% vs 41.6%), a mental health condition (35.7% vs 11.9%), or a complex chronic condition (9.8% vs 4.3%) than other Medicaid enrollees (all P costs may benefit from better delineation of the appropriate prescription of these medications. Copyright © 2017 by the American Academy of Pediatrics.
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1985-07-30
This final rule provides the additional requirements to the conditions and procedures for initial approval and reapproval of Medicaid Management Information Systems (MMIS) that were added by section 1903(r) of the Social Security Act (as amended by section 901 of the Mental Health Systems Act of 1980, Pub. L. 96-398). These provisions are intended to improve States' MMIS, ensure efficient system operations, and make the procedures for detection of fraud, waste, and abuse more effective. In addition, this final rule specifies the procedures we follow in reducing the level of Federal financial participation in State administrative expenditures if a State fails to meet the conditions for initial operation, initial approval, or reapproval of an MMIS.
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Propagating Degrees of Freedom in f(R Gravity
Directory of Open Access Journals (Sweden)
Yun Soo Myung
2016-01-01
Full Text Available We have computed the number of polarization modes of gravitational waves propagating in the Minkowski background in f(R gravity. These are three of two from transverse-traceless tensor modes and one from a massive trace mode, which confirms the results found in the literature. There is no massless breathing mode and the massive trace mode corresponds to the Ricci scalar. A newly defined metric tensor in f(R gravity satisfies the transverse-traceless (TT condition as well as the TT wave equation.
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The coincidence problem in holographic f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Bisabr, Yousef, E-mail: y-bisabr@srttu.edu [Department of Physics, Shahid Rajaee Teacher Training University, Lavizan, Tehran 16788 (Iran, Islamic Republic of)
2011-09-15
It is well known that f(R) gravity models formulated in the Einstein conformal frame are equivalent to Einstein gravity together with a minimally coupled scalar field. In this case, the scalar field couples with the matter sector and the coupling term is given by the conformal factor. We apply the holographic principle to such interacting models. In a spatially flat universe, we show that the Einstein frame representation of f(R) models leads to a constant ratio of energy densities of dark matter to dark energy.
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Hall, Allyson G; Lemak, Christy Harris; Landry, Amy Yarbrough; Duncan, R Paul
2013-04-01
Engaging individuals in their own health care proves challenging for policy makers, health plans, and providers. Florida Medicaid introduced the Enhanced Benefits Rewards (EBR) program in 2006, providing financial incentives as rewards to beneficiaries who engage in health care seeking and healthy behaviors. This study analyzed beneficiary survey data from 2009 to determine predictors associated with awareness of and participation in the EBR program. Non-English speakers, those in a racial and ethnic minority group, those with less than a high school education, and those with limited or no connection to a health care provider were associated with lower awareness of the program. Among those aware of the program, these factors were also associated with reduced likelihood of engaging in the program. Individuals in fair or poor health were also less likely to engage in an approved behavior. Individuals who speak Spanish at home and those without a high school diploma were more likely than other groups to spend their earned program credits. Findings underscore the fact that initial engagement in such a program can prove challenging as different groups are not equally likely to be aware of or participate in an approved activity or redeem a credit. Physicians may play important roles in encouraging participation in programs to incentivize healthy behaviors.
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Distinguishing f(R) theories from general relativity by gravitational lensing effect
Energy Technology Data Exchange (ETDEWEB)
Liu, Hongguang [Beijing Normal University, Department of Physics, Beijing (China); Aix Marseille Universite et Universite de Toulon, Centre de Physique Theorique (UMR 7332), Marseille (France); Wang, Xin; Li, Haida; Ma, Yongge [Beijing Normal University, Department of Physics, Beijing (China)
2017-11-15
The post-Newtonian formulation of a general class of f(R) theories is set up in a third-order approximation. It turns out that the information of a specific form of f(R) gravity is encoded in the Yukawa potential, which is contained in the perturbative expansion of the metric components. Although the Yukawa potential is canceled in the second-order expression of the effective refraction index of light, detailed analysis shows that the difference of the lensing effect between the f(R) gravity and general relativity does appear at the third order when √(f''(0)/f{sup '}(0)) is larger than the distance d{sub 0} to the gravitational source. However, the difference between these two kinds of theories will disappear in the axially symmetric spacetime region. Therefore only in very rare case the f(R) theories are distinguishable from general relativity by gravitational lensing effect in a third-order post-Newtonian approximation. (orig.)
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General proof of the entropy principle for self-gravitating fluid in f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Fang, Xiongjun [Department of Physics and Key Laboratory of Low Dimensional Quantum Structures andQuantum Control of Ministry of Education, Hunan Normal University,Changsha, Hunan 410081 (China); Guo, Minyong [Department of Physics, Beijing Normal University,Beijing 100875 (China); Jing, Jiliang [Department of Physics and Key Laboratory of Low Dimensional Quantum Structures andQuantum Control of Ministry of Education, Hunan Normal University,Changsha, Hunan 410081 (China)
2016-08-29
The discussions on the connection between gravity and thermodynamics attract much attention recently. We consider a static self-gravitating perfect fluid system in f(R) gravity, which is an important theory could explain the accelerated expansion of the universe. We first show that the Tolman-Oppenheimer-Volkoff equation of f(R) theories can be obtained by thermodynamical method in spherical symmetric spacetime. Then we prove that the maximum entropy principle is also valid for f(R) gravity in general static spacetimes beyond spherical symmetry. The result shows that if the constraint equation is satisfied and the temperature of fluid obeys Tolmans law, the extrema of total entropy implies other components of gravitational equations. Conversely, if f(R) gravitational equation hold, the total entropy of the fluid should be extremum. Our work suggests a general and solid connection between f(R) gravity and thermodynamics.
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Zheng, Nan Tracy; Haber, Susan; Hoover, Sonja; Feng, Zhanlian
2017-12-01
Medicaid programs are not required to pay the full Medicare coinsurance and deductibles for Medicare-Medicaid dually eligible beneficiaries. We examined the association between the percentage of Medicare cost sharing paid by Medicaid and the likelihood that a dually eligible beneficiary used evaluation and management (E&M) services and safety net provider services. Medicare and Medicaid Analytic eXtract enrollment and claims data for 2009. Multivariate analyses used fee-for-service dually eligible and Medicare-only beneficiaries in 20 states. A comparison group of Medicare-only beneficiaries controlled for state factors that might influence utilization. Paying 100 percent of the Medicare cost sharing compared to 20 percent increased the likelihood (relative to Medicare-only) that a dually eligible beneficiary had any E&M visit by 6.4 percent. This difference in the percentage of cost sharing paid decreased the likelihood of using safety net providers, by 37.7 percent for federally qualified health centers and rural health centers, and by 19.8 percent for hospital outpatient departments. Reimbursing the full Medicare cost-sharing amount would improve access for dually eligible beneficiaries, although the magnitude of the effect will vary by state and type of service. © Health Research and Educational Trust.
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Thermodynamic laws for generalized f(R) gravity with curvature-matter coupling
International Nuclear Information System (INIS)
Wu Yabo; Zhao Yueyue; Cai Ronggen; Lu Jianbo; Lu Junwang; Gao Xiaojing
2012-01-01
The first law and the generalized second law (GSL) of thermodynamics for the generalized f(R) gravity with curvature-matter coupling are studied in the spatially homogeneous, isotropic FRW universe. The research results show that the field equations of the generalized f(R) gravity with curvature-matter coupling can be cast to the form of the first law of thermodynamics with the so-called the entropy production terms dS ¯ and the GSL can be given by considering the FRW universe filled only with ordinary matter enclosed by the dynamical apparent horizon with the Hawking temperature. Furthermore, as a concrete example, by utilizing the GSL the constraints on the gravitational model with f 1 (R)=R+αR l and f 2 (R)=R m are also discussed. It is worth noting these results given by us are quite general and can degenerate to the ones in Einstein's general relativity and pure f(R) gravity with non-coupling and non-minimal coupling as special cases. Comparing with the case of Einstein's general relativity, the appearance of the entropy production term dS ¯ in the first law of thermodynamics demonstrates that the horizon thermodynamics is non-equilibrium one for generalized f(R) gravity with curvature-matter coupling, which is consistent with the arguments given in Akbar and Cai (2007) [13] and Eling et al. (2006) [18].
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Stakeholder assessment of comparative effectiveness research needs for Medicaid populations
Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian
2015-01-01
Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement. PMID:26388438
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Lehmann, C U; Longhurst, C A; Hersh, W; Mohan, V; Levy, B P; Embi, P J; Finnell, J T; Turner, A M; Martin, R; Williamson, J; Munger, B
2015-01-01
In the US, the new subspecialty of Clinical Informatics focuses on systems-level improvements in care delivery through the use of health information technology (HIT), data analytics, clinical decision support, data visualization and related tools. Clinical informatics is one of the first subspecialties in medicine open to physicians trained in any primary specialty. Clinical Informatics benefits patients and payers such as Medicare and Medicaid through its potential to reduce errors, increase safety, reduce costs, and improve care coordination and efficiency. Even though Clinical Informatics benefits patients and payers, because GME funding from the Centers for Medicare and Medicaid Services (CMS) has not grown at the same rate as training programs, the majority of the cost of training new Clinical Informaticians is currently paid by academic health science centers, which is unsustainable. To maintain the value of HIT investments by the government and health care organizations, we must train sufficient leaders in Clinical Informatics. In the best interest of patients, payers, and the US society, it is therefore critical to find viable financial models for Clinical Informatics fellowship programs. To support the development of adequate training programs in Clinical Informatics, we request that the Centers for Medicare and Medicaid Services (CMS) issue clarifying guidance that would allow accredited ACGME institutions to bill for clinical services delivered by fellows at the fellowship program site within their primary specialty.
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Constraining f(R gravity in solar system, cosmology and binary pulsar systems
Directory of Open Access Journals (Sweden)
Tan Liu
2018-02-01
Full Text Available The f(R gravity can be cast into the form of a scalar–tensor theory, and scalar degree of freedom can be suppressed in high-density regions by the chameleon mechanism. In this article, for the general f(R gravity, using a scalar–tensor representation with the chameleon mechanism, we calculate the parametrized post-Newtonian parameters γ and β, the effective gravitational constant Geff, and the effective cosmological constant Λeff. In addition, for the general f(R gravity, we also calculate the rate of orbital period decay of the binary system due to gravitational radiation. Then we apply these results to specific f(R models (Hu–Sawicki model, Tsujikawa model and Starobinsky model and derive the constraints on the model parameters by combining the observations in solar system, cosmological scales and the binary systems.
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Kim, Il Won; Morse, Daniel E; Evans, John Spencer
2004-12-21
The AP7 protein is one of several mollusk shell proteins which are responsible for aragonite polymorph formation and stabilization within the nacre layer of the Pacific red abalone, H. rufescens. Previously, we demonstrated that the 30-AA N-terminal domain of AP7, denoted as AP7-1, exists as an unfolded sequence and possesses the capability of inhibiting calcium carbonate crystal growth in vitro via growth step frustration or interruption. However, very little is known with regard to the interactive capabilities of this sequence with Ca(II) and with calcium carbonates. Using multidisciplinary techniques, we determine that the AP7-1 polypeptide interacts with Ca(II) ions at the -DD- sequence clusters, yet retains its unfolded, conformationally labile structure in the presence of Ca(II) ions. Further, NMR experiments reveal that the extended structured sequence blocks, -GNGM-, -SVRTQG-, and -ISYL, exhibit motional, chemical exchange, and/or backbone geometry perturbations in response to Ca(II) interactions with AP7-1. Solid-state NMR magic angle spinning studies verify that during the course of in vitro calcium carbonate crystal growth, AP7-1 becomes bound to calcite fragments and cannot be entirely displaced from the mineral fragments using competitive Ca(II) washing. Finally, using a scrambled sequence version of the AP7-1 polypeptide, we observe that sequence scrambling does not adversely affect the crystal growth inhibitory activity of AP7-1, suggesting that the amino acid composition of AP7-1 may be more critical to growth step inhibition than the linear ordering of amino acids.
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2012-09-26
... September 30, 1998 (63 FR 52192). Pursuant to this authority, the BTS, now part of the Research and... transferred the responsibility for the F&OS program from BTS to FMCSA (69 FR 51009). On August 10, 2006 (71 FR... financial and statistical reporting regulations of BTS formerly located in chapter XI of title 49 CFR to...
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A no-hair theorem for black holes in f(R) gravity
Cañate, Pedro
2018-01-01
In this work we present a no-hair theorem which discards the existence of four-dimensional asymptotically flat, static and spherically symmetric or stationary axisymmetric, non-trivial black holes in the frame of f(R) gravity under metric formalism. Here we show that our no-hair theorem also can discard asymptotic de Sitter stationary and axisymmetric non-trivial black holes. The novelty is that this no-hair theorem is built without resorting to known mapping between f(R) gravity and scalar–tensor theory. Thus, an advantage will be that our no-hair theorem applies as well to metric f(R) models that cannot be mapped to scalar–tensor theory.
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Extension of loop quantum gravity to f(R) theories.
Zhang, Xiangdong; Ma, Yongge
2011-04-29
The four-dimensional metric f(R) theories of gravity are cast into connection-dynamical formalism with real su(2) connections as configuration variables. Through this formalism, the classical metric f(R) theories are quantized by extending the loop quantization scheme of general relativity. Our results imply that the nonperturbative quantization procedure of loop quantum gravity is valid not only for general relativity but also for a rather general class of four-dimensional metric theories of gravity.
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Rittenhouse, Diane R; Robinson, James C
2006-01-01
Care management processes (CMPs), tools to improve the efficiency and quality of primary care delivery, are particularly important for low-income patients facing substantial barriers to care. To measure the adoption of CMPs by medical groups, Independent Practice Associations, community clinics, and hospital-based clinics in California's Medicaid program and the factors associated with CMP adoption. Telephone survey of every provider organization with at least 6 primary care physicians and at least 1 Medi-Cal HMO contract, Spring 2003. One hundred twenty-three organizations participated, accounting for 64% of provider organizations serving Medicaid managed care in California. We surveyed 30 measures of CMP use for asthma and diabetes, and for child and adolescent preventive services. The mean number of CMPs used by each organization was 4.5 for asthma and 4.9 for diabetes (of a possible 8). The mean number of CMPs for preventive services was 4.0 for children and 3.5 for adolescents (of a possible 7). Organizations with more extensive involvement in Medi-Cal managed care used more CMPs for chronic illness and preventive service. Community clinics and hospital-based clinics used more CMPs for asthma and diabetes than did Independent Practice Associations (IPAs), and profitable organizations used more CMPs for child and adolescent preventive services than did entities facing severe financial constraints. The use of CMPs by Medicaid HMOs and the presence of external (financial and nonfinancial) incentives for clinical performance were strongly associated with use of care management by provider organizations. Physician and provider organizations heavily involved in California's Medicaid program are extensively engaged in preventive and chronic care management programs.
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Recent Health Care Use and Medicaid Entry of Medicare Beneficiaries.
Keohane, Laura M; Trivedi, Amal N; Mor, Vincent
2017-10-01
To examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. We identified Medicare beneficiaries without full Medicaid or use of hospital or nursing home services in 2008 (N = 2,163,387). A discrete survival analysis estimated beneficiaries' monthly likelihood of entry into the full Medicaid program between January 2009 and June 2010. During the 18-month study period, Medicaid entry occurred for 1.1% and 3.7% of beneficiaries who aged into Medicare or originally qualified for Medicare due to disability, respectively. Among beneficiaries who aged into Medicare, 49% of new Medicaid participants had no use of inpatient, skilled nursing facility, or nursing home services during the study period. Individuals who recently used inpatient, skilled nursing facility or nursing home services had monthly rates of 1.9, 14.0, and 38.1 new Medicaid participants per 1,000 beneficiaries, respectively, compared with 0.4 new Medicaid participants per 1,000 beneficiaries with no recent use of these services. Although recent health care use predicted greater likelihood of Medicaid entry, half of new Medicaid participants used no hospital or nursing home care during the study period. These patterns should be considered when designing and evaluating interventions to reform health care delivery for dual-eligible beneficiaries. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Constraint on reconstructed f(R) gravity models from gravitational waves
Lee, Seokcheon
2018-06-01
The gravitational wave (GW) detection of a binary neutron star inspiral made by the Advanced LIGO and Advanced Virgo paves the unprecedented way for multi-messenger observations. The propagation speed of this GW can be scrutinized by comparing the arrival times between GW and neutrinos or photons. It provides the constraint on the mass of the graviton. f(R) gravity theories have the habitual non-zero mass gravitons in addition to usual massless ones. Previously, we show that the model independent f(R) gravity theories can be constructed from the both background evolution and the matter growth with one undetermined parameter. We show that this parameter can be constrained from the graviton mass bound obtained from GW detection. Thus, the GW detection provides the invaluable constraint on the validity of f(R) gravity theories.
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Medicaid care management: description of high-cost addictions treatment clients.
Neighbors, Charles J; Sun, Yi; Yerneni, Rajeev; Tesiny, Ed; Burke, Constance; Bardsley, Leland; McDonald, Rebecca; Morgenstern, Jon
2013-09-01
High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control. We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals cost clients in the top decile of AODTx expenditures (HC; n=5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data. HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals. Copyright © 2013 Elsevier Inc. All rights reserved.
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The Expanding Role of Managed Care in the Medicaid Program
Caswell, Kyle J.; Long, Sharon K.
2015-01-01
States increasingly use managed care for Medicaid enrollees, yet evidence of its impact on health care outcomes is mixed. This research studies county-level Medicaid managed care (MMC) penetration and health care outcomes among nonelderly disabled and nondisabled enrollees. Results for nondisabled adults show that increased penetration is associated with increased probability of an emergency department visit, difficulty seeing a specialist, and unmet need for prescription drugs, and is not associated with reduced expenditures. We find no association between penetration and health care outcomes for disabled adults. This suggests that the primary gains from MMC may be administrative simplicity and budget predictability for states rather than reduced expenditures or improved access for individuals. PMID:25882616
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Lipton, Brandy J; Decker, Sandra L
2016-02-01
Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time. This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies. Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points. Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Medicaid and CHIP Payment and Access Commission - statistics
U.S. Department of Health & Human Services — MACStats includes state-specific information about program enrollment, spending, eligibility levels, optional Medicaid benefits covered, and the federal medical...
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Energy Technology Data Exchange (ETDEWEB)
Lu, Jianbo; Wu, Yabo; Wang, Yan; Yang, Weiqiang [Liaoning Normal University, Department of Physics, Dalian (China); Liu, Molin [Xinyang Normal University, Department of Physics, Xinyang (China)
2016-12-15
Tensions between several cosmic observations were found recently, such as the inconsistent values of H{sub 0} (or σ{sub 8}) were indicated by the different cosmic observations. Introducing the massive neutrinos in ΛCDM could potentially solve the tensions. Viable f(R) gravity producing ΛCDM background expansion with massive neutrinos is investigated in this paper. We fit the current observational data: Planck-2015 CMB, RSD, BAO, and SNIa to constrain the mass of neutrinos in viable f(R) theory. The constraint results at 95% confidence level are: Σm{sub ν} < 0.202 eV for the active-neutrino case, m{sub ν,sterile}{sup eff} < 0.757 eV with N{sub eff} < 3.22 for the sterile neutrino case. For the effects due to the mass of the neutrinos, the constraint results on model parameter at 95% confidence level become f{sub R0} x 10{sup -6} > -1.89 and f{sub R0} x 10{sup -6} > -2.02 for two cases, respectively. It is also shown that the fitting values of several parameters much depend on the neutrino properties, such as the cold dark matter density, the cosmological quantities at matter-radiation equality, the neutrino density and the fraction of baryonic mass in helium. Finally, the constraint result shows that the tension between direct and CMB measurements of H{sub 0} gets slightly weaker in the viable f(R) model than that in the base ΛCDM model. (orig.)
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Aviation Safety Program: Weather Accident Prevention (WxAP) Project Overview and Status
Nadell, Shari-Beth
2003-01-01
This paper presents a project overview and status for the Weather Accident Prevention (WxAP) aviation safety program. The topics include: 1) Weather Accident Prevention Project Background/History; 2) Project Modifications; 3) Project Accomplishments; and 4) Project's Next Steps.
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42 CFR 419.30 - Base expenditure target for calendar year 1999.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Base expenditure target for calendar year 1999. 419.30 Section 419.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Services § 419.30 Base expenditure target for calendar year 1999. (a) CMS estimates the aggregate amount...
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Probing the f(R) formalism through gravitational wave polarizations
International Nuclear Information System (INIS)
Alves, M.E.S.; Miranda, O.D.; Araujo, J.C.N. de
2009-01-01
The direct observation of gravitational waves (GW) in the near future, and the corresponding determination of the number of independent polarizations, is a powerful tool to test general relativity and alternative theories of gravity. In the present work we use the Newman-Penrose formalism to characterize GWs in quadratic gravity and in a particular class of f(R) Lagrangians. We find that both quadratic gravity and the f(R) theory belong to the most general invariant class of GWs, i.e., they can present up to six independent polarizations of GWs. For a particular combination of the parameters, we find that quadratic gravity can present up to five polarizations states. On the other hand, if we use the Palatini approach for f(R) theories, GWs present only the usual two transverse-traceless polarizations such as in general relativity. Thus, we conclude that the observation of GWs can strongly constrain the suitable formalism for these theories.
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On Analytical Solutions of f(R) Modified Gravity Theories in FLRW Cosmologies
Domazet, Silvije; Radovanović, Voja; Simonović, Marko; Štefančić, Hrvoje
2013-02-01
A novel analytical method for f(R) modified theories without matter in Friedmann-Lemaitre-Robertson-Walker (FLRW) spacetimes is introduced. The equation of motion for the scale factor in terms of cosmic time is reduced to the equation for the evolution of the Ricci scalar R with the Hubble parameter H. The solution of equation of motion for actions of the form of power law in Ricci scalar R is presented with a detailed elaboration of the action quadratic in R. The reverse use of the introduced method is exemplified in finding functional forms f(R), which leads to specified scale factor functions. The analytical solutions are corroborated by numerical calculations with excellent agreement. Possible further applications to the phases of inflationary expansion and late-time acceleration as well as f(R) theories with radiation are outlined.
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f(R in Holographic and Agegraphic Dark Energy Models and the Generalized Uncertainty Principle
Directory of Open Access Journals (Sweden)
Barun Majumder
2013-01-01
Full Text Available We studied a unified approach with the holographic, new agegraphic, and f(R dark energy model to construct the form of f(R which in general is responsible for the curvature driven explanation of the very early inflation along with presently observed late time acceleration. We considered the generalized uncertainty principle in our approach which incorporated the corrections in the entropy-area relation and thereby modified the energy densities for the cosmological dark energy models considered. We found that holographic and new agegraphic f(R gravity models can behave like phantom or quintessence models in the spatially flat FRW universe. We also found a distinct term in the form of f(R which goes as R 3 / 2 due to the consideration of the GUP modified energy densities. Although the presence of this term in the action can be important in explaining the early inflationary scenario, Capozziello et al. recently showed that f(R ~ R 3 / 2 leads to an accelerated expansion, that is, a negative value for the deceleration parameter q which fits well with SNeIa and WMAP data.
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Medicaid Primary Care Physician Fees and the Use of Preventive Services among Medicaid Enrollees
Atherly, Adam; Mortensen, Karoline
2014-01-01
Objective The Patient Protection and Affordable Care Act (ACA) increases Medicaid physician fees for preventive care up to Medicare rates for 2013 and 2014. The purpose of this paper was to model the relationship between Medicaid preventive care payment rates and the use of U.S. Preventive Services Task Force (USPSTF)–recommended preventive care use among Medicaid enrollees. Data Sources/Study Session We used data from the 2003 and 2008 Medical Expenditure Panel Survey (MEPS), a national probability sample of the U.S. civilian, noninstitutionalized population, linked to Kaiser state Medicaid benefits data, including the state Medicaid-to-Medicare physician fee ratio in 2003 and 2008. Study Design Probit models were used to estimate the probability that eligible individuals received one of five USPSF-recommended preventive services. A difference-in-difference model was used to separate out the effect of changes in the Medicaid payment rate and other factors. Data Collection/Extraction Methods Data were linked using state identifiers. Principal Findings Although Medicaid enrollees had a lower rate of use of the five preventive services in univariate analysis, neither Medicaid enrollment nor changes in Medicaid payment rates had statistically significant effects on meeting screening recommendations for the five screenings. The results were robust to a number of different sensitivity tests. Individual and state characteristics were significant. Conclusions Our results suggest that although temporary changes in primary care provider payments for preventive services for Medicaid enrollees may have other desirable effects, they are unlikely to substantially increase the use of these selected USPSTF-recommended preventive care services among Medicaid enrollees. PMID:24628495
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Medicaid expenditures for children living with smokers
Directory of Open Access Journals (Sweden)
Levy Douglas E
2011-05-01
Full Text Available Abstract Background Children's exposure to secondhand smoke is associated with increased morbidity. We estimated Medicaid expenditures for children living with smokers compared to those living with no smokers in the United States. Methods Data were overall and service-specific (i.e., inpatient, ambulatory, emergency department, prescription drug, and dental annual Medicaid expenditures for children 0-11 years old from the 2000-2007 Medical Expenditures Panel Surveys. Smokers' presence in households was determined by adult respondents' self reports. There were 25,835 person-years of observation. We used multivariate analyses to adjust for child, parent, and geographic characteristics. Results Children with Medicaid expenditures were nearly twice as likely to live with a smoker as other children in the U.S. population. Adjusted analyses revealed no detectable differences in children's overall Medicaid expenditures by presence of smokers in the household. Medicaid children who lived with smokers on average had $10 (95% CI $3, $18 higher emergency department expenditures per year than those living with no smokers. Conclusions Living with at least one smoker (a proxy for secondhand smoke exposure is unrelated to children's overall short-term Medicaid expenditures, but has a modest impact on emergency department expenditures. Additional research is necessary to understand the relationship between secondhand smoke exposure and long-term health and economic outcomes.
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AP1000{sup R} nuclear power plant safety overview for spent fuel cooling
Energy Technology Data Exchange (ETDEWEB)
Gorgemans, J.; Mulhollem, L.; Glavin, J.; Pfister, A.; Conway, L.; Schulz, T.; Oriani, L.; Cummins, E.; Winters, J. [Westinghouse Electric Company LLC, 1000 Westinghouse Drive, Cranberry Township, PA 16066 (United States)
2012-07-01
The AP1000{sup R} plant is an 1100-MWe class pressurized water reactor with passive safety features and extensive plant simplifications that enhance construction, operation, maintenance, safety and costs. The AP1000 design uses passive features to mitigate design basis accidents. The passive safety systems are designed to function without safety-grade support systems such as AC power, component cooling water, service water or HVAC. Furthermore, these passive features 'fail safe' during a non-LOCA event such that DC power and instrumentation are not required. The AP1000 also has simple, active, defense-in-depth systems to support normal plant operations. These active systems provide the first level of defense against more probable events and they provide investment protection, reduce the demands on the passive features and support the probabilistic risk assessment. The AP1000 passive safety approach allows the plant to achieve and maintain safe shutdown in case of an accident for 72 hours without operator action, meeting the expectations provided in the U.S. Utility Requirement Document and the European Utility Requirements for passive plants. Limited operator actions are required to maintain safe conditions in the spent fuel pool via passive means. In line with the AP1000 approach to safety described above, the AP1000 plant design features multiple, diverse lines of defense to ensure spent fuel cooling can be maintained for design-basis events and beyond design-basis accidents. During normal and abnormal conditions, defense-in-depth and other systems provide highly reliable spent fuel pool cooling. They rely on off-site AC power or the on-site standby diesel generators. For unlikely design basis events with an extended loss of AC power (i.e., station blackout) or loss of heat sink or both, spent fuel cooling can still be provided indefinitely: - Passive systems, requiring minimal or no operator actions, are sufficient for at least 72 hours under all
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75 FR 8391 - Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)
2010-02-24
... Conversion Program (ALCP) provides funding for the physical costs of converting some or all the units of an... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-10] Assisted Living Conversion... rehabilitate, modernize, or retrofit aging structure, common areas, or individual dwelling units through the...
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Reconstructing an f(R) model from holographic dark energy: using the observational evidence
International Nuclear Information System (INIS)
Saaidi, Kh; Aghamohammadi, A
2012-01-01
We investigate the correspondence relation between f(R) gravity and an interacting holographic dark energy (HDE). By obtaining the conditions needed for some observational evidence such as positive acceleration expansion of the Universe, crossing the phantom divide line and validity of the thermodynamics second law in an interacting HDE model and corresponding it with the f(R) model of gravity, we find a viable f(R) model that can explain the present Universe. We also obtain the explicit evolutionary forms of the corresponding scalar field, potential and scale factor of the Universe. (paper)
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Sheff, Alex; Park, Elyse R; Neagle, Mary; Oreskovic, Nicolas M
2017-07-25
Care coordination programs for high-risk, high-cost patients are a critical component of population health management. These programs aim to improve outcomes and reduce costs and have proliferated over the last decade. Some programs, originally designed for Medicare patients, are now transitioning to also serve Medicaid populations. However, there are still gaps in the understanding of what barriers to care Medicaid patients experience, and what supports will be most effective for providing them care coordination. We conducted two focus groups (n = 13) and thematic analyses to assess the outcomes drivers and programmatic preferences of Medicaid patients enrolled in a high-risk care coordination program at a major academic medical center in Boston, MA. Two focus groups identified areas where care coordination efforts were having a positive impact, as well as areas of unmet needs among the Medicaid population. Six themes emerged from the focus groups that clustered in three groupings: In the first group (1) enrollment in an existing medical care coordination programs, and (2) provider communication largely presented as positive accounts of assistance, and good relationships with providers, though participants also pointed to areas where these efforts fell short. In the second group (3) trauma histories, (4) mental health challenges, and (5) executive function difficulties all presented challenges faced by high-risk Medicaid patients that would likely require redress through additional programmatic supports. Finally, in the third group, (6) peer-to-peer support tendencies among patients suggested an untapped resource for care coordination programs. Programs aimed at high-risk Medicaid patients will want to consider programmatic adjustments to attend to patient needs in five areas: (1) provider connection/care coordination, (2) trauma, (3) mental health, (4) executive function/paperwork and coaching support, and (5) peer-to-peer support.
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Energy Technology Data Exchange (ETDEWEB)
FULLER, R.K.
1999-02-23
This document is the final report for tank 241-AP-106 grab samples. Three grab samples 6AP-98-1, 6AP-98-2 and 6AP-98-3 were taken from riser 1 of tank 241-AP-106 on May 28, 1998 and received by the 222-S Laboratory on May 28, 1998. Analyses were performed in accordance with the ''Compatability Grab Sampling and Analysis Plan'' (TSAP) (Sasaki, 1998) and the ''Data Quality Objectives for Tank Farms Waste Compatability Program (DQO). The analytical results are presented in the data summary report. No notification limits were exceeded. The request for sample analysis received for AP-106 indicated that the samples were polychlorinated biphenyl (PCB) suspects. The results of this analysis indicated that no PCBs were present at the Toxic Substance Control Act (TSCA) regulated limit of 50 ppm. The results and raw data for the PCB analysis are included in this document.
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International Nuclear Information System (INIS)
FULLER, R.K.
1999-01-01
This document is the final report for tank 241-AP-106 grab samples. Three grab samples 6AP-98-1, 6AP-98-2 and 6AP-98-3 were taken from riser 1 of tank 241-AP-106 on May 28, 1998 and received by the 222-S Laboratory on May 28, 1998. Analyses were performed in accordance with the ''Compatability Grab Sampling and Analysis Plan'' (TSAP) (Sasaki, 1998) and the ''Data Quality Objectives for Tank Farms Waste Compatability Program (DQO). The analytical results are presented in the data summary report. No notification limits were exceeded. The request for sample analysis received for AP-106 indicated that the samples were polychlorinated biphenyl (PCB) suspects. The results of this analysis indicated that no PCBs were present at the Toxic Substance Control Act (TSCA) regulated limit of 50 ppm. The results and raw data for the PCB analysis are included in this document
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Medicaid eligibility policy in the 1980s: medical utilitarianism and the "deserving" poor.
Tanenbaum, S J
1995-01-01
Between 1981 and the early 1990s, the Medicaid program grew substantially, in part because, for the first time in the program's history, eligibility for medical assistance was severed from eligibility for income-maintenance payments. Program participation had always been reserved for the "deserving poor," and these were originally defined as persons excluded from market relationships through no fault of their own. The Medicaid expansion of the 1980s, however, created a new constituency of poor, and not-so-poor, persons whose actual or predictable medical problems promised a calculable return on program funds.
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Comparison of Orthodontic Medicaid Funding in the United States 2006 to 2015
Directory of Open Access Journals (Sweden)
Gerald Minick
2017-08-01
Full Text Available IntroductionOrthodontic treatment is reimbursed by Medicaid based on orthodontic and financial need with qualifiers determined by individual states. Changes in Medicaid-funded orthodontic treatment following the “Great Recession” in 2007 and the enactment of the Affordable Care Act in 2010 were compared for the 50 United States and the District of Columbia to better understand disparities in access to care. The results from this 2015 survey were compared to data gathered in 2006 (1.Materials and methodsMedicaid officials were contacted by email, telephone, or postal mail regarding the age limit for treatment, practitioner type who can determine eligibility and provide treatment, records required for case review, and rate and frequency of reimbursement. When not attained by direct contact, the information was gleaned from online websites, provider manuals, and state orthodontists.ResultsInformation gathered from 50 states and the District of Columbia documents that Medicaid program characteristics and expenditures continue to vary by state. Expenditures and reimbursement rates have decreased since 2006 and vary widely by geographic region. Some states have tightened restrictions on qualifiers and increased submission requirements by providers.ConclusionThe variation and lack of uniformity that still exists among Medicaid orthodontic programs in different states creates disparities in orthodontic care for US citizens. Barriers to care for Medicaid-funded orthodontic treatment have increased since 2006.
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Thompson, Frank J; Burke, Courtney
2007-12-01
Executive federalism emphasizes collaboration between the executive branches at the national and state levels to transform grant programs through the implementation process. In this regard, Medicaid demonstration waivers loomed large during the presidencies of Bill Clinton and George W. Bush. This article documents and compares the volume and substance of section 1115 Medicaid waiver activity under the two presidencies. From the perspective of policy performance, Medicaid demonstration waivers provide modest support for the view that states serve as laboratories for policy learning in the health care arena. More broadly, the waivers have not yielded a major solution to the problem of the uninsured and are unlikely to do so. At the same time, they have not (as some have suggested) been a subterranean force for the erosion of Medicaid. To the contrary, these waivers have often enhanced health services for low-income people; above all, they have helped preserve Medicaid as an entitlement by undercutting support for those seeking to convert the program into a block grant. From the perspective of the democratic process, we find that Congress has been a more significant player in shaping waivers than the executive federalism model suggests. While the decision processes surrounding Medicaid waivers often fall short of democratic standards with respect to transparency and opportunities for public input, they still compare favorably to certain alternatives.
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String duality transformations in f(R) gravity from Noether symmetry approach
Energy Technology Data Exchange (ETDEWEB)
Capozziello, Salvatore [Dipartimento di Fisica, Università di Napoli ' ' Federico II' ' , Compl. Univ. di Monte S. Angelo, Edificio G, Via Cinthia, I-80126, Napoli (Italy); Gionti, Gabriele S.J. [Specola Vaticana, Vatican City, V-00120, Vatican City State (Vatican City State, Holy See); Vernieri, Daniele, E-mail: capozziello@na.inf.it, E-mail: ggionti@as.arizona.edu, E-mail: vernieri@iap.fr [Sorbonne Universités, UPMC Univ Paris 6 et CNRS, UMR 7095, Institut d' Astrophysique de Paris, GReCO, 98bis Bd Arago, 75014 Paris (France)
2016-01-01
We select f(R) gravity models that undergo scale factor duality transformations. As a starting point, we consider the tree-level effective gravitational action of bosonic String Theory coupled with the dilaton field. This theory inherits the Busher's duality of its parent String Theory. Using conformal transformations of the metric tensor, it is possible to map the tree-level dilaton-graviton string effective action into f(R) gravity, relating the dilaton field to the Ricci scalar curvature. Furthermore, the duality can be framed under the standard of Noether symmetries and exact cosmological solutions are derived. Using suitable changes of variables, the string-based f(R) Lagrangians are shown in cases where the duality transformation becomes a parity inversion.
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String duality transformations in f(R) gravity from Noether symmetry approach
International Nuclear Information System (INIS)
Capozziello, Salvatore; Gionti, Gabriele S.J.; Vernieri, Daniele
2016-01-01
We select f(R) gravity models that undergo scale factor duality transformations. As a starting point, we consider the tree-level effective gravitational action of bosonic String Theory coupled with the dilaton field. This theory inherits the Busher's duality of its parent String Theory. Using conformal transformations of the metric tensor, it is possible to map the tree-level dilaton-graviton string effective action into f(R) gravity, relating the dilaton field to the Ricci scalar curvature. Furthermore, the duality can be framed under the standard of Noether symmetries and exact cosmological solutions are derived. Using suitable changes of variables, the string-based f(R) Lagrangians are shown in cases where the duality transformation becomes a parity inversion
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Unifying inflation with dark energy in modified F(R) Horava-Lifshitz gravity
International Nuclear Information System (INIS)
Elizalde, E.; Saez-Gomez, D.; Nojiri, S.; Odintsov, S.D.
2010-01-01
We study FRW cosmology for a non-linear modified F(R) Horava-Lifshitz gravity which has a viable convenient counterpart. A unified description of early-time inflation and late-time acceleration is possible in this theory, but the cosmological dynamic details are generically different from the ones of the convenient viable F(R) model. Remarkably, for some specific choice of parameters they do coincide. The emergence of finite-time future singularities is investigated in detail. It is shown that these singularities can be cured by adding an extra, higher-derivative term, which turns out to be qualitatively different when compared with the corresponding one of the convenient F(R) theory. (orig.)
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42 CFR 495.332 - State Medicaid health information technology (HIT) plan requirements.
2010-10-01
... and strategic plan for the next 5 years. (2) A description of how the State Medicaid HIT plan will be... processes that enable improved program administration for the Medicaid enterprise; (ii) Includes business... used certified EHR technology during the EHR reporting period, and that they have adopted, implemented...
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2001-12-03
This interim final rule with comment period delays for 1 year the effective date of the last sentence of 42 CFR 411.354(d)(1). Section 411.354(d)(1) was promulgated in the final rule entitled "Medicare and Medicaid Programs; Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships," published in the Federal Register on January 4, 2001 (66 FR 856). A 1-year delay in the effective date of the last sentence in Section 411.354(d)(1) will give Department officials the opportunity to reconsider the definition of compensation that is "set in advance" as it relates to percentage compensation methodologies in order to avoid unnecessarily disrupting existing contractual arrangements for physician services. Accordingly, the last sentence of Section 411.354(d)(1), which would have become effective January 4, 2002, will not become effective until January 6,2003.
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Neonatal Abstinence Syndrome: Trend and Expenditure in Louisiana Medicaid, 2003-2013.
Okoroh, Ekwutosi M; Gee, Rebekah E; Jiang, Baogong; McNeil, Melissa B; Hardy-Decuir, Beverly A; Zapata, Amy L
2017-07-01
Objectives Determine trends in incidence and expenditure for perinatal drug exposure and neonatal abstinence syndrome (NAS) among Louisiana's Medicaid population. We also describe the maternal characteristics of NAS affected infants. Methods Retrospective cohort analysis using linked Medicaid and vital records data from 2003 to 2013. Conducted incidence and cost trends for drug exposed infants with and without NAS. Also performed comparison statistics among drug exposed infants with and without NAS and those not drug exposed. Results As rate of perinatal drug exposure increased, NAS rate per 1000 live Medicaid births also increased, from 2.1 (2003) to 3.6 (2007) to 8.0 (2013) (P for trend Medicaid also increased from $1.3 million to $3.6 million to $8.7 million (P for trend Medicaid infants quadrupled and the cost for caring for the affected infants increased six-fold. Medicaid, as the predominant payer for pregnant women and children affected by substance use disorders, must play a more active role in expanding access to comprehensive substance abuse treatment programs.
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2010-10-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); Office of Liaison, Policy and Review; Meeting of the NTP Board of Scientific Counselors: Amended Notice AGENCY: National....gov ). Dated: October 21, 2010. John R. Bucher, Associate Director, National Toxicology Program. [FR...
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SPES-2, an experimental program to support the AP600 development
Energy Technology Data Exchange (ETDEWEB)
Tarantini, M. [ENEA, Nuclear Fission Branch, Bolonga (Italy); Medich, C. [SIET S.p.A. Piacenza (Italy)
1995-09-01
In support of the development of the AP600 reactor, ENEA, ENEL, ANSALDO and Westinghouse have signed a research agreement. In the framework of this agreement a complex Full Height Full Pressure (FHFP) integral system testing program has been planned on SPES-2 facility. The main purpose of this paper is to point out the status of the test program; describe the hot per-operational test performed and the complete test matrix, giving all the necessary references on the work already published. Two identical Small Break LOCA transients, performed with Pressurizer to Core Make-up Tank (PRZ-CMT) balance line (Test S00203) and without PRZ-CMT balance line (Test S00303) are then compared, to show how the SPES-2 facility can contribute in confirming the new AP600 reactor design choices and can give useful indications to designers. Although the detailed analysis of test data has not been completed, some consideration on the analytical tools utilized and on the SPES-2 capability to simulate the reference plant is then drawn.
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Congress of the U.S., Washington, DC. House Committee on Energy and Commerce.
Two hearings held a month apart examine major issues concerning Medicaid benefits in family welfare and nursing home reform. The first set of hearings discusses the proposed Family Welfare Reform Act of 1987 (H.R. 1720), which is intended to replace the Aid to Families with Dependent Children (AFDC) program of the Social Security Act Title IV.…
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Late time acceleration of the universe in f(R) gravity model
International Nuclear Information System (INIS)
Mukherjee, Ankan
2014-01-01
In this work, a new way to look at the nature of late time dynamics of the universe for f(R) gravity models using the contracted Bianchi Identity has been proposed. As the Einstein field equations contain derivatives of the curvature scalar R, the contracted Bianchi identity yields a second order nonlinear differential equation in H, the Hubble parameter. This equation is studied for two particular forms of f(R), and the late time behaviour of the model is discussed. (author)
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Disabling health care? Medicaid managed care and people with disabilities in America
DEFF Research Database (Denmark)
Hiranandani, Vanmala Sunder
2011-01-01
Medicaid, America's largest government-funded health insurance program, plays a pivotal role in providing health services to eight million adults with disabilities. Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using...... business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical disabilities present their own constellation of health care issues that is not readily appreciated in health and social services....... The purpose of the study was to understand their experiences in accessing physical health care services and to ascertain the effects of managed care on their health and well-being. This study found beneficiaries encounter numerous barriers in accessing preventative, treatment, and acute care services. Overall...
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2013-11-20
... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5683-N-102] 10-Day Notice of Proposed Information Collection: Generic Customer Satisfaction Surveys; Physical Inspection Pilot Program...
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Express Lane Eligibility for Medicaid and CHIP Coverage
U.S. Department of Health & Human Services — States may rely on eligibility information from "Express Lane" agency programs to streamline and simplify enrollment and renewal in Medicaid and CHIP. Express Lane...
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Stability of the Einstein static universe in f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Shabani, Hamid [University of Sistan and Baluchestan, Physics Department, Faculty of Sciences, Zahedan (Iran, Islamic Republic of); Ziaie, Amir Hadi [Kahnooj Branch, Islamic Azad University, Department of Physics, Kerman (Iran, Islamic Republic of)
2017-01-15
The Einstein static (ES) universe has played a major role in various emergent scenarios recently proposed in order to cure the problem of the initial singularity of the standard model of cosmology. In the model we address, we study the existence and stability of an ES universe in the context of f(R, T) modified theories of gravity. Considering specific forms of the f(R, T) function, we seek for the existence of solutions representing ES state. Using dynamical system techniques along with numerical analysis, we find two classes of solutions: the first one is always unstable of the saddle type, while the second is always stable so that its dynamical behavior corresponds to a center equilibrium point. The importance of the second class of solutions is due to the significant role they play in constructing non-singular emergent models in which the universe could have experienced past-eternally a series of infinite oscillations about such an initial static state after which it enters, through a suitable physical mechanism, to an inflationary era. Considering specific forms for the functionality of f(R, T), we show that this theory is capable of providing cosmological solutions which admit emergent universe (EU) scenarios. We also investigate homogeneous scalar perturbations for the mentioned models. The stability regions of the solutions are parametrized by a linear equation of state (EoS) parameter and other free parameters that will be introduced for the models. Our results suggest that modifications in f(R, T) gravity would lead to stable solutions which are unstable in f(R) gravity model. (orig.)
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Stability of the Einstein static universe in f(R, T) gravity
International Nuclear Information System (INIS)
Shabani, Hamid; Ziaie, Amir Hadi
2017-01-01
The Einstein static (ES) universe has played a major role in various emergent scenarios recently proposed in order to cure the problem of the initial singularity of the standard model of cosmology. In the model we address, we study the existence and stability of an ES universe in the context of f(R, T) modified theories of gravity. Considering specific forms of the f(R, T) function, we seek for the existence of solutions representing ES state. Using dynamical system techniques along with numerical analysis, we find two classes of solutions: the first one is always unstable of the saddle type, while the second is always stable so that its dynamical behavior corresponds to a center equilibrium point. The importance of the second class of solutions is due to the significant role they play in constructing non-singular emergent models in which the universe could have experienced past-eternally a series of infinite oscillations about such an initial static state after which it enters, through a suitable physical mechanism, to an inflationary era. Considering specific forms for the functionality of f(R, T), we show that this theory is capable of providing cosmological solutions which admit emergent universe (EU) scenarios. We also investigate homogeneous scalar perturbations for the mentioned models. The stability regions of the solutions are parametrized by a linear equation of state (EoS) parameter and other free parameters that will be introduced for the models. Our results suggest that modifications in f(R, T) gravity would lead to stable solutions which are unstable in f(R) gravity model. (orig.)
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Energy Technology Data Exchange (ETDEWEB)
Bossamykin, V S; Koshelev, A S; Gerasimov, A I; Gordeev, V S; Grishin, A V; Averchenkov, V Ya; Lazarev, S A; Maslov, G N; Odintsov, Yu M [All-Russian Scientific Research Institute of Experimental Physics, Sarov (Russian Federation)
1997-12-31
Some results are given of investigations on joint operation modes of the linear induction electron accelerator LIA-30 ({approx} 40 MeV, {approx} 100 kA, {approx} 20 ns) and the pulsed reactor FR-1 with a compact metal core, aimed at achieving high intensity neutron fluxes. The multiplication factor Q for prompt neutrons in the FR-1 booster mode operation increased from 100 to 4500. The total output of prompt neutrons from FR-1 at Q = 2570 was 1.4 x 10{sup 16} 1/pulse with a pulse half width of {approx} 25 {mu}s. (author). 4 figs., 4 refs.
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Japanese Language and Culture: 10-3Y, 20-3Y, 30-3Y. 3-Year Program Guide to Implementation
Alberta Education, 2009
2009-01-01
This guide to implementation is intended to support the Japanese Language and Culture 10-3Y, 20-3Y, 30-3Y Program of Studies. It was developed primarily for teachers, yet it includes information that may be useful for administrators and other stakeholders in their efforts to plan for and implement the new Japanese program of studies. Familiarity…
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Exact solutions for scalar field cosmology in f(R) gravity
Maharaj, S. D.; Goswami, R.; Chervon, S. V.; Nikolaev, A. V.
2017-09-01
We study scalar field FLRW cosmology in the content of f(R) gravity. Our consideration is restricted to the spatially flat Friedmann universe. We derived the general evolution equations of the model, and showed that the scalar field equation is automatically satisfied for any form of the f(R) function. We also derived representations for kinetic and potential energies, as well as for the acceleration in terms of the Hubble parameter and the form of the f(R) function. Next we found the exact cosmological solutions in modified gravity without specifying the f(R) function. With negligible acceleration of the scalar curvature, we found that the de Sitter inflationary solution is always attained. Also we obtained new solutions with special restrictions on the integration constants. These solutions contain oscillating, accelerating, decelerating and even contracting universes. For further investigation, we selected special cases which can be applied with early or late inflation. We also found exact solutions for the general case for the model with negligible acceleration of the scalar curvature in terms of special Airy functions. Using initial conditions which represent the universe at the present epoch, we determined the constants of integration. This allows for the comparison of the scale factor in the new solutions with that for current stage of the universe evolution in the ΛCDM model.
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Kohn, Linda T.
2009-01-01
The five largest insular areas of the United States--American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands--receive federal funding through Medicaid and the State Children's Health Insurance Program (CHIP), joint federal-state programs that finance health care for certain low-income…
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Chameleon halo modeling in f(R) gravity
International Nuclear Information System (INIS)
Li Yin; Hu, Wayne
2011-01-01
We model the chameleon effect on cosmological statistics for the modified gravity f(R) model of cosmic acceleration. The chameleon effect, required to make the model compatible with local tests of gravity, reduces force enhancement as a function of the depth of the gravitational potential wells of collapsed structure and so is readily incorporated into a halo model by including parameters for the chameleon mass threshold and rapidity of transition. We show that the abundance of halos around the chameleon mass threshold is enhanced by both the merging from below and the lack of merging to larger masses. This property also controls the power spectrum in the nonlinear regime and we provide a description of the transition to the linear regime that is valid for a wide range of f(R) models.
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Medicaid Waivers and Public Sector Mental Health Service Penetration Rates for Youth.
Graaf, Genevieve; Snowden, Lonnie
2018-01-22
To assist families of youth with serious emotional disturbance in financing youth's comprehensive care, some states have sought and received Medicaid waivers. Medicaid waivers waive or relax the Medicaid means test for eligibility to provide insurance coverage to nonpoor families for expensive, otherwise out-of-reach treatment for youth with Serious Emotional Disturbance (SED). Waivers promote treatment access for the most troubled youth, and the present study investigated whether any of several Medicaid waiver options-and those that completely omit the means test in particular-are associated with higher state-wide public sector treatment penetration rates. The investigators obtained data from the U.S. Census, SAMHSA's Uniform Reporting System, and the Centers for Medicare and Medicaid Services. Analysis employed random intercept and random slope linear regression models, controlling for a variety of state demographic and fiscal variables, to determine whether a relationship between Medicaid waiver policies and state-level public sector penetration rates could be observed. Findings indicate that, whether relaxing or completely waiving Medicaid's qualifying income limits, waivers increase public sector penetration rates, particularly for youth under age 17. However, completely waiving Medicaid income limits did not uniquely contribute to penetration rate increases. States offering Medicaid waivers that either relax or completely waive Medicaid's means test to qualify for health coverage present higher public sector treatment rates for youth with behavioral health care needs. There is no evidence that restricting the program to waiving the means test for accessing Medicaid would increase treatment access. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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The Role of Medicare's Inpatient Cost-Sharing in Medicaid Entry.
Keohane, Laura M; Trivedi, Amal N; Mor, Vincent
2018-04-01
To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge. In a regression discontinuity analysis, we take advantage of this Medicare benefit feature to test whether beneficiaries with greater cost-sharing have higher rates of Medicaid enrollment. We identified 221,248 Medicare beneficiaries with an initial hospital stay and a readmission 53-59 days later (no deductible) or 60-66 days later (charged a deductible). Among beneficiaries in low-socioeconomic areas with two hospitalizations, those readmitted 60-66 days after discharge were 21 percent more likely to join Medicaid compared with those readmitted 53-59 days following their initial hospitalization (absolute difference in adjusted risk of Medicaid entry: 3.7 percent vs. 3.1 percent, p = .01). Increasing Medicare cost-sharing requirements may promote Medicaid enrollment among low-income beneficiaries. Potential savings from an increased cost-sharing in the Medicare program may be offset by increased Medicaid participation. © Health Research and Educational Trust.
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75 FR 66653 - Airworthiness Directives; McDonnell Douglas Corporation Model MD-90-30 Airplanes
2010-10-29
... Airworthiness Directives; McDonnell Douglas Corporation Model MD- 90-30 Airplanes AGENCY: Federal Aviation...-15667 (73 FR 52203, September 9, 2008), and adding the following new AD: 2010-22-04 McDonnell Douglas... supersedes AD 2008-18-10, Amendment 39-15667. Applicability (c) This AD applies to McDonnell Douglas...
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The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs.
Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel
2013-08-01
Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on quality of care in a large-scale setting-the implementation of P4P for nursing homes by state Medicaid agencies. 2001-2009 nursing home Minimum Data Set and Online Survey, Certification, and Reporting (OSCAR) datasets. Between 2001 and 2009, eight state Medicaid agencies adopted P4P programs in nursing homes. We use a difference-in-differences approach to test for changes in nursing home quality under P4P, taking advantage of the variation in timing of implementation across these eight states and using nursing homes in the 42 non-P4P states plus Washington, DC as contemporaneous controls. Quality improvement under P4P was inconsistent. While three clinical quality measures (the percent of residents being physically restrained, in moderate to severe pain, and developed pressure sores) improved with the implementation of P4P in states with P4P compared with states without P4P, other targeted quality measures either did not change or worsened. Of the two structural measures of quality that were tied to payment (total number of deficiencies and nurse staffing) deficiency rates worsened slightly under P4P while staffing levels did not change. Medicaid-based P4P in nursing homes did not result in consistent improvements in nursing home quality. Expectations for improvement in nursing home care under P4P should be tempered. © Health Research and Educational Trust.
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Thick brane in f(R) gravity with Palatini dynamics
Energy Technology Data Exchange (ETDEWEB)
Bazeia, D.; Losano, L. [Universidade Federal da Paraiba, Departamento de Fisica, Joao Pessoa, PB (Brazil); Menezes, R. [Universidade Federal da Paraiba, Departamento de Ciencias Exatas, Rio Tinto, PB (Brazil); Universidade Federal de Campina Grande, Departamento de Fisica, Campina Grande, PB (Brazil); Olmo, Gonzalo J. [Universidade Federal da Paraiba, Departamento de Fisica, Joao Pessoa, PB (Brazil); Universidad de Valencia, Departamento de Fisica Teorica, IFIC, Centro Mixto Universidad de Valencia-CSIC, Burjassot, Valencia (Spain); Rubiera-Garcia, D. [Universidade Federal da Paraiba, Departamento de Fisica, Joao Pessoa, PB (Brazil); Universidade de Lisboa, Faculdade de Ciencias, Instituto de Astrofisica e Ciencias do Espaco, Lisbon (Portugal); Fudan University, Department of Physics, Center for Field Theory and Particle Physics, Shanghai (China)
2015-12-15
This work deals with modified gravity in five-dimensional space-time. We study a thick Palatini f(R) brane, that is, a braneworld scenario described by an anti-de Sitter warped geometry with a single extra dimension of infinite extent, sourced by a real scalar field under the Palatini approach, where the metric and the connection are regarded as independent degrees of freedom. We consider a first-order framework which we use to provide exact solutions for the scalar field and warp factor. We also investigate a perturbative scenario such that the Palatini approach is implemented through a Lagrangian f(R) = R + εR{sup n}, where the small parameter ε controls the deviation from the standard thick brane case. In both cases it is found that the warp factor tends to localize the extra dimension due to the nonlinear corrections. (orig.)
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Kercsmar, Carolyn M; Beck, Andrew F; Sauers-Ford, Hadley; Simmons, Jeffrey; Wiener, Brandy; Crosby, Lisa; Wade-Murphy, Susan; Schoettker, Pamela J; Chundi, Pavan K; Samaan, Zeina; Mansour, Mona
2017-11-01
Asthma is the most common chronic condition of childhood. Hospitalizations and emergency department (ED) visits for asthma are more frequently experienced by minority children and adolescents and those with low socioeconomic status. To reduce asthma-related hospitalizations and ED visits for Medicaid-insured pediatric patients residing in Hamilton County, Ohio. From January 1, 2010, through December 31, 2015, a multidisciplinary team used quality-improvement methods and the chronic care model to conduct interventions in inpatient, outpatient, and community settings in a large, urban academic pediatric hospital in Hamilton County, Ohio. Children and adolescents aged 2 to 17 years who resided in Hamilton County, had a diagnosis of asthma, and were Medicaid insured were studied. Interventions were implemented in 3 phases: hospital-based inpatient care redesign, outpatient-based care enhancements, and community-based supports. Plan-do-study-act cycles allowed for small-scale implementation of change concepts and rapid evaluation of how such tests affected processes and outcomes of interest. The study measured asthma-related hospitalizations and ED visits per 10 000 Medicaid-insured pediatric patients. Data were measured monthly on a rolling 12-month mean basis. Data from multiple previous years were used to establish a baseline. Data were tracked with annotated control charts and with interrupted time-series analysis. Of the estimated 36 000 children and adolescents with asthma in Hamilton County (approximately 13 000 of whom are Medicaid insured and 6000 of whom are cared for in Cincinnati Children's Hospital primary care practices), asthma-related hospitalizations decreased from 8.1 (95% CI, 7.7-8.5) to 4.7 (95% CI, 4.3-5.1) per 10 000 Medicaid patients per month by June 30, 2014, a 41.8% (95% CI, 41.7%-42.0%) relative reduction. Emergency department visits decreased from 21.5 (95% CI, 20.6-22.3) to 12.4 (95% CI, 11.5-13.2) per 10 000 Medicaid patients per
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Hiraki, Linda T; Feldman, Candace H; Liu, Jun; Alarcón, Graciela S; Fischer, Michael A; Winkelmayer, Wolfgang C; Costenbader, Karen H
2012-08-01
To investigate the nationwide prevalence, incidence, and sociodemographics of systemic lupus erythematosus (SLE) and lupus nephritis among children in the US Medicaid beneficiary population. Children ages 3 years to Classification of Diseases, Ninth Revision [ICD-9] code of 710.0 for SLE, each >30 days apart) were identified from the US Medicaid Analytic eXtract database from 2000 to 2004. This database contains all inpatient and outpatient Medicaid claims for 47 US states and the District of Columbia. Lupus nephritis was identified from ≥2 ICD-9 billing codes for glomerulonephritis, proteinuria, or renal failure, each recorded >30 days apart. The prevalence and incidence of SLE and lupus nephritis were calculated among Medicaid-enrolled children overall and within sociodemographic groups. Of the 30,420,597 Medicaid-enrolled children during these years, 2,959 were identified as having SLE. The prevalence of SLE was 9.73 (95% confidence interval [95% CI] 9.38-10.08) per 100,000 Medicaid-enrolled children. Among the children with SLE, 84% were female, 40% were African American, 25% were Hispanic, 21% were White, and 42% resided in the South region of the US. Moreover, of the children with SLE, 1,106 (37%) had lupus nephritis, representing a prevalence of 3.64 (95% CI 3.43-3.86) per 100,000 children. The average annual incidence of SLE was 2.22 cases (95% CI 2.05-2.40) and that of lupus nephritis was 0.72 cases (95% CI 0.63-0.83) per 100,000 Medicaid enrollees per year. The prevalence and incidence rates of SLE and lupus nephritis increased with age, were higher in girls than in boys, and were higher in all non-White racial/ethnic groups. In the current study, the prevalence and incidence rates of SLE among Medicaid-enrolled children in the US are high compared to studies in other populations. In addition, these data represent the first population-based estimates of the prevalence and incidence of lupus nephritis in the US to date. Copyright © 2012 by the American
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MEDICAID: HCFA Reversed Its Position and Approved Additional State Financing Schemes
National Research Council Canada - National Science Library
2001-01-01
States have been searching for ways to help finance the $196 billion Medicaid program, a jointly funded federal-state program providing health care services to certain low-income, elderly, and disabled people...
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AP1000R design robustness against extreme external events - Seismic, flooding, and aircraft crash
International Nuclear Information System (INIS)
Pfister, A.; Goossen, C.; Coogler, K.; Gorgemans, J.
2012-01-01
Both the International Atomic Energy Agency (IAEA) and the U.S. Nuclear Regulatory Commission (NRC) require existing and new nuclear power plants to conduct plant assessments to demonstrate the unit's ability to withstand external hazards. The events that occurred at the Fukushima-Dai-ichi nuclear power station demonstrated the importance of designing a nuclear power plant with the ability to protect the plant against extreme external hazards. The innovative design of the AP1000 R nuclear power plant provides unparalleled protection against catastrophic external events which can lead to extensive infrastructure damage and place the plant in an extended abnormal situation. The AP1000 plant is an 1100-MWe pressurized water reactor with passive safety features and extensive plant simplifications that enhance construction, operation, maintenance and safety. The plant's compact safety related footprint and protection provided by its robust nuclear island structures prevent significant damage to systems, structures, and components required to safely shutdown the plant and maintain core and spent fuel pool cooling and containment integrity following extreme external events. The AP1000 nuclear power plant has been extensively analyzed and reviewed to demonstrate that it's nuclear island design and plant layout provide protection against both design basis and extreme beyond design basis external hazards such as extreme seismic events, external flooding that exceeds the maximum probable flood limit, and malicious aircraft impact. The AP1000 nuclear power plant uses fail safe passive features to mitigate design basis accidents. The passive safety systems are designed to function without safety-grade support systems (such as AC power, component cooling water, service water, compressed air or HVAC). The plant has been designed to protect systems, structures, and components critical to placing the reactor in a safe shutdown condition within the steel containment vessel which is
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Magnetic Measurements of Storage Ring Magnets for the APS Upgrade Project
Energy Technology Data Exchange (ETDEWEB)
Doose, C.; Dejus, R.; Jaski, M.; Jansma, W.; Collins, J.; Donnelly, A.; Liu, J.; Cease, H.; Decker, G.; Jain, A.; DiMarco, J.
2017-06-01
Extensive prototyping of storage ring magnets is ongoing at the Advanced Photon Source (APS) in support of the APS Multi-Bend Achromat (MBA) upgrade project (APS-U) [1]. As part of the R&D activities four quadrupole magnets with slightly different geometries and pole tip materials, and one sextupole magnet with vanadium permendur (VP) pole tips were designed, built and tested. Magnets were measured individually using a rotating coil and a Hall probe for detailed mapping of the magnetic field. Magnets were then assembled and aligned relative to each other on a steel support plate and concrete plinth using precision machined surfaces to gain experience with the alignment method chosen for the APS-U storage ring magnets. The required alignment of magnets on a common support structure is 30 μm rms. Measurements of magnetic field quality, strength and magnet alignment after subjecting the magnets and assemblies to different tests are presented.
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Saloner, Brendan; Stoller, Kenneth B; Barry, Colleen L
2016-06-01
This study examined differences in opioid agonist therapy (OAT) utilization among Medicaid-enrolled adults receiving public-sector opioid use disorder treatment in states with Medicaid coverage of methadone maintenance, states with block grant funding only, and states without public coverage of methadone. Person-level treatment admission data, which included information on reason for treatment and use of OAT from 36 states were linked to state-level Medicaid policies collected in a 50-state survey. Probabilities of OAT use among Medicaid enrollees in opioid addiction treatment were calculated, with adjustment for demographic characteristics and patterns of substance use. In adjusted analysis, 45.0% of Medicaid-enrolled individuals in opioid addiction treatment in states with Medicaid coverage for methadone maintenance used OAT, compared with 30.1% in states with block grant coverage only and 17.0% in states with no coverage. Differences were widest in nonintensive outpatient settings. Medicaid methadone maintenance coverage is critical for encouraging OAT among individuals with opioid use disorders.
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77 FR 14303 - Federal Acquisition Regulation; Women-Owned Small Business (WOSB) Program
2012-03-09
... Economically Disadvantaged Women-Owned Small Business (EDWOSB) Concerns (APR 2012) (15 U.S.C. 637(m)).'' 4. On...: ``(25) 52.219-30, Notice of Set-Aside for Women-Owned Small Business (WOSB) Concerns Eligible Under the... Business Concerns Eligible Under the Women-Owned Small Business Program (APR 2012)'' [FR Doc. C1-2012-4475...
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Kepler observations of rapidly oscillating Ap, δ Scuti and γ Doradus pulsations in Ap stars
DEFF Research Database (Denmark)
Balona, Luis A.; Cunha, Margarida S.; Kurtz, Donald W.
2011-01-01
Observations of the A5p star KIC 8677585 obtained during the Kepler 10-d commissioning run with 1-min time resolution show that it is a rapidly oscillating Ap (roAp) star with several frequencies with periods near 10 min. In addition, a low frequency at 3.142 d−1 is also clearly present....... Multiperiodic γ Doradus (γ Dor) and δ Scuti (δ Sct) pulsations, never before seen in any Ap star, are present in Kepler observations of at least three other Ap stars. Since γ Dor pulsations are seen in Ap stars, it is likely that the low frequency in KIC 8677585 is also a γ Dor pulsation. The simultaneous...... presence of both γ Dor and roAp pulsations and the unexpected detection of δ Sct and γ Dor pulsations in Ap stars present new opportunities and challenges for the interpretation of these stars. Since it is easy to confuse Am and Ap stars at classification dispersions, the nature of these Ap stars...
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Förändrat omhändertagande av patienter med uretärsten : - Lärdomar från ett förbättringsarbete
Khatami, Annelie
2014-01-01
Bakgrund: Omkring 10-15 % av befolkningen, oftast i arbetsför ålder, riskerar att någon gång drabbas av njursten. Nationella riktlinjer för njurstensbehandling saknas, men studier stödjer behandling inom 48 timmar för snabb symtomlindring och minskade besvär för patienten. Inom studerad verksamhet var tiden från diagnos till behandling lång och återinläggningarna var många, varför ett förbättringsarbete initierades. Syfte: Syftet med förbättringsarbetet var att halvera tiden från diagnos till...
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Enhanced Geothermal Systems (EGS) R&D Program
Energy Technology Data Exchange (ETDEWEB)
Entingh, Daniel J.
1999-08-18
The purpose of this workshop was to develop technical background facts necessary for planning continued research and development of Enhanced Geothermal Systems (EGS). EGS are geothermal reservoirs that require improvement of their permeability or fluid contents in order to achieve economic energy production. The initial focus of this R&D program is devising and testing means to extract additional economic energy from marginal volumes of hydrothermal reservoirs that are already producing commercial energy. By mid-1999, the evolution of the EGS R&D Program, begun in FY 1988 by the U.S. Department of Energy (DOE), reached the stage where considerable expertise had to be brought to bear on what technical goals should be pursued. The main purpose of this Workshop was to do that. The Workshop was sponsored by the Office of Geothermal Technologies of the Department of Energy. Its purpose and timing were endorsed by the EGS National Coordinating Committee, through which the EGS R&D Program receives guidance from members of the U.S. geothermal industry. Section 1.0 of this report documents the EGS R&D Program Review Session. There, managers and researchers described the goals and activities of the program. Recent experience with injection at The Geysers and analysis of downhole conditions at Dixie Valley highlighted this session. Section 2.0 contains a number of technical presentations that were invited or volunteered to illuminate important technical and economic facts and opportunities for research. The emphasis here was on fi.acture creation, detection, and analysis. Section 3.0 documents the initial general discussions of the participants. Important topics that emerged were: Specificity of defined projects, Optimizing cost effectiveness, Main technical areas to work on, Overlaps between EGS and Reservoir Technology R&D areas, Relationship of microseismic events to hydraulic fractures, and Defining criteria for prioritizing research thrusts. Sections 4.0 and 5.0 report
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Medicaid Home Care Services and Survival in New York City
Albert, Steven M.; Simone, Bridget; Brassard, Andrea; Stern, Yaakov; Mayeux, Richard
2005-01-01
Purpose: New York City's Medicaid Home Care Services Program provides an integrated program of housekeeping and personal assistance care along with regular nursing assessments. We sought to determine if this program of supportive care offers a survival benefit to older adults. Design and Methods: Administrative data from New York City's Medicaid…
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Generalisation for regular black holes on general relativity to f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Rodrigues, Manuel E. [Universidade Federal do Para Campus Universitario de Abaetetuba, Faculdade de Ciencias Exatas e Tecnologia, Abaetetuba, Para (Brazil); Universidade Federal do Para, Faculdade de Fisica, PPGF, Belem, Para (Brazil); Fabris, Julio C. [Universidade Federal do Espirito Santo, Vitoria, ES (Brazil); National Research Nuclear University MEPhI, Moscow (Russian Federation); Junior, Ednaldo L.B. [Universidade Federal do Para, Faculdade de Fisica, PPGF, Belem, Para (Brazil); Universidade Federal do Para, Campus Universitario de Tucurui, Faculdade de Engenharia da Computacao, Tucurui, Para (Brazil); Marques, Glauber T. [Universidade Federal Rural da Amazonia ICIBE - LASIC, Belem, PA (Brazil)
2016-05-15
IIn this paper, we determine regular black hole solutions using a very general f(R) theory, coupled to a nonlinear electromagnetic field given by a Lagrangian L{sub NED}. The functions f(R) and L{sub NED} are in principle left unspecified. Instead, the model is constructed through a choice of the mass function M(r) presented in the metric coefficients. Solutions which have a regular behaviour of the geometric invariants are found. These solutions have two horizons, the event horizon and the Cauchy horizon. All energy conditions are satisfied in the whole space-time, except the strong energy condition (SEC), which is violated near the Cauchy horizon.We present also a new theorem related to the energy conditions in f(R) gravity, re-obtaining the well-known conditions in the context of general relativity when the geometry of the solution is the same. (orig.)
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Social Work's Role in Medicaid Reform: A Qualitative Study.
Bachman, Sara S; Wachman, Madeline; Manning, Leticia; Cohen, Alexander M; Seifert, Robert W; Jones, David K; Fitzgerald, Therese; Nuzum, Rachel; Riley, Patricia
2017-12-01
To critically analyze social work's role in Medicaid reform. We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work's practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work's involvement in systems-level practice include lack of visibility, insufficient clarity on social work's role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level.
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Raising the acceptance of the AP2-line
International Nuclear Information System (INIS)
Trbojevic, D.
1989-01-01
The 120 GeV Main Ring proton beam collides with the target at the end of the AP-1 line and creates antiprotons and other secondary particles. The AP-2 line transfers the negative particles from the target to the Debuncher. To provide a bigger antiproton stack size in the Accumulator, both the Debuncher as well as the AP-2 line acceptance have to be raised. This is a proposal for the improvement of the AP-2 line acceptance. The first part of the memo presents an acceptance examination of the existing AP-2 line by computer simulation, while the second presents a short proposal for aperture corrections. The computer program TURTLE was used to trace antiprotons through the AP-2 line without taking into account other negative charged particles. Betatron functions were obtained from the output of the SYNCH computer program. The SYNCH program was also used to check the dispersion match between the AP-2 line and the Debuncher. 3 refs., 6 figs., 5 tabs
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76 FR 67801 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations
2011-11-02
... Furnished by Non-Physician Practitioners in the Assignment Process c. Assignment of Beneficiaries to ACOs... Insurance Program CMP Civil Monetary Penalties CMS Centers for Medicare & Medicaid Services CNM Certified... the current payment system by rewarding providers for delivering high quality, efficient clinical care...
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International Nuclear Information System (INIS)
Bruschi, H.J.
1996-01-01
At the 1994 Pacific Basin Conference, Mr. Bruschi presented a paper describing the AP600, Westinghouse's advanced light water reactor design with passive safety features. Since then, a rigorous test program was completed and AP600 became the most thoroughly tested advanced reactor system design in history. Westinghouse is now well on its way toward receiving Final Design Approval from the U.S. Nuclear Regulatory Commission for AP600. In this paper, the results of the test program will be discussed and an update on prospects for building the plant will be covered. (author)
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Energy Technology Data Exchange (ETDEWEB)
Bruschi, H.J. [Westinghouse Electric Corp., Pittsburgh, PA (United States)
1996-10-01
At the 1994 Pacific Basin Conference, Mr. Bruschi presented a paper describing the AP600, Westinghouse`s advanced light water reactor design with passive safety features. Since then, a rigorous test program was completed and AP600 became the most thoroughly tested advanced reactor system design in history. Westinghouse is now well on its way toward receiving Final Design Approval from the U.S. Nuclear Regulatory Commission for AP600. In this paper, the results of the test program will be discussed and an update on prospects for building the plant will be covered. (author)
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2012-04-20
... Statistics on September 30, 1998 (63 FR 52192). Pursuant to this authority, the BTS, now part of the Research... transferred the responsibility for the F&OS program from BTS, to FMCSA (69 FR 51009). On August 10, 2006 (71... financial and statistical reporting regulations of BTS that were formerly located at chapter XI of title 49...
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Static spherically symmetric wormholes in f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Zubair, M.; Ahmad, Yasir [Institute Of Information Technology, Department of Mathematics, COMSATS, Lahore (Pakistan); Waheed, Saira [Prince Mohammad Bin Fahd University, Al Khobar (Saudi Arabia)
2016-08-15
In this work, we explore wormhole solutions in f(R, T) theory of gravity, where R is the scalar curvature and T is the trace of stress-energy tensor of matter. To investigate this, we consider a static spherically symmetric geometry with matter contents as anisotropic, isotropic, and barotropic fluids in three separate cases. By taking into account the Starobinsky f(R) model, we analyze the behavior of energy conditions for these different kinds of fluids. It is shown that the wormhole solutions can be constructed without exotic matter in few regions of space-time. We also give the graphical illustration of the results obtained and discuss the equilibrium picture for the anisotropic case only. It is concluded that the wormhole solutions with anisotropic matter are realistic and stable in this theory of gravity. (orig.)
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2010-05-10
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Toxicology Program (NTP) Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM.... Bucher, Associate Director, National Toxicology Program. [FR Doc. 2010-10958 Filed 5-7-10; 8:45 am...
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Intellectually Gifted Females and Their Perspectives of Lived Experience in the AP and IB Programs
Vanderbrook, Carrie M.
2006-01-01
The Advanced Placement (AP) and International Baccalaureate (IB) programs serve as popular choices for many intellectually gifted high school students. This article describes an aspect of a larger study that examined 5 intellectually gifted females' perceptions of their educational experience while enrolled in one of the programs. Using the…
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TRICARE Applied Behavior Analysis (ABA) Benefit: Comparison with Medicaid and Commercial Benefits.
Maglione, Margaret; Kadiyala, Srikanth; Kress, Amii; Hastings, Jaime L; O'Hanlon, Claire E
2017-01-01
This study compared the Applied Behavior Analysis (ABA) benefit provided by TRICARE as an early intervention for autism spectrum disorder with similar benefits in Medicaid and commercial health insurance plans. The sponsor, the Office of the Under Secretary of Defense for Personnel and Readiness, was particularly interested in how a proposed TRICARE reimbursement rate decrease from $125 per hour to $68 per hour for ABA services performed by a Board Certified Behavior Analyst compared with reimbursement rates (defined as third-party payment to the service provider) in Medicaid and commercial health insurance plans. Information on ABA coverage in state Medicaid programs was collected from Medicaid state waiver databases; subsequently, Medicaid provider reimbursement data were collected from state Medicaid fee schedules. Applied Behavior Analysis provider reimbursement in the commercial health insurance system was estimated using Truven Health MarketScan® data. A weighted mean U.S. reimbursement rate was calculated for several services using cross-state information on the number of children diagnosed with autism spectrum disorder. Locations of potential provider shortages were also identified. Medicaid and commercial insurance reimbursement rates varied considerably across the United States. This project concluded that the proposed $68-per-hour reimbursement rate for services provided by a board certified analyst was more than 25 percent below the U.S. mean.
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Kranker, Keith
2016-03-01
In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution. Copyright © 2016 Elsevier B.V. All rights reserved.
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MEDICAID and SCHIP: Recent HHS Approvals of Demonstration Waiver Projects Raise Concerns
National Research Council Canada - National Science Library
2002-01-01
States provide health care coverage to about 40 million low-income uninsured adults and children largely through two federal-state programs-Medicaid and the State Children's Health Insurance Program (SCHIP...
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Hodapp, Theodore
The Phys21 report, ``Preparing Physics Students for 21st Century Careers,'' provides guidance for physics programs to improve their degree programs to make them more relevant for student career choices. Undertaking such changes and assessing impact varies widely by institution, with many departments inventing assessments with each periodic departmental or programmatic review. American Physical Society has embarked on a process to integrate information from Phys21, the results of other national studies, and educational research outcomes to generate a best-practices guide to help physics departments conduct program review, assessment, and improvement. It is anticipated that departments will be able to use this document to help with their role in university-level accreditation, and in making the case for improvements to departmental programs. Accreditation of physics programs could stem from such a document, and I will discuss some of the thinking of the APS Committee on Education in creating this guide, and how they are advising APS to move forward in the higher education landscape that is increasingly subject to standards-based evaluations. I will describe plans for the design, review, and dissemination of this guide, and how faculty can provide input into its development. This material is based upon work supported by the National Science Foundation under Grant No. 1540570. Opinions expressed do not necessarily reflect those of the NSF.
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76 FR 18812 - Submission for Review: RI 30-10, Disabled Dependent Questionnaire
2011-04-05
... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: RI 30-10, Disabled Dependent Questionnaire... Dependent Questionnaire. As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C... (202) 606-0910. SUPPLEMENTARY INFORMATION: The RI 30-10, Disabled Dependent Questionnaire, is used to...
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76 FR 36582 - Submission for Review: Disabled Dependent Questionnaire, RI 30-10
2011-06-22
... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Disabled Dependent Questionnaire, RI 30-10... Dependent Questionnaire. As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C.... SUPPLEMENTARY INFORMATION: RI 30-10, Disabled Dependent Questionnaire, is used to collect sufficient information...
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Munshi, Kiraat D; Mager, Douglas; Ward, Krista M; Mischel, Brian; Henderson, Rochelle R
2018-02-01
Formulary or preferred drug list (PDL) management is an effective strategy to ensure clinically efficient prescription drug management by managed care organizations (MCOs). Medicaid MCOs participating in Florida's Medicaid program were required to use a state-mandated PDL between May and August 2014. To examine differences in prescription drug use and plan costs between a single Florida Medicaid managed care (MMC) health plan that implemented a state-mandated PDL policy on July 1, 2014, and a comparable MMC health plan in another state without a state-mandated PDL, controlling for sociodemographic confounders. A retrospective analysis with a pre-post design was conducted using deidentified administrative claims data from a large pharmacy benefit manager. The prepolicy evaluation period was January 1 through June 30, 2014, and the postpolicy period was January 1 through June 30, 2015. Continuously eligible Florida MMC plan members were matched on sociodemographic and health characteristics to their counterparts enrolled in a comparable MMC health plan in another state without a state-mandated formulary. Outcomes were drug use, measured as the number of 30-day adjusted nonspecialty drug prescriptions per member per period, and total drug plan costs per member per period for all drugs, with separate measures for generic and brand drugs. Bivariate comparisons were conducted using t-tests. Employing a difference-in-differences (DID) analytic approach, multivariate negative binomial regression and generalized estimating equation models were used to analyze prescription drug use and costs. The final analytical sample consisted of 18,372 enrollees, evenly divided between the 2 groups. In the postpolicy evaluation period, overall and generic use declined, while brand use increased for members in the Florida health plan. Drug costs, especially for brands, significantly increased for Florida health plan members. No significant changes were observed over the same time period
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Power-law cosmic expansion in f(R) gravity models
International Nuclear Information System (INIS)
Goheer, Naureen; Larena, Julien; Dunsby, Peter K. S.
2009-01-01
We show that within the class of f(R) gravity theories, Friedmann-Lemaitre-Robertson-Walker power-law perfect fluid solutions only exist for R n gravity. This significantly restricts the set of exact cosmological solutions which have similar properties to what is found in standard general relativity.
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Medicare and Medicaid fraud and abuse regulations.
Liang, F Z; Black, B L
1991-11-01
Specific business arrangements that are protected under legislation and regulations governing parties doing business with Medicare or Medicaid are discussed. Regulations implementing the Medicare and Medicaid Patient Protection Act of 1987 specify practices and activities that are not subject to criminal penalties under the antikickback provisions of the Social Security Act or to exclusion from Medicare or state health-care programs. As of July 29, 1991, all organized health-care settings that receive payments from either Medicare or state health-care programs must comply with these regulations. The final rule sets forth "safe harbors"--exceptions to prohibitions against (1) kickbacks, bribes, rebates, and other illegal activities involving remunerations for patient referrals and (2) inducements to purchase or lease goods paid for by Medicare or state health-care programs. The safe harbors comprise 11 broad categories--investment interests, space rental, equipment rental, personal services and management contracts, purchase of a medical practice, referral services, warranties, discounts, employees, group purchasing organizations, and waiver of deductibles and coinsurance. Implications for pharmacy are discussed. These regulations will affect the purchase of pharmaceuticals by institutional pharmacies. Each institution should review its current practices to determine whether they are within the safe harbors.
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Hwang, S-K; Jin, H; Kwon, J T; Chang, S-H; Kim, T H; Cho, C-S; Lee, K H; Young, M R; Colburn, N H; Beck, G R; Yang, H-S; Cho, M-H
2007-09-01
The long-term survival of lung cancer patients treated with conventional therapies remains poor and therefore the need for novel approaches remains high. This has led to the re-emergence of aerosol delivery as a therapeutic intervention. In this study, glucosylated polyethylenimine (GPEI) was used as carrier to investigate programmed cell death 4 (PDCD4) and PDCD4 mutant (D418A), an eIF4A-binding mutant, on PDCD4-related signaling and activator protein-1 (AP-1) activity in the lungs of AP-1 luciferase reporter mice. After confirming the efficiency of GPEI as a carrier in lungs, the effects of aerosol-delivered PDCD4 were investigated in AP-1 luciferase reporter mice. Aerosol delivery of GPEI/PDCD4 through a nose-only inhalation facilitated the apoptosis of lungs whereas aerosol PDCD4 mutant did not. Also, such aerosol delivery regulated proteins relevant to cell-cycle control and suppressed AP-1 activity. Results obtained by western blot analysis, immunohistochemistry, luciferase assay and deoxynucleotidyl-transferase-mediated nick end labeling study suggest that combined actions such as facilitating apoptosis, controlling cell cycle and suppression of AP-1 activity by PDCD4 may provide useful tool for designing lung tumor prevention and treatment by which PDCD4 functions as a transformation suppressor in the future.
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The simplest non-minimal matter-geometry coupling in the f(R, T) cosmology
Energy Technology Data Exchange (ETDEWEB)
Moraes, P.H.R.S. [ITA - Instituto Tecnologico de Aeronautica, Departamento de Fisica, Sao Paulo (Brazil); Sahoo, P.K. [Birla Institute of Technology and Science-Pilani, Department of Mathematics, Hyderabad (India)
2017-07-15
f(R, T) gravity is an extended theory of gravity in which the gravitational action contains general terms of both the Ricci scalar R and the trace of the energy-momentum tensor T. In this way, f(R, T) models are capable of describing a non-minimal coupling between geometry (through terms in R) and matter (through terms in T). In this article we construct a cosmological model from the simplest non-minimal matter-geometry coupling within the f(R, T) gravity formalism, by means of an effective energy-momentum tensor, given by the sum of the usual matter energy-momentum tensor with a dark energy contribution, with the latter coming from the matter-geometry coupling terms. We apply the energy conditions to our solutions in order to obtain a range of values for the free parameters of the model which yield a healthy and well-behaved scenario. For some values of the free parameters which are submissive to the energy conditions application, it is possible to predict a transition from a decelerated period of the expansion of the universe to a period of acceleration (dark energy era). We also propose further applications of this particular case of the f(R, T) formalism in order to check its reliability in other fields, rather than cosmology. (orig.)
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The simplest non-minimal matter-geometry coupling in the f(R, T) cosmology
International Nuclear Information System (INIS)
Moraes, P.H.R.S.; Sahoo, P.K.
2017-01-01
f(R, T) gravity is an extended theory of gravity in which the gravitational action contains general terms of both the Ricci scalar R and the trace of the energy-momentum tensor T. In this way, f(R, T) models are capable of describing a non-minimal coupling between geometry (through terms in R) and matter (through terms in T). In this article we construct a cosmological model from the simplest non-minimal matter-geometry coupling within the f(R, T) gravity formalism, by means of an effective energy-momentum tensor, given by the sum of the usual matter energy-momentum tensor with a dark energy contribution, with the latter coming from the matter-geometry coupling terms. We apply the energy conditions to our solutions in order to obtain a range of values for the free parameters of the model which yield a healthy and well-behaved scenario. For some values of the free parameters which are submissive to the energy conditions application, it is possible to predict a transition from a decelerated period of the expansion of the universe to a period of acceleration (dark energy era). We also propose further applications of this particular case of the f(R, T) formalism in order to check its reliability in other fields, rather than cosmology. (orig.)
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Medicaid Drug Claims Statistics
U.S. Department of Health & Human Services — The Medicaid Drug Claims Statistics CD is a useful tool that conveniently breaks up Medicaid claim counts and separates them by quarter and includes an annual count.
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Diagnostic Risk Adjustment for Medicaid: The Disability Payment System
Kronick, Richard; Dreyfus, Tony; Lee, Lora; Zhou, Zhiyuan
1996-01-01
This article describes a system of diagnostic categories that Medicaid programs can use for adjusting capitation payments to health plans that enroll people with disability. Medicaid claims from Colorado, Michigan, Missouri, New York, and Ohio are analyzed to demonstrate that the greater predictability of costs among people with disabilities makes risk adjustment more feasible than for a general population and more critical to creating health systems for people with disability. The application of our diagnostic categories to State claims data is described, including estimated effects on subsequent-year costs of various diagnoses. The challenges of implementing adjustment by diagnosis are explored. PMID:10172665
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Medicaid Analytic eXtract (MAX) Chartbooks
U.S. Department of Health & Human Services — The Medicaid Analytic eXtract Chartbooks are research tools and reference guides on Medicaid enrollees and their Medicaid experience in 2002 and 2004. Developed for...
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Energy Technology Data Exchange (ETDEWEB)
Dong, Wenjie, E-mail: dongwenjie200581@126.com [Department of Internal Medicine-Oncology, The First Affiliated Hospital, Zhengzhou University (China); Shen, Ruizhe; Cheng, Shidan [Department of Gastroenterology, Rui-jin Hospital, Shanghai Jiao Tong University, Shanghai (China)
2014-10-31
Highlights: • TIP30 expression is frequently suppressed in ESCC. • TIP30 was hypermethylated in ESCC. • Reduction of TIP30 was significantly correlated with LN metastasis. • miR-10b is a direct regulator of TIP30. - Abstract: TIP30 is a putative tumor suppressor that can promote apoptosis and inhibit angiogenesis. However, the role of TIP30 in esophageal squamous cell carcinoma (ESCC) biology has not been investigated. Immunohistochemistry was used to investigate the expression of TIP30 in 70 ESCC. Hypermethylation of TIP30 was evaluated by the methylation specific PCR (MSP) method in ESCC (tumor and paired adjacent non-tumor tissues). Lost expression of TIP30 was observed in 50 of 70 (71.4%) ESCC. 61.4% (43 of 70) of primary tumors analyzed displayed TIP30 hypermethylation, indicating that this aberrant characteristic is common in ESCC. Moreover, a statistically significant inverse association was found between TIP30 methylation status and expression of the TIP30 protein in tumor tissues (p = 0.001). We also found that microRNA-10b (miR-10b) targets a homologous DNA region in the 3′untranslated region of the TIP30 gene and represses its expression at the transcriptional level. Reporter assay with 3′UTR of TIP30 cloned downstream of the luciferase gene showed reduced luciferase activity in the presence of miR-10b, providing strong evidence that miR-10b is a direct regulator of TIP30. These results suggest that TIP30 expression is regulated by promoter methylation and miR-10b in ESCC.
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Labrum, Joseph T; Paziuk, Taylor; Rihn, Theresa C; Hilibrand, Alan S; Vaccaro, Alexander R; Maltenfort, Mitchell G; Rihn, Jeffrey A
2017-06-01
A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion. In the survey, the caller assumed a fictitious identity as a 38-year-old male who experienced an ankle fracture 1 day before calling, and attempted to secure an appointment within 2 weeks. During initial contact, the fictitious patient reported Medicaid insurance status. One month later, the fictitious patient contacted the same orthopaedic practice and reported private insurance coverage status. National Orthopaedic Survey: Private and academic orthopaedic practices operating in each state in the United States were called and asked to complete a survey assessing their practice model of Medicaid insurance acceptance. State reimbursement rates for three different Current Procedural Terminology (CPT ®) codes were collected from state Medicaid agencies. Results Simulated Patient Survey: Offices were less likely to accept Medicaid than commercial insurance (30 of 64 [47%] versus 62 of 64 [97%]; odds ratio [OR], 0.0145; 95% CI, 0
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Compact stars in f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Das, Amit; Guha, B.K. [Indian Institute of Engineering Science and Technology, Department of Physics, Howrah, West Bengal (India); Rahaman, Farook [Jadavpur University, Department of Mathematics, Kolkata, West Bengal (India); Ray, Saibal [Government College of Engineering and Ceramic Technology, Department of Physics, Kolkata, West Bengal (India)
2016-12-15
In the present paper we generate a set of solutions describing the interior of a compact star under f(R, T) theory of gravity which admits conformal motion. An extension of general relativity, the f(R, T) gravity is associated to Ricci scalar R and the trace of the energy-momentum tensor T. To handle the Einstein field equations in the form of differential equations of second order, first of all we adopt the Lie algebra with conformal Killing vectors (CKV) which enable one to get a solvable form of such equations and second we consider the equation of state (EOS) p = ωρ with 0 < ω < 1 for the fluid distribution consisting of normal matter, ω being the EOS parameter. We therefore analytically explore several physical aspects of the model to represent behavior of the compact stars such as - energy conditions, TOV equation, stability of the system, Buchdahl condition, compactness and redshift. It is checked that the physical validity and the acceptability of the present model within the specified observational constraint in connection to a dozen of the compact star candidates are quite satisfactory. (orig.)
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Recent changes in Medicaid policy and their possible effects on mental health services.
Buck, Jeffrey A
2009-11-01
As Medicaid has emerged as the primary funder of public mental health services, its character has affected the organization and delivery of such services. Recent changes to the program, however, promise to further affect the direction of changes in states' mental health service systems. One group of changes will further limit the flexibility of Medicaid mental health funding, while increasing provider accountability and the authority of state Medicaid agencies. Others will increase incentives for deinstitutionalization and community-based care and promote person-centered treatment principles. These changes will likely affect state mental health systems, mental health providers, and the nature of service delivery.
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Social Work’s Role in Medicaid Reform: A Qualitative Study
Wachman, Madeline; Manning, Leticia; Cohen, Alexander M.; Seifert, Robert W.; Jones, David K.; Fitzgerald, Therese; Nuzum, Rachel; Riley, Patricia
2017-01-01
Objectives. To critically analyze social work’s role in Medicaid reform. Methods. We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. Results. Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work’s practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work’s involvement in systems-level practice include lack of visibility, insufficient clarity on social work’s role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. Conclusions. Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level. PMID:29236537
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Brane f(R) gravity and the dark side of the universe
International Nuclear Information System (INIS)
Borzou, A.; Sepangi, H. R.; Shahidi, S.; Yousefi, R.
2009-01-01
We consider a brane world scenario in which the bulk action is assumed to have the form of a generic function of the Ricci scalar f(R) and derive the resulting Einstein field equation on the brane. In a constant curvature bulk a conserved geometric quantity appears in the field equations which can be associated with matter. We present spherically symmetric solutions which account for galaxy rotation curves in a specific form. Then cosmological solutions by assuming a specific form for f(R) are derived which can explain an accelerated expanding universe.
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Westinghouse AP1000 advanced passive plant: design features and benefits
International Nuclear Information System (INIS)
Walls, S.J.; Cummins, W.E.
2003-01-01
The Westinghouse AP1000 Program is aimed at implementing the AP1000 plant to provide a further major improvement in plant economics while maintaining the passive safety advantages established by the AP600. An objective is to retain to the maximum extent possible the plant design of the AP600 so as to retain the licensing basis, cost estimate, construction schedule, modularization scheme, and the detailed design from the AP600 program. Westinghouse and the US Nuclear Regulatory Commission staff have embarked on a program to complete Design Certification for the AP1000 by 2004. A pre-certification review phase was completed in March 2002 and was successful in establishing the applicability of the AP600 test program and AP600 safety analysis codes to the AP1000 Design Certification. On March 28, 2002, Westinghouse submitted to US NRC the AP1000 Design Control Document and Probabilistic Risk Assessment, thereby initiating the formal design certification review process. The results presented in these documents verify the safety performance of the API 000 and conformance with US NRC licensing requirements. Plans are being developed for implementation of a series of AP1000 plants in the US. Key factors in this planning are the economics of AP1000, and the associated business model for licensing, constructing and operating these new plants. Similarly plans are being developed to get the AP1000 design reviewed for use in the UK. Part of this planning has been to examine the AP1000 design relative to anticipated UK safety and licensing issues. (author)
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2011-10-11
... support programs to study and combat the spread of infectious diseases and to advance sustainable natural... Register. (Presidential Sig.) THE WHITE HOUSE, Washington, September 30, 2011 [FR Doc. 2011-26333 Filed 10...
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State-level Medicaid expenditures attributable to smoking.
Armour, Brian S; Finkelstein, Eric A; Fiebelkorn, Ian C
2009-07-01
Medicaid recipients are disproportionately affected by tobacco-related disease because their smoking prevalence is approximately 53% greater than that of the overall US adult population. This study estimates state-level smoking-attributable Medicaid expenditures. We used state-level and national data and a 4-part econometric model to estimate the fraction of each state's Medicaid expenditures attributable to smoking. These fractions were multiplied by state-level Medicaid expenditure estimates obtained from the Centers for Medicare and Medicaid Services to estimate smoking-attributable expenditures. The smoking-attributable fraction for all states was 11.0% (95% confidence interval, 0.4%-17.0%). Medicaid smoking-attributable expenditures ranged from $40 million (Wyoming) to $3.3 billion (New York) in 2004 and totaled $22 billion nationwide. Cigarette smoking accounts for a sizeable share of annual state Medicaid expenditures. To reduce smoking prevalence among recipients and the growth rate in smoking-attributable Medicaid expenditures, state health departments and state health plans such as Medicaid are encouraged to provide free or low-cost access to smoking cessation counseling and medication.
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Morisky, Donald E; Kominski, Gerald F; Afifi, Abdelmonem A; Kotlerman, Jenny B
2009-06-01
Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of 15,275 patients with one or more chronic illnesses (congestive heart failure, hypertension, diabetes, or asthma) was undertaken. Control of hypertension improved from baseline to Year 1 (adjusted odds ratio = 1.60, p management program benefited in terms of controlling hypertension, asthma symptoms, and cholesterol and blood glucose levels.
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Update on the development of cotton gin PM10 emission factors for EPA's AP-42
A cotton ginning industry-supported project was initiated in 2008 to update the U.S. Environmental Protection Agency’s (EPA) Compilation of Air Pollution Emission Factors (AP-42) to include PM10 emission factors. This study develops emission factors from the PM10 emission factor data collected from ...
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Equity in Medicaid Reimbursement for Otolaryngologists.
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.
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78 FR 29055 - State Medicaid Fraud Control Units; Data Mining
2013-05-17
... pursue Medicaid provider fraud, we finalize proposals to permit Federal financial participation (FFP) in... general approach to data mining by MFCUs is to give each MFCU the autonomy to choose how to operate its...) to read as follows: Sec. 1007.19 Federal financial participation (FFP). * * * * * (e) * * * (2...
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2010-09-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); NTP Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM); Availability of Interagency..., Associate Director, National Toxicology Program. [FR Doc. 2010-23262 Filed 9-16-10; 8:45 am] BILLING CODE...
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2010-06-10
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); NTP Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM): Availability of the Biennial... Toxicology Program. [FR Doc. 2010-13952 Filed 6-9-10; 8:45 am] BILLING CODE 4140-01-P ...
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Poor oral health as an obstacle to employment for Medicaid beneficiaries with disabilities.
Hall, Jean P; Chapman, Shawna L Carroll; Kurth, Noelle K
2013-01-01
To inform policy with better information about the oral health-care needs of a Medicaid population that engages in employment, that is, people ages 16 to 64 with Social Security-determined disabilities enrolled in a Medicaid Buy-In program. Statistically test for significant differences among responses to a Medicaid Buy-In program satisfaction survey that included oral health questions from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System and the Oral Health Impact Profile (OHIP) to results for the state's general population and the US general population. All measures of dental care access and oral health were significantly worse for the study population as compared with a state general population or a US general population. Differences were particularly pronounced for the OHIP measure for difficulty doing one's job due to dental problems, which was almost five times higher for the study population. More comprehensive dental benefits for the study population could result in increased oral and overall health, and eventual cost savings to Medicaid as more people work, have improved health, and pay premiums for coverage. © 2012 American Association of Public Health Dentistry.
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Study of some chaotic inflationary models in f(R) gravity
Sharif, M.; Nawazish, Iqra
2018-04-01
In this paper, we discuss an inflationary scenario via scalar field and fluid cosmology for an anisotropic homogeneous universe model in f(R) gravity. We consider an equation of state which corresponds to a quasi-de Sitter expansion and investigate the effect of the anisotropy parameter for different values of the deviation parameter. We evaluate potential models like linear, quadratic and quartic models which correspond to chaotic inflation. We construct the observational parameters for a power-law model of f(R) gravity and construct the graphical analysis of tensor-scalar ratio and spectral index which indicates the consistency of these parameters with Planck 2015 data.
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Stewart, Alexandra M.; Lindley, Megan C.; Chang, Kristen H.M.; Cox, Marisa A.
2013-01-01
Medicaid is the largest funding source of health services for the poorest people in the United States. Medicaid enrollees have greater health care, needs, and higher health risks than other individuals in the country and, experience disproportionately low rates of preventive care. Without, Medicaid coverage, poor uninsured adults may not be vaccinated or would, rely on publicly-funded programs that provide vaccinations. We examined each programs’ policies related to benefit coverage and, copa...
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Hill, V.; Christlieb, N.; Beers, T. C.; Barklem, P. S.; Kratz, K.-L.; Nordström, B.; Pfeiffer, B.; Farouqi, K.
2017-11-01
We report an abundance analysis for the highly r-process-enhanced (r-II) star CS 29497-004, a very metal-poor giant with solar system Teff = 5013 K and [Fe/H] = -2.85, whose nature was initially discovered in the course of the HERES project. Our analysis is based on high signal-to-noise ratio, high-resolution (R 75 000) VLT/UVES spectra and MARCS model atmospheres under the assumption of local thermodynamic equilibrium, and obtains abundance measurements for a total of 46 elements, 31 of which are neutron-capture elements. As is the case for the other 25 r-II stars currently known, the heavy-element abundance pattern of CS 29497-004 well-matches a scaled solar system second peak r-process-element abundance pattern. We confirm our previous detection of Th, and demonstrate that this star does not exhibit an "actinide boost". Uranium is also detected (log ɛ(U) = -2.20 ± 0.30), albeit with a large measurement error that hampers its use as a precision cosmo-chronometer. Combining the various elemental chronometer pairs that are available for this star, we derive a mean age of 12.2 ± 3.7 Gyr using the theoretical production ratios from published waiting-point approximation models. We further explore the high-entropy wind model (Farouqi et al. 2010, ApJ, 712, 1359) production ratios arising from different neutron richness of the ejecta (Ye), and derive an age of 13.7 ± 4.4 Gyr for a best-fitting Ye = 0.447. The U/Th nuclei-chronometer is confirmed to be the most resilient to theoretical production ratios and yields an age of 16.5 ± 6.6 Gyr. Lead (Pb) is also tentatively detected in CS 29497-004, at a level compatible with a scaled solar r-process, or with the theoretical expectations for a pure r-process in this star. Based on observations collected at the European Southern Observatory, Paranal, Chile (Proposal Number 170.D-0010).Table B.1 is only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr
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Development of cotton gin PM10 emission factors for EPA’s AP-42
The Compilation of Air Pollution Emission Factors (AP-42) emission factors are assigned ratings, from A (Excellent) to E (Poor), based on the quality of data used to develop them. All current PM10 cotton gin emission factors received quality ratings of D or lower. In an effort to improve these ratin...
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Revisiting van der Waals like behavior of f(R AdS black holes via the two point correlation function
Directory of Open Access Journals (Sweden)
Jie-Xiong Mo
2017-05-01
Full Text Available Van der Waals like behavior of f(R AdS black holes is revisited via two point correlation function, which is dual to the geodesic length in the bulk. The equation of motion constrained by the boundary condition is solved numerically and both the effect of boundary region size and f(R gravity are probed. Moreover, an analogous specific heat related to δL is introduced. It is shown that the T−δL graphs of f(R AdS black holes exhibit reverse van der Waals like behavior just as the T−S graphs do. Free energy analysis is carried out to determine the first order phase transition temperature T⁎ and the unstable branch in T−δL curve is removed by a bar T=T⁎. It is shown that the first order phase transition temperature is the same at least to the order of 10−10 for different choices of the parameter b although the values of free energy vary with b. Our result further supports the former finding that charged f(R AdS black holes behave much like RN-AdS black holes. We also check the analogous equal area law numerically and find that the relative errors for both the cases θ0=0.1 and θ0=0.2 are small enough. The fitting functions between log|T−Tc| and log|δL−δLc| for both cases are also obtained. It is shown that the slope is around 3, implying that the critical exponent is about 2/3. This result is in accordance with those in former literatures of specific heat related to the thermal entropy or entanglement entropy.
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Glassmire, David M; Jhawar, Amandeep; Burchett, Danielle; Tarescavage, Anthony M
2017-05-01
The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) F(p) (Infrequency-Psychopathology) scale was developed to measure overreporting in a manner that was minimally confounded by genuine psychopathology, which was a problem with using the MMPI-2 F (Infrequency) scale among patients with severe mental illness. Although revised versions of both of these scales are included on the MMPI-2-Restructured Form and used in a forensic context, no item-level research has been conducted on their sensitivity to genuine psychopathology among forensic psychiatric inpatients. Therefore, we examined the psychometric properties of the scales in a sample of 438 criminally committed forensic psychiatric inpatients who were adjudicated as not guilty by reason of insanity and had no known incentive to overreport. We found that 20 of the 21 Fp-r items (95.2%) demonstrated endorsement rates ≤ 20%, with 14 of the items (66.7%) endorsed by less than 10% of the sample. Similar findings were observed across genders and across patients with mood and psychotic disorders. The one item endorsed by more than 20% of the sample had a 23.7% overall endorsement rate and significantly different endorsement rates across ethnic groups, with the highest endorsements occurring among Hispanic/Latino (43.3% endorsement rate) patients. Endorsement rates of F-r items were generally higher than for Fp-r items. At the scale level, we also examined correlations with the Restructured Clinical Scales and found that Fp-r demonstrated lower correlations than F-r, indicating that Fp-r is less associated with a broad range of psychopathology. Finally, we found that Fp-r demonstrated slightly higher specificity values than F-r at all T score cutoffs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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R data analysis without programming
Gerbing, David W
2013-01-01
This book prepares readers to analyze data and interpret statistical results using R more quickly than other texts. R is a challenging program to learn because code must be created to get started. To alleviate that challenge, Professor Gerbing developed lessR. LessR extensions remove the need to program. By introducing R through less R, readers learn how to organize data for analysis, read the data into R, and produce output without performing numerous functions and programming exercises first. With lessR, readers can select the necessary procedure and change the relevant variables without pro
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Ji, Xu; Wilk, Adam S; Druss, Benjamin G; Lally, Cathy; Cummings, Janet R
2017-08-01
Gaps in Medicaid coverage may disrupt access to and continuity of care. This can be detrimental for beneficiaries with chronic conditions, such as major depression, for whom disruptions in access to outpatient care may lead to increased use of acute care. However, little is known about how Medicaid coverage discontinuities impact acute care utilization among adults with depression. Examine the relationship between Medicaid discontinuities and service utilization among adults with major depression. A total of 139,164 adults (18-64) with major depression was identified using the 2003-2004 Medicaid Analytic eXtract Files. We used generalized linear and two-part models to examine the effect of Medicaid discontinuity on service utilization. To establish causality in this relationship, we used instrumental variables analysis, relying on exogenous variation in a state-level policy for identification. Emergency department (ED) visits, inpatient episodes, inpatient days, and Medicaid-reimbursed costs. Approximately 29.4% of beneficiaries experienced coverage disruptions. In instrumental variables models, those with coverage disruptions incurred an increase of $650 in acute care costs per-person per Medicaid-covered month compared with those with continuous coverage, evidenced by an increase in ED use (0.1 more ED visits per-person-month) and inpatient days (0.6 more days per-person-month). The increase in acute costs contributed to an overall increase in all-cause costs by $310 per-person-month (all P-valuesMedicaid coverage may help prevent acute episodes requiring high-cost interventions.
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Czech Academy of Sciences Publication Activity Database
Pechar, Michal; Pola, Robert; Laga, Richard; Braunová, Alena; Filippov, Sergey K.; Bogomolova, Anna; Bednárová, Lucie; Vaněk, O.; Ulbrich, Karel
2014-01-01
Roč. 15, č. 7 (2014), s. 2590-2599 ISSN 1525-7797 R&D Projects: GA ČR GCP207/12/J030 Grant - others:AV ČR(CZ) AP0802 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:61389013 ; RVO:61388963 Keywords : coiled coil * self-assembly * hydrophilic polymer Subject RIV: CD - Macromolecular Chemistry; FR - Pharmacology ; Medidal Chemistry (UOCHB-X) Impact factor: 5.750, year: 2014
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Lyu, Shuhua; Liu, Han; Liu, Xia; Liu, Shan; Wang, Yahong; Yu, Qi; Niu, Yun
2017-10-01
The association between androgen-induced androgen receptor (AR) activating signal and microRNA (miR)-30a was investigated, as well as the function of miR-30a in estrogen receptor-negative (ER - ), progesterone receptor-negative (PR - ), and AR-positive (AR + ) MDA-MB-453 breast cancer cells. Androgen-induced AR activating signal upregulated the expression of AR, and downregulated the expression of miR-30a, b and c. Bioinformatics analysis indicated a putative miR-30a, b and c binding site in the 3'-untranslated region of AR mRNA. It was confirmed that the AR gene is a direct target of miR-30a, whereas AR does not target the miR-30a promoter, and AR activating signal may indirectly downregulate miR-30a through other cell signaling pathways. In this positive feedback mechanism AR is then upregulated through miR-30a. Overexpression of miR-30a inhibited cell proliferation, whereas inhibition of miR-30a expression by specific antisense oligonucleotides, increased cell growth. Previously, androgen-induced AR activating signal was demonstrated to inhibit cell proliferation in ER - , PR - and AR + MDA-MB-453 breast cancer cells, but AR activating signal downregulated the expression of miR-30a, relieving the inhibition of MDA-MB-453 cell growth. Therefore, in MDA-MB-453 breast cancer cells, miR-30a has two different functions regarding cell growth: Inhibition of cell proliferation through a positive feedback signaling pathway; and the relative promotion of cell proliferation through downregulation of miR-30a. Thus, the association between AR activating signal and microRNAs is complex, and microRNAs may possess different functions due to different signaling pathways. Although the results of the present study were obtained in one cell line, they contribute to subsequent studies on ER - , PR - and AR + breast cancer.
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Importprocessen för inrednings- och gåvoartiklar från USA till Finland : En handbok för företagaren
Smeds, Desiré; Backlund, Johanna
2016-01-01
Det här examensarbetet handlar om import från USA med fokus på inrednings- och gåvoartiklar. I arbetet lyfter vi steg för steg fram de delar som utgör importprocessen hela vägen från hur man hittar en pålitlig leverantör till förtullningen av produkterna här i Finland. Syftet med arbetet är att det skall kunna fungera som en handbok för företag som vill starta en småskalig importverksamhet av inrednings- och gåvoartiklar. Vi tar även upp information om import och internationell handel i a...
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Wormholes in viable f(R) modified theories of gravity and weak energy condition
Energy Technology Data Exchange (ETDEWEB)
Pavlovic, Petar [Universitaet Hamburg, II. Institut fuer Theoretische Physik, Hamburg (Germany); Sossich, Marko [University of Zagreb, Department of Physics, Faculty of Electrical Engineering and Computing, Zagreb (Croatia)
2015-03-01
In this work wormholes in viable f(R) gravity models are analyzed. We are interested in exact solutions for stress-energy tensor components depending on different shape and redshift functions. Several solutions of gravitational equations for different f(R) models are examined. The solutions found imply no need for exotic material, while this need is implied in the standard general theory of relativity. A simple expression for weak energy condition (WEC) violation near the throat is derived and analyzed. High curvature regime is also discussed, as well as the question of the highest possible values of the Ricci scalar for which the WEC is not violated near the throat, and corresponding functions are calculated for several models. The approach here differs from the one that has been common since no additional assumptions to simplify the equations have been made, and the functions in f(R) models are not considered to be arbitrary functions, but rather a feature of the theory that has to be evaluated on the basis of consistency with observations for the Solar System and cosmological evolution. Therefore in this work we show that the existence of wormholes without exotic matter is not only possible in simple arbitrary f(R) models, but also in models that are in accordance with empirical data. (orig.)
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Saving Teens: Using a Policy Discontinuity to Estimate the Effects of Medicaid Eligibility
Bruce D. Meyer; Laura R. Wherry
2012-01-01
This paper uses a policy discontinuity to identify the immediate and long-term effects of public health insurance coverage during childhood. Our identification strategy exploits a unique feature of several early Medicaid expansions that extended eligibility only to children born after September 30, 1983. This feature resulted in a large discontinuity in the lifetime years of Medicaid eligibility of children at this birthdate cutoff. Those with family incomes at or just below the poverty line ...
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75 FR 30243 - Medicaid Program; Premiums and Cost Sharing
2010-05-28
... each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, phone 1-800-743... Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Pub. L. 110- 343), relate to the...
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Westinghouse AP600 advanced nuclear plant design
International Nuclear Information System (INIS)
Gangloff, W.
1999-01-01
As part of the cooperative US Department of Energy (DOE) Advanced Light Water Reactor (ALWR) Program and the Electric Power Research Institute (EPRI), the Westinghouse AP600 team has developed a simplified, safe, and economic 600-megawatt plant to enter into a new era of nuclear power generation. Designed to satisfy the standards set by DOE and defined in the ALWR Utility Requirements Document (URD), the Westinghouse AP600 is an elegant combination of innovative safety systems that rely on dependable natural forces and proven technologies. The Westinghouse AP600 design simplifies plant systems and significant operation, inspections, maintenance, and quality assurance requirements by greatly reducing the amount of valves, pumps, piping, HVAC ducting, and other complex components. The AP600 safety systems are predominantly passive, depending on the reliable natural forces of gravity, circulation, convection, evaporation, and condensation, instead of AC power supplies and motor-driven components. The AP600 provides a high degree of public safety and licensing certainty. It draws upon 40 years of experience in light water reactor components and technology, so no demonstration plant is required. During the AP600 design program, a comprehensive test program was carried out to verify plant components, passive safety systems components, and containment behavior. When the test program was completed at the end of 1994, the AP600 became the most thoroughly tested advanced reactor design ever reviewed by the US Nuclear Regulatory Commission (NRC). The test results confirmed the exceptional behavior of the passive systems and have been instrumental in facilitating code validations. Westinghouse received Final Design Approval from the NRC in September 1998. (author)
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76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative
2011-10-03
...] Medicare Program; Comprehensive Primary Care Initiative AGENCY: Centers for Medicare & Medicaid Services... organizations to participate in the Comprehensive Primary Care initiative (CPC), a multipayer model designed to... the Comprehensive Primary Care initiative or the application process. SUPPLEMENTARY INFORMATION: I...
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Energy Technology Data Exchange (ETDEWEB)
Pfister, A.; Goossen, C.; Coogler, K.; Gorgemans, J. [Westinghouse Electric Company LLC, 1000 Westinghouse Drive, Cranberry Township, PA 16066 (United States)
2012-07-01
Both the International Atomic Energy Agency (IAEA) and the U.S. Nuclear Regulatory Commission (NRC) require existing and new nuclear power plants to conduct plant assessments to demonstrate the unit's ability to withstand external hazards. The events that occurred at the Fukushima-Dai-ichi nuclear power station demonstrated the importance of designing a nuclear power plant with the ability to protect the plant against extreme external hazards. The innovative design of the AP1000{sup R} nuclear power plant provides unparalleled protection against catastrophic external events which can lead to extensive infrastructure damage and place the plant in an extended abnormal situation. The AP1000 plant is an 1100-MWe pressurized water reactor with passive safety features and extensive plant simplifications that enhance construction, operation, maintenance and safety. The plant's compact safety related footprint and protection provided by its robust nuclear island structures prevent significant damage to systems, structures, and components required to safely shutdown the plant and maintain core and spent fuel pool cooling and containment integrity following extreme external events. The AP1000 nuclear power plant has been extensively analyzed and reviewed to demonstrate that it's nuclear island design and plant layout provide protection against both design basis and extreme beyond design basis external hazards such as extreme seismic events, external flooding that exceeds the maximum probable flood limit, and malicious aircraft impact. The AP1000 nuclear power plant uses fail safe passive features to mitigate design basis accidents. The passive safety systems are designed to function without safety-grade support systems (such as AC power, component cooling water, service water, compressed air or HVAC). The plant has been designed to protect systems, structures, and components critical to placing the reactor in a safe shutdown condition within the steel
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1998-03-31
This document delays the effective date of the final rule on salary equivalency guidelines, published in the Federal Register (63 FR 5106) on January 30, 1998, from April 1, 1998 to April 10, 1998. In addition, we are making a technical correction in the preamble to the January 30, 1998 final rule.
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Sternberg, Robert J
2018-03-01
This introduction to the special symposium on the top 30 most-cited articles in APS journals considers some of the factors that lead some articles to have huge impact. What is it that scientists can do to achieve the greatest impact for their work?
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Keohane, Laura M; Trivedi, Amal; Mor, Vincent
2017-10-01
Medically needy pathways may provide temporary catastrophic coverage for low-income Medicare beneficiaries who do not otherwise qualify for full Medicaid benefits. Between January 2009 and June 2010, states with medically needy pathways had a higher percentage of low-income beneficiaries join Medicaid than states without such programs (7.5% vs. 4.1%, p < .01). However, among new full Medicaid participants, living in a state with a medically needy pathway was associated with a 3.8 percentage point (adjusted 95% confidence interval [1.8, 5.8]) increase in the probability of switching to partial Medicaid and a 4.5 percentage point (adjusted 95% confidence interval [2.9, 6.2]) increase in the probability of exiting Medicaid within 12 months. The predicted risk of leaving Medicaid was greatest when new Medicaid participants used only hospital services, rather than nursing home services, in their first month of Medicaid benefits. Alternative strategies for protecting low-income Medicare beneficiaries' access to care could provide more stable coverage.
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Brantley, Erin; Bysshe, Tyler; Steinmetz, Erika; Bruen, Brian K.
2016-01-01
Introduction State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers. Methods We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014. Results Medicaid policies that require patients to obtain counseling to get medications reduced the use of cessation medications by approximately one-quarter to one-third; states that cover all types of cessation medications increased usage by approximately one-quarter to one-third. Non-Medicaid policies did not have significant effects on use levels. Conclusions States could increase efforts to quit by developing more comprehensive coverage and reducing barriers to coverage. Reductions in barriers could bolster smoking cessation rates, and the costs would be small compared with the costs of treating smoking-related diseases. Innovative initiatives to help smokers quit could improve health and reduce health care costs. PMID:27788063
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Buescher, P A; Roth, M S; Williams, D; Goforth, C M
1991-12-01
Care coordination is an important component of the enhanced prenatal care services provided under the recent expansions of the Medicaid program. The effect of maternity care coordination services on birth outcomes in North Carolina was assessed by comparing women on Medicaid who did and did not receive these services. Health program data files, including Medicaid claims paid for maternity care coordination, were linked to 1988 and 1989 live birth certificates. Simple comparisons of percentages and rates were supplemented by a logistic regression analysis. Among women on Medicaid who did not receive maternity care coordination services, the low birth weight rate was 21% higher, the very low birth weight rate was 62% higher, and the infant mortality rate was 23% higher than among women on Medicaid who did receive such services. It was estimated that, for each $1.00 spent on maternity care coordination, Medicaid saved $2.02 in medical costs for newborns up to 60 days of age. Among the women who did receive maternity care coordination, those receiving it for 3 or more months had better outcomes than those receiving it for less than 3 months. These results suggest that maternity care coordination can be effective in reducing low birth weight, infant mortality, and newborn medical care costs among babies born to women in poverty.
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Medicaid expansion and access to care among cancer survivors: a baseline overview.
Tarazi, Wafa W; Bradley, Cathy J; Harless, David W; Bear, Harry D; Sabik, Lindsay M
2016-06-01
Medicaid expansion under the Affordable Care Act facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Medicaid expansions may provide increased access to care for cancer survivors, a growing population with chronic conditions. We compare access to health care services among cancer survivors living in non-expansion states to those living in expansion states, prior to Medicaid expansion under the Affordable Care Act. We use the 2012 and 2013 Behavioral Risk Factor Surveillance System to estimate multiple logistic regression models to compare inability to see a doctor because of cost, having a personal doctor, and receiving an annual checkup in the past year between cancer survivors who lived in non-expansion states and survivors who lived in expansion states. Cancer survivors in non-expansion states had statistically significantly lower odds of having a personal doctor (adjusted odds ratio [AOR] 0.76, 95 % confidence interval [CI] 0.63-0.92, p Medicaid could potentially leave many cancer survivors with limited access to routine care. Existing disparities in access to care are likely to widen between cancer survivors in Medicaid non-expansion and expansion states.
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How Medicaid Expansion Affected Out-of-Pocket Health Care Spending for Low-Income Families.
Glied, Sherry; Chakraborty, Ougni; Russo, Therese
2017-08-01
ISSUE. Prior research shows that low-income residents of states that expanded Medicaid under the Affordable Care Act are less likely to experience financial barriers to health care access, but the impact on out-of-pocket spending has not yet been measured. GOAL. Assess how the Medicaid expansion affected out-of-pocket health care spending for low-income families compared to those in states that did not expand and consider whether effects differed in states that expanded under conventional Medicaid rules vs. waiver programs. METHODS. Analysis of the Consumer Expenditure Survey 2010–2015. KEY FINDINGS AND CONCLUSIONS. Compared to families in nonexpansion states, low-income families in states that did expand Medicaid saved an average of $382 in annual spending on health care. In these states, low-income families were less like to report any out-of-pocket spending on insurance premiums or medical care than were similar families in nonexpansion states. For families that did have some out-of-pocket spending, spending levels were lower in states that expanded Medicaid. Low-income families in Medicaid expansion states were also much less likely to have catastrophically high spending levels. The form of coverage expansion — conventional Medicaid or waiver rules — did not have a statistically significant effect on these outcomes.
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2011-10-31
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed National Toxicology... Session AGENCY: Division of the National Toxicology Program (DNTP), National Institute of Environmental.... Bucher, Associate Director, National Toxicology Program. [FR Doc. 2011-28132 Filed 10-28-11; 8:45 am...
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Firm- and drug-specific patterns of generic drug payments by US medicaid programs: 1991-2008.
Kelton, Christina M L; Chang, Lenisa V; Guo, Jeff J; Yu, Yan; Berry, Edmund A; Bian, Boyang; Heaton, Pamela C
2014-04-01
The entry of generic drugs into markets previously monopolized by patented, branded drugs often represents large potential savings for healthcare payers in the USA. Our objectives were to describe and explain the trends in drug reimbursement by public Medicaid programmes post-generic entry for as many drug markets and for as long a time period as possible. The data were the Medicaid State Drug Utilization Data maintained by the Centers for Medicare and Medicaid Services. Quarterly utilization and expenditure data from 1991 to 2008 were extracted for 83 drugs, produced by 229 firms, that experienced initial generic entry between 1992 and 2004. A relative 'price' for a specific drug, firm and quarter was constructed as Medicaid reimbursement per unit (e.g. tablet, capsule or vial) divided by average reimbursement per unit for the branded drug the year before entry. Fixed-effects models controlling for time-, firm- and drug-specific differences were estimated to explain reimbursement. Twelve quarters after generic entry, 18 % of drugs had average per-unit reimbursement less than 50 % of the original branded-drug reimbursement. For each additional firm manufacturing the drug, reimbursement per unit, relative to the pre-generic-entry branded-drug reimbursement, was estimated to fall by 17 (p < 0.01) and 3 (p < 0.01) percentage points for generic and branded-drug companies, respectively. Each additional quarter post-generic entry brought a 2 (p < 0.01) percentage point drop in relative reimbursement. State Medicaid programmes generally have been able to obtain relief from high drug prices following patent expirations for many branded-drug medications by adjusting reimbursement following the expanded competition in the pharmaceutical market.
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Garafalo, Steven D; Luth, Eric S; Moss, Benjamin J; Monteiro, Michael I; Malkin, Emily; Juo, Peter
2015-05-15
Regulation of glutamate receptor (GluR) abundance at synapses by clathrin-mediated endocytosis can control synaptic strength and plasticity. We take advantage of viable, null mutations in subunits of the clathrin adaptor protein 2 (AP2) complex in Caenorhabditis elegans to characterize the in vivo role of AP2 in GluR trafficking. In contrast to our predictions for an endocytic adaptor, we found that levels of the GluR GLR-1 are decreased at synapses in the ventral nerve cord (VNC) of animals with mutations in the AP2 subunits APM-2/μ2, APA-2/α, or APS-2/σ2. Rescue experiments indicate that APM-2/μ2 functions in glr-1-expressing interneurons and the mature nervous system to promote GLR-1 levels in the VNC. Genetic analyses suggest that APM-2/μ2 acts upstream of GLR-1 endocytosis in the VNC. Consistent with this, GLR-1 accumulates in cell bodies of apm-2 mutants. However, GLR-1 does not appear to accumulate at the plasma membrane of the cell body as expected, but instead accumulates in intracellular compartments including Syntaxin-13- and RAB-14-labeled endosomes. This study reveals a novel role for the AP2 clathrin adaptor in promoting the abundance of GluRs at synapses in vivo, and implicates AP2 in the regulation of GluR trafficking at an early step in the secretory pathway. © 2015 Garafalo et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).
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Medicaid Disproportionate Share Hospital Payments
U.S. Department of Health & Human Services — Medicaid Disproportionate Share Hospital (DSH) Payments This link provides you with information about Medicaid DSH Payments. You can find information on DSH Audit...
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Medicare and Medicaid Linked Files
U.S. Department of Health & Human Services — The Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) has been developed to allow for the examination of all Medicare and Medicaid enrollment and...
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Black, Kelly
2014-01-01
This book is designed for people with some experience in basic programming practices. It is also assumed that they have some basic experience using R and are familiar using the command line in an R environment. Our primary goal is to raise a beginner to a more advanced level to make him/her more comfortable creating programs and extending R to solve common problems.
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VizieR Online Data Catalog: Standard Galactic field RR Lyrae. I. Photometry (Monson+, 2017)
Monson, A. J.; Beaton, R. L.; Scowcroft, V.; Freedman, W. L.; Madore, B. F.; Rich, J. A.; Seibert, M.; Kollmeier, J. A.; Clementini, G.
2017-06-01
The Three-hundred MilliMeter Telescope (TMMT) is a fully robotic, 300mm telescope at Las Campanas Observatory (LCO), for which the nightly operation and data processing have been completely automated. Over the course of two years data were collected on 179 individual nights for our sample of the 55 RR Lyrae in the B, V, and IC broadband filters. Of these nights, 76 were under photometric conditions and calibrated directly. The 103 nonphotometric nights were roughly calibrated by using the default transformation equations, but only provide differential photometry relative to the calibrated frames. This resulted in 59698 final individual observations. Individual data points have a typical photometric precision of 0.02mag. The statistical error falls rapidly with hundreds of observations, with the zero-point uncertainties being the largest source of uncertainty in the final reported mean magnitude. To compare the results of our TMMT campaign to previous studies of these RR Lyrae (RRL) and to fill gaps in our TMMT phase coverage, we have compiled available broadband data from literature published over the past 30 years and spanning our full wavelength coverage (0.4 to 4.5μm) from the optical to mid-infrared. We have homogenized these diverse data sets to the following filter systems: Johnson UBV, Kron-Cousins RI, 2MASS J,H,Ks, and Spitzer [3.6], [4.5]. The All Sky Automated Survey (ASAS; http://www.astrouw.edu.pl/asas/) is a long-term project monitoring all stars brighter than V~14mag. The program covers both hemispheres, with telescopes at Las Campanas Observatory in Chile and Haleakala on Maui, both of which provide simultaneous I and V photometry. The GEOS RR Lyr Survey (http://www.ast.obs-mip.fr/users/leborgne/dbRR/grrs.html) is a long-term program utilizing TAROT (http://tarot.obs-hp.fr/) at Calern Observatory (Nice University, France). Annual data releases from this project add times for maximum light for program stars over the last year of observations. In
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Advanced Object-Oriented Programming in R
DEFF Research Database (Denmark)
Mailund, Thomas
2017-01-01
Learn how to write object-oriented programs in R and how to construct classes and class hierarchies in the three object-oriented systems available in R. This book gives an introduction to object-oriented programming in the R programming language and shows you how to use and apply R in an object......-oriented manner. You will then be able to use this powerful programming style in your own statistical programming projects to write flexible and extendable software. After reading Advanced Object-Oriented Programming in R, you'll come away with a practical project that you can reuse in your own analytics coding...... of data being manipulated. You will: Define and use classes and generic functions using R Work with the R class hierarchies Benefit from implementation reuse Handle operator overloading Apply the S4 and R6 classes...
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Advanced Object-Oriented Programming in R
DEFF Research Database (Denmark)
Mailund, Thomas
Learn how to write object-oriented programs in R and how to construct classes and class hierarchies in the three object-oriented systems available in R. This book gives an introduction to object-oriented programming in the R programming language and shows you how to use and apply R in an object......-oriented manner. You will then be able to use this powerful programming style in your own statistical programming projects to write flexible and extendable software. After reading Advanced Object-Oriented Programming in R, you'll come away with a practical project that you can reuse in your own analytics coding...... of data being manipulated. You will: Define and use classes and generic functions using R Work with the R class hierarchies Benefit from implementation reuse Handle operator overloading Apply the S4 and R6 classes...
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Charges collection induced in APS by heavy particles: influence of design parameters
International Nuclear Information System (INIS)
Belredon, Xavier
2003-01-01
We have studied the design parameters influence on heavy ions-induced charge collection physics in APS. The goal is to determine the key parameters for an optimised space environment 'particle detector' APS design. It appears that diffusion is the dominant charge collection mechanism in all the studied technology types, with a smaller magnitude in case of epitaxial technologies. Following proton irradiation, a delayed charge collection and loss of collected charges have been observed. These phenomena are explained by the combination of carriers diffusion and action of the traps generated in the device. Even if they cannot be avoid in space applications, these effects are reduced in case of epitaxial technologies. This work led to the design parameters definition of an optimized APS 'particle detector' and to its fabrication. The results obtained on this APS confirm the previous conclusions and let us define the detection range of such detectors from 0.03 to 50 MeV.cm 2 .mg -1 . (author) [fr
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Veilleux, Jean Wright
2012-01-01
This Article argues that the current approach of the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to enforcement of the Ethics in Patient Referrals Act (the "Stark Law") is unnecessarily punitive and discourages health-care providers from self-disclosing even very minor violations of the Stark Law. This Article suggests a number of specific changes to encourage provider self-disclosure and proposes that CMS create a demonstration project under the authority of the Patient Protection and Affordable Care Act to test the reforms. A demonstration project provides the perfect vehicle to prove that increased self-disclosure protocols for the Stark Law can decrease the government's costs of enforcement, improve program integrity, and encourage providers to deal responsibly with the inevitable minor lapses in compliance that arise in such an enormous government program as Medicare.
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Early Medicaid Expansion In Connecticut Stemmed The Growth In Hospital Uncompensated Care.
Nikpay, Sayeh; Buchmueller, Thomas; Levy, Helen
2015-07-01
As states continue to debate whether or not to expand Medicaid under the Affordable Care Act (ACA), a key consideration is the impact of expansion on the financial position of hospitals, including their burden of uncompensated care. Conclusive evidence from coverage expansions that occurred in 2014 is several years away. In the meantime, we analyzed the experience of hospitals in Connecticut, which expanded Medicaid coverage to a large number of childless adults in April 2010 under the ACA. Using hospital-level panel data from Medicare cost reports, we performed difference-in-differences analyses to compare the change in Medicaid volume and uncompensated care in the period 2007-13 in Connecticut to changes in other Northeastern states. We found that early Medicaid expansion in Connecticut was associated with an increase in Medicaid discharges of 7-9 percentage points, relative to a baseline rate of 11 percent, and an increase of 7-8 percentage points in Medicaid revenue as a share of total revenue, relative to a baseline share of 10 percent. Also, in contrast to the national and regional trends of increasing uncompensated care during this period, hospitals in Connecticut experienced no increase in uncompensated care. We conclude that uncompensated care in Connecticut was roughly one-third lower than what it would have been without early Medicaid expansion. The results suggest that ACA Medicaid expansions could reduce hospitals' uncompensated care burden. Project HOPE—The People-to-People Health Foundation, Inc.
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75 FR 14454 - National Protection and Programs Directorate; National Infrastructure Advisory Council
2010-03-25
..., National Infrastructure Advisory Council. [FR Doc. 2010-6633 Filed 3-24-10; 8:45 am] BILLING CODE 9110-9P-P ... Directorate; National Infrastructure Advisory Council AGENCY: National Protection and Programs Directorate... Infrastructure Advisory Council (NIAC) will meet on Tuesday, April 13, 2010, at the National Press Club's...
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MEDICAID FINANCIAL MANAGEMENT: Better Oversight of State Claims for Federal Reimbursement Needed
National Research Council Canada - National Science Library
Calbom, Linda
2002-01-01
.... Developing baseline information on Medicaid issues at greatest risk for improper payments and measuring improvements in program management against that baseline is key to achieving effective financial oversight...
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Iritani, Katherine M.
2009-01-01
In this statement, Katherine M. Iritani, Acting Director, Health Care reports that dental disease remains a significant problem for children in Medicaid. Although dental services are a mandatory benefit for the 30 million children served by Medicaid, these children often experience elevated levels of dental problems and have difficulty finding…
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Can Bundled Payments Be Successful in the Medicaid Population for Primary Joint Arthroplasty?
Courtney, P Maxwell; Edmiston, Tori; Batko, Brian; Levine, Brett R
2017-11-01
Although some bundled payment models have had success in total joint arthroplasty, concerns exist about access to care for higher cost patients who use more resources. The purpose of this study is to determine whether Medicaid patients have increased hospital costs and more resource utilization in a 90-day episode of care than Medicare or privately insured patients. We retrospectively reviewed a consecutive series of 7268 primary hip and knee arthroplasty patients at a single institution. Using a propensity score-matching algorithm for demographic variables, we matched the 92 consecutive Medicaid patients with 184 privately insured and 184 Medicare patients. Hospital-specific costs, discharge disposition, complications, and 90-day readmissions were analyzed. Medicaid patients had higher mean inpatient hospital costs than both of the matched Medicare and privately insured groups ($15,396 vs $12,165 vs $13,864, P Medicaid and Medicare patients were more likely to be discharged to a rehabilitation facility than privately insured patients (17% vs 21% vs 1%, P Medicaid insurance was a significant independent risk factor for increased hospital costs (odds ratio 3.64, 95% confidence interval 1.80-7.38, P Medicaid patients because of concerns about patient selection and access to care. Further study is needed to determine whether bundling Medicaid arthroplasty costs in a stand-alone program with a separate target price will result in improved outcomes and decreased costs. Copyright © 2017 Elsevier Inc. All rights reserved.
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Directory of Open Access Journals (Sweden)
Panagiotis A. Konstantinopoulos
2007-01-01
Full Text Available Background: COX-2 and VEGF are important triggers of colon cancer growth, metastasis and angiogenesis. Cox-2 promoter contains transcriptional regulatory elements for AP-1 and NF-κ:B transcription factors whilst vegf is a known AP-1 downstream target gene. We investigated whether stromal myofibroblasts surrounding colon adenocarcinomas express COX-2 and VEGF and whether activation of AP-1 and NF-κ:B, as well as expression of EGF-R parallel expression of COX-2 and VEGF in these cells. Methods: Immunohistochemical methodology was performed on archival sections from 40 patients with colon adenocarcinomas. We evaluated c-FOS, p-c-JUN (phosphorylated c-JUN, p-Iκ:B-α (phosphorylated Iκ:B-α, EGF-R, COX-2, NF-κ:B and VEGF expression in stromal myofibroblasts surrounding colon adenocarcinomas. Double immunostaining with a-smooth muscle actin and each antibody was done to verify the expression of these molecules in stromal myofibroblasts. Results: VEGF, p-Iκ:B-α, NF-κ:B, c-FOS, p-c-JUN, EGF-R and COX-2 were expressed in stromal myofibroblasts surrounding colon adenocarcinomas in the majority of cases. EGF-R, p-Iκ:B-α, NF-κ:B, c-FOS and p-c-JUN correlated positively with COX-2 and VEGF expression. Conclusion: Stromal myofibroblasts surrounding colon adenocarcinomas are an important source of VEGF and COX-2 production, while AP-1 and NF-κ:B transcription factors are activated and EGF-R is expressed in these cells and associated with COX-2 and VEGF production.
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Occupational Therapy in Medicaid Home and Community-Based Services Waivers.
Friedman, Carli; VanPuymbrouck, Laura
Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. Comparisons across states strengthen the profession's ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs. Copyright © 2018 by the American Occupational Therapy Association, Inc.
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Occupational Therapy in Medicaid Home and Community-Based Services Waivers
VanPuymbrouck, Laura
2018-01-01
OBJECTIVE. Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. METHOD. Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. RESULTS. In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. CONCLUSION. Comparisons across states strengthen the profession’s ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs. PMID:29426389
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The Affordable Care Act Medicaid Expansions and Personal Finance.
Caswell, Kyle J; Waidmann, Timothy A
2017-09-01
Using a novel data set from a major credit bureau, we examine the early effects of the Affordable Care Act Medicaid expansions on personal finance. We analyze less common events such as personal bankruptcy, and more common occurrences such as medical collection balances, and change in credit scores. We estimate triple-difference models that compare individual outcomes across counties that expanded Medicaid versus counties that did not, and across expansion counties that had more uninsured residents versus those with fewer. Results demonstrate financial improvements in states that expanded their Medicaid programs as measured by improved credit scores, reduced balances past due as a percent of total debt, reduced probability of a medical collection balance of $1,000 or more, reduced probability of having one or more recent medical bills go to collections, reduction in the probability of experiencing a new derogatory balance of any type, reduced probability of incurring a new derogatory balance equal to $1,000 or more, and a reduction in the probability of a new bankruptcy filing.
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Konetzka, R Tamara; Skira, Meghan M; Werner, Rachel M
2018-01-01
Pay-for-performance (P4P) programs have become a popular policy tool aimed at improving health care quality. We analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented P4P programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, we examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in those measures. We find larger weights on clinical outcomes often lead to larger improvements, but small weights can lead to no improvement or worsening of some clinical outcomes. We find a qualifier for P4P eligibility based on having few or no severe inspection deficiencies is more effective at decreasing inspection deficiencies than using weights, suggesting simple rules for participation may incent larger improvement.
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42 CFR 423.800 - Administration of subsidy program.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Administration of subsidy program. 423.800 Section 423.800 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost...
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42 CFR 423.159 - Electronic prescription drug program.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159 Section 423.159 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...
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2010-05-12
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); Office of Liaison, Policy and Review; Meeting of the Scientific Advisory Committee on Alternative Toxicological Methods... Director, National Toxicology Program. [FR Doc. 2010-11318 Filed 5-11-10; 8:45 am] BILLING CODE 4140-01-P ...
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Evaluating State Options for Reducing Medicaid Churning
Swartz, Katherine; Short, Pamela Farley; Graefe, Deborah R.; Uberoi, Namrata
2015-01-01
Medicaid churning - the constant exit and re-entry of beneficiaries as their eligibility changes - has long been a problem for both Medicaid administrators and recipients. Churning will continue under the Affordable Care Act, because despite new federal rules, Medicaid eligibility will continue to be based on current monthly income. We developed a longitudinal simulation model to evaluate four policy options for modifying or extending Medicaid eligibility to reduce churning. The simulations suggest that two options, extending Medicaid eligibility either to the end of a calendar year or for twelve months after enrollment, would be far more effective in reducing churning than the other options of a three-month extension or eligibility based on projected annual income. States should consider implementation of the option that best balances costs, including both administration and services, with improved health of Medicaid enrollees. PMID:26153313
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Service Use in the Month and Year Prior to Suicide Among Adults Enrolled in Ohio Medicaid.
Fontanella, Cynthia A; Warner, Lynn A; Hiance-Steelesmith, Danielle L; Sweeney, Helen Anne; Bridge, Jeffrey A; McKeon, Richard; Campo, John V
2017-07-01
The purpose of this study was to inform suicide prevention efforts by estimating the incidence of suicide among adult Medicaid enrollees and describing clinical profiles and service utilization patterns among decedents. Death certificate data for adults (N=1,338) ages 19 to 65 who died by suicide between January 1, 2008, and December 31, 2013, were linked with Ohio Medicaid data. The suicide rate was 18.9 deaths per 100,000 Ohio Medicaid enrollees. Most decedents (83%) made a general medical or mental health visit within one year of suicide, with 50% doing so within 30 days and 27% within one week before death. In the year before suicide, the median number of visits was 16, indicating a subgroup with intensive service utilization. Decedents whose visits were proximal to suicide (within 30 days) rather than distal (31-365 days) were more likely to have individual and co-occurring behavioral and general medical conditions and to be Medicaid eligible through disability. In the year before suicide, most visits (79%) were outpatient general medical visits. Also in the year before suicide, decedents with serious psychiatric disorders were more likely than those without such disorders to make only mental health visits, and those with chronic general medical conditions were more likely than those without such conditions to make only general medical visits. Medicaid enrollment designates a "virtual boundary" around a subpopulation of health care consumers relevant to national suicide prevention efforts. Findings highlight the potential of using Medicaid data to identify individuals at risk of suicide for screening, prevention, and intervention.
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Directory of Open Access Journals (Sweden)
Feng Zhang
2018-03-01
Full Text Available miR-25, a member of the miR-106b-25 cluster, has been reported as playing an important role in many biological processes by numerous studies, while the role of miR-25 in metabolism and its transcriptional regulation mechanism remain unclear. In this study, gain-of-function and loss-of-function assays demonstrated that miR-25-3p positively regulated the metabolism of C2C12 cells by attenuating phosphoinositide 3-kinase (PI3K gene expression and triglyceride (TG content, and enhancing the content of adenosine triphosphate (ATP and reactive oxygen species (ROS. Furthermore, the results from bioinformatics analysis, dual luciferase assay, site-directed mutagenesis, qRT-PCR, and Western blotting demonstrated that miR-25-3p directly targeted the AKT serine/threonine kinase 1 (Akt1 3′ untranslated region (3′UTR. The core promoter of miR-25-3p was identified, and the transcription factor activator protein-2α (AP-2α significantly increased the expression of mature miR-25-3p by binding to its core promoter in vivo, as indicated by the chromatin immunoprecipitation (ChIP assay, and AP-2α binding also downregulated the expression of Akt1. Taken together, our findings suggest that miR-25-3p, positively regulated by the transcription factor AP-2α, enhances C2C12 cell metabolism by targeting the Akt1 gene.
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Dental Care for Medicaid and CHIP Enrollees
... FAQs Home › Medicaid › Benefits › Dental Care Dental Care Dental Care Related Resources Learn How to Report the ... services and opportunities and challenges to obtaining care. Dental Benefits for Children in Medicaid Medicaid covers dental ...
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Medicaid in Ohio: The Politics of Expansion, Reauthorization, and Reform.
Skinner, Daniel
2015-12-01
When, in 2012, the US Supreme Court held that Medicaid expansion sanctioned by the Affordable Care Act (ACA) was essentially optional for states, it ushered in a newly contentious state politics. States led by Republican governors and legislatures opposed to the ACA had to decide whether to accept extensive federal funding to expand Medicaid for citizens in their states who were earning up to 138 percent of the federal poverty level. This Report from the States focuses on Ohio, whose Republican governor successfully navigated the rancorous politics of Medicaid to expand the state's program in 2014. Working at odds with his own party and gaining praise from traditional political opponents for his leadership on the issue, John Kasich circumvented the state legislature, turning to the Controlling Board to bring about initial expansion. In the wake of Kasich's landslide reelection in 2014, the politics of expansion and reauthorization have given way to a pervasive discourse of "reform." In this next phase Kasich has endorsed policy positions (e.g., cost sharing, a focus on "personal responsibility") that reunite him with his party's more traditional view of Medicaid while continuing to emphasize the importance of expansion. Copyright © 2016 by Duke University Press.
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Pärimuslik ajalugu ja Fr. R. Kreutzwald / Tiiu Jaago
Jaago, Tiiu, 1960-
2005-01-01
Pärimuslik ajalugu kui rahvapärane ajalookäsitus, mida saab uurida folkloorse jutustamise kaudu. Fr. R. Kreutzwaldi ja F. K. H. Kruse sõnavõttudest Aruküla koobaste päritolu kohta ajakirjas "Das Inland" aastast 1844
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Ideologies of aid, practices of power: lessons for Medicaid managed care.
Nelson, Nancy L
2005-03-01
The articles in this special issue teach valuable lessons based on what happened in New Mexico with the shift to Medicaid managed care. By reframing these lessons in broader historical and cultural terms with reference to aid programs, we have the opportunity to learn a great deal more about the relationship between poverty, public policy, and ideology. Medicaid as a state and federal aid program in the United States and economic development programs as foreign aid provide useful analogies specifically because they exhibit a variety of parallel patterns. The increasing concatenation of corporate interests with state and nongovernmental interests in aid programs is ultimately producing a less centralized system of power and responsibility. This process of decentralization, however, is not undermining the sources of power behind aid efforts, although it does make the connections between intent, planning, and outcome less direct. Ultimately, the devolution of power produces many unintended consequences for aid policy. But it also reinforces the perspective that aid and the need for it are nonpolitical issues.
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Rodriguez, Hector P; McClellan, Sean R; Bibi, Salma; Casalino, Lawrence P; Ramsay, Patricia P; Shortell, Stephen M
2016-06-01
Practice ownership and Medicaid revenue may affect the use of care management processes (CMPs) for chronic conditions and expansion of health information technology (HIT). Using a national cohort of medical practices, we compared the use of CMPs and HIT from 2006/2008 to 2013 by practice ownership and level of Medicaid revenue. Poisson regression models estimated changes in CMP use, and linear regression estimated changes in HIT, by practice ownership and Medicaid patient revenue, controlling for other practice characteristics. Compared with physician-owned practices, system-owned practices adopted a greater number of CMPs and HIT functions over time (p < .001). High Medicaid revenue (≥30.0%) was associated with less adoption of CMPs (p < .001) and HIT (p < .01). System-owned practices (p < .001) and community health centers (p < .001) with high Medicaid revenue were more likely than physician-owned practices with high Medicaid revenue to adopt CMPs over time. System and community health center ownership appear to help high Medicaid practices overcome CMP adoption constraints. © The Author(s) 2015.
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Vela, Veronica X; Patton, Elizabeth W; Sanghavi, Darshak; Wood, Susan F; Shin, Peter; Rosenbaum, Sara
Long-acting reversible contraception (LARC) is the most effective reversible method to prevent unplanned pregnancies. Variability in state-level policies and the high cost of LARC could create substantial inconsistencies in Medicaid coverage, despite federal guidance aimed at enhancing broad access. This study surveyed state Medicaid payment policies and outreach activities related to LARC to explore the scope of services covered. Using publicly available information, we performed a content analysis of state Medicaid family planning and LARC payment policies. Purposeful sampling led to a selection of nine states with diverse geographic locations, political climates, Medicaid expansion status, and the number of women covered by Medicaid. All nine states' Medicaid programs covered some aspects of LARC. However, only a single state's payment structure incorporated all core aspects of high-quality LARC service delivery, including counseling, device, insertion, removal, and follow-up care. Most states did not explicitly address counseling, device removal, or follow-up care. Some states had strategies to enhance access, including policies to increase device reimbursement, stocking and delivery programs to remove cost barriers, and covering devices and insertion after an abortion. Although Medicaid policy encourages LARC methods, state payment policies frequently fail to address key aspects of care, including counseling, follow-up care, and removal, resulting in highly variable state-level practices. Although some states include payment policy innovations to support LARC access, significant opportunities remain. Published by Elsevier Inc.
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Directory of Open Access Journals (Sweden)
Roberta Tarkany Basting
2004-06-01
Full Text Available This in vitro study evaluated the shear bond strength (SBS of dentin treated with two 10% carbamide peroxide bleaching agents 15 days after bleaching and storage in artificial saliva. Dentin fragments were randomly divided into 3 groups (n = 20 for the treatment with the two different bleaching agents (Rembrandt 10% or Opalescence 10% or with a placebo agent, applied to the tooth surface for 8 hours a day. During the remaining time, the specimens were stored in artificial saliva. After 42 days, the fragments were stored in artificial saliva for 14 days. Another group (n = 20 was exposed to distilled and deionized water for 56 days. An adhesive system and microhybrid composite resin were used to prepare specimens for the SBS test. SBS tests were performed and the fractured surfaces were visually examined using a stereoscope at 30 X magnification. The analysis of variance (ANOVA and SIDAK tests showed higher SBS values for dentin treated with Opalescence 10% than for dentin treated with Rembrandt 10% or placebo. Groups treated with Rembrandt 10%, Opalescence 10% or placebo did not differ from the group treated with distilled and deionized water. Ten percent carbamide peroxide agents or a placebo agent caused no differences in SBS of dentin after 15 days of storage in artificial saliva.Este estudo in vitro avaliou a resistência ao cisalhamento da dentina submetida ao tratamento com dois agentes clareadores contendo peróxido de carbamida a 10% depois de 15 dias de clareamento e armazenagem em saliva artificial. Fragmentos de dentina foram aleatoriamente distribuídos em 3 grupos (n = 20 para receber o tratamento com dois diferentes agentes clareadores (Rembrandt a 10% ou Opalescence a 10% ou com um agente placebo, aplicados na superfície dental por 8 horas diárias. No restante do tempo, os espécimens permaneceram imersos em saliva artificial. Após o tratamento por 42 dias, os fragmentos foram armazenados em saliva artificial por 14 dias. Outro
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Design and commissioning of the APS beam charge and current monitors
International Nuclear Information System (INIS)
Wang, X.; Lenkszus, F.; Rotela, E.
1995-01-01
The non-intercepting charge and current monitors suitable for a wide range of beam parameters have been developed and installed in the Advanced Photon Source (APS) low energy transport lines, positron accumulator ring (PAR), and injector synchrotron. The positron or electron beam pulse in the APS has charge ranging from 100 pC to 10 nC with pulse width varying from 30 ps to 30 ns. The beam charge and current are measured with a current transformer and subsequent current monitoring electronics based on an ultrafast, high precision gated integrator. The signal processing electronics, data acquisition, and communication with the control system are managed by a VME-based system. This paper summarizes the hardware and software features of the systems. The results of recent operations are presented. copyright 1995 American Institute of Physics
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2010-11-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP): Office of Liaison... Materials The agenda topic is the peer review of the findings and conclusions of draft NTP TRs of toxicology.... Bucher, Associate Director, National Toxicology Program. [FR Doc. 2010-29945 Filed 11-26-10; 8:45 am...
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Market environment and Medicaid acceptance: What influences the access gap?
Bond, Amelia; Pajerowski, William; Polsky, Daniel; Richards, Michael R
2017-12-01
The U.S. health care system is undergoing significant changes. Two prominent shifts include millions added to Medicaid and greater integration and consolidation among firms. We empirically assess if these two industry trends may have implications for each other. Using experimentally derived ("secret shopper") data on primary care physicians' real-world behavior, we observe their willingness to accept new privately insured and Medicaid patients across 10 states. We combine this measure of patient acceptance with detailed information on physician and commercial insurer market structure and show that insurer and provider concentration are each positively associated with relative improvements in appointment availability for Medicaid patients. The former is consistent with a smaller price discrepancy between commercial and Medicaid patients and suggests a beneficial spillover from greater insurer market power. The findings for physician concentration do not align with a simple price bargaining explanation but do appear driven by physician firms that are not vertically integrated with a health system. These same firms also tend to rely more on nonphysician clinical staff. Copyright © 2017 John Wiley & Sons, Ltd.
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Dynamical analysis of cylindrically symmetric anisotropic sources in f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Zubair, M.; Azmat, Hina [COMSATS Institute of Information Technology, Department of Mathematics, Lahore (Pakistan); Noureen, Ifra [University of Management and Technology, Department of Mathematics, Lahore (Pakistan)
2017-03-15
In this paper, we have analyzed the stability of cylindrically symmetric collapsing object filled with locally anisotropic fluid in f(R, T) theory, where R is the scalar curvature and T is the trace of stress-energy tensor of matter. Modified field equations and dynamical equations are constructed in f(R, T) gravity. The evolution or collapse equation is derived from dynamical equations by performing a linear perturbation on them. The instability range is explored in both the Newtonian and the post-Newtonian regimes with the help of an adiabatic index, which defines the impact of the physical parameters on the instability range. Some conditions are imposed on the physical quantities to secure the stability of the gravitating sources. (orig.)
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Medicaid spending on contraceptive coverage and pregnancy-related care
2014-01-01
Objective Up to 50% of pregnancies are unintended in the United States, and the healthcare costs associated with pregnancy are the most expensive among hospitalized conditions. The current study aims to assess Medicaid spending on various methods of contraception and on pregnancy care including unintended pregnancies. Methods We analyzed Medicaid health claims data from 2004 to 2010. Women 14–49 years of age initiating contraceptive methods and pregnant women were included as separate cohorts. Medicaid spending was summarized using mean all-cause and contraceptive healthcare payments per patient per month (PPPM) over a follow-up period of up to 12 months. Medicaid payments were also estimated in 2008 per female member of childbearing age per month (PFCPM) and per member per month (PMPM). Medicaid payments on unintended pregnancies were also evaluated PFCPM and PMPM in 2008. Results For short-acting reversible contraception (SARC) users, all-cause payments and contraceptive payments PPPM were respectively $365 and $18.3 for oral contraceptive (OC) users, $308 and $19.9 for transdermal users, $215 and $21.6 for vaginal ring users, and $410 and $8.8 for injectable users. For long-acting reversible contraception (LARC) users (follow-up of 9–10 months), corresponding payments were $194 and $36.8 for IUD users, and $237 and $29.9 for implant users. Pregnancy cohort all-cause mean healthcare payments PPPM were $610. Payments PFCPM and PMPM for contraceptives were $1.44 and $0.54, while corresponding costs of pregnancies were estimated at $39.91 and $14.81, respectively. Payments PFCPM and PMPM for contraceptives represented a small fraction at 6.56% ($1.44/$21.95) and 6.63% ($0.54/$8.15), respectively of the estimated payments for unintended pregnancy. Conclusions This study of a large sample of Medicaid beneficiaries demonstrated that, over a follow-up period of 12 months, Medicaid payments for pregnancy were considerably higher than payments for either SARC or
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Westinghouse AP1000 licensing maturity
International Nuclear Information System (INIS)
Schulz, T.; Vijuk, R.P.
2005-01-01
The Westinghouse AP1000 Program is aimed at making available a nuclear power plant that is economical in the U.S deregulated electrical power industry in the near-term. The AP1000 is two-loop 1000 MWe pressurizer water reactor (PWR). It is an up rated version of the AP600. The AP1000 uses passive safety systems to provide significant and measurable improvements in plant simplification, safety, reliability, investment protection and plant costs. The AP1000 uses proven technology, which builds on over 35 years of operating PWR experience. The AP1000 received Final Design Approval by the United States Nuclear Regulatory Commission (U.S. NRC) in September 2004. The AP1000 meets the US utility requirements. The AP1000 and its sister plant the AP600 have gone through a very through and complete licensing review. This paper describes the U.S. NRC review efforts of both the AP600 and the AP1000. The detail of the review and the independent calculations, evaluations and testing is discussed. The AP600 licensing documentation was submitted in 1992. The U.S. NRC granted Final Design Approval in 1999. During the intervening 7 years, the U.S. NRC asked thousands of questions, performed independent safety analysis, audited Westinghouse calculations and analysis, and performed independent testing. The more significant areas of discussion will be described. For the AP1000 Westinghouse first engaged the U.S. NRC in pre-certification discussions to define the extent of the review required, since the design is so similar to the AP600. The AP1000 licensing documentation was submitted in March 2002. The U.S. NRC granted Final Design Approval in September 2004. During the intervening 2 1/2 years, the U.S. NRC asked hundreds of questions, performed independent safety analysis, audited Westinghouse calculations and analysis, and performed independent testing. The more significant areas of discussion will be described. The implications of this review and approval on AP1000 applications in
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Ferrand, Yann; Kelton, Christina M L; Guo, Jeff J; Levy, Martin S; Yu, Yan
2011-03-01
Medicaid programs' spending on antidepressants increased from $159 million in 1991 to $2 billion in 2005. The National Institute for Health Care Management attributed this expenditure growth to increases in drug utilization, entry of newer higher-priced antidepressants, and greater prescription drug insurance coverage. Rising enrollment in Medicaid has also contributed to this expenditure growth. This research examines the impact of specific events, including branded-drug and generic entry, a black box warning, direct-to-consumer advertising (DTCA), and new indication approval, on Medicaid spending on antidepressants. Using quarterly expenditure data for 1991-2005 from the national Medicaid pharmacy claims database maintained by the Centers for Medicare and Medicaid Services, a time-series autoregressive integrated moving average (ARIMA) intervention analysis was performed on 6 specific antidepressant drugs and on overall antidepressant spending. Twenty-nine potentially relevant interventions and their dates of occurrence were identified from the literature. Each was tested for an impact on the time series. Forecasts from the models were compared with a holdout sample of actual expenditure data. Interventions with significant impacts on Medicaid expenditures included the patent expiration of Prozac® (P0.05), implying that the expanding market for antidepressants overwhelmed the effect of generic competition. Copyright © 2011 Elsevier Inc. All rights reserved.
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VizieR Online Data Catalog: Spitzer h and {chi} Persei candidate members (Cloutier+, 2014)
Cloutier, R.; Currie, T.; Rieke, G. H.; Kenyon, S. J.; Balog, Z.; Jayawardhana, R.
2017-08-01
The IRAC (Fazio et al. 2004ApJS..154...39F) observed h and {chi} Persei on October 30, 2008 (AOR IDs 2182740, 21828608, 21828096, 21828864, 21828352, and 2182912). Solar activity was normal to below average. Zodical emission ranged between ~0.02 and 2 MJy/sr from 3.6 um to 8 um. Image processing and photometry were performed separately for the short-exposure and long-exposure frames. The MIPS (Rieke et al. 2004ApJS..154...25R) imaged h and {chi} Persei on 2008 March 15-16, 2008 October 25-26, and 2009 March 26 and 29 as a part of General Observation Programs 40690 and 50664 (PI: Scott Kenyon). To identify and characterize disks surrounding h and {chi} Persei stars, we combine Spitzer data with optical/near-IR data for likely cluster members, updating the list from Currie et al. (2010, J/ApJS/186/191) with a more accurate one of 13956 stars (Table 1). (3 data files).
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Son, Minsik; Kim, Aeyung; Lee, Jaewoo; Park, Chul-Hong; Heo, Jin-Chul; Lee, Hyun-Jin; Lee, Sang-Han
2010-08-01
Some active alkaloids isolated from Lycoris, a bulbous perennial herb, was shown to possess various anti-tumor and anti-inflammatory activities. In this study, we evaluated the in vitro apoptotic effect of ethanol extract from Lycoris radiata (LRE) and further probed the underlying molecular mechanisms of LRE effects. The survival rate of B16F10 melanoma cells exposed to LRE was decreased in a dose-dependent manner, cell growth was retarded by arresting cell cycle at G1 phase and apoptotic appearance such as caspase-3 activation as well as DNA fragmentation was observed by LRE treatment. In addition, LRE induced p38 and c-Jun phosphorylation, followed by activation of transcription factor AP-1. Pretreatment with the p38 inhibitor (SB203580) blocked LRE-induced AP-1 transcriptional activity, and curcumin, AP-1 inhibitor, dramatically inhibited LRE-induced apoptosis in B16F10 melanoma cells. Our results collectively indicate that LRE-mediated apoptosis occurs through the activation of p38 and AP-1 pathway and potentially LRE exhibits anti-cancer activity against B16F10 melanoma cells.
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Simberg, Maximilian
2014-01-01
Det här arbetet behandlar kreativ frihet och konstnärligt oberoende i filmskapande, utgående från begreppet independent film och regissörerna David Lynch, Jim Jarmusch och Steven Soderbergh. Den centrala frågeställningen är hur det har varit möjligt för en filmkonstnär att uppnå konstnärligt oberoende och samtidigt ha en långlivad och framgångsrik karriär. Arbetets fokus ligger på de tre regissörernas genombrottsfilmer; Eraserhead, Stranger Than Paradise och sex, lies, and videotape, och förs...
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International Nuclear Information System (INIS)
Klusoň, Josef; Nojiri, Shin'ichi; Odintsov, Sergei D.
2013-01-01
We propose new version of massive F(R) gravity which is natural generalization of convenient massive ghost-free gravity. Its Hamiltonian formulation in scalar-tensor frame is developed. We show that such F(R) theory is ghost-free. The cosmological evolution of such theory is investigated. Despite the strong Bianchi identity constraint the possibility of cosmic acceleration (especially, in the presence of cold dark matter) is established. Ghost-free massive F(R,T) gravity is also proposed
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The APS control system network upgrade
International Nuclear Information System (INIS)
Sidorowicz, K. v.; Leibfritz, D.; McDowell, W. P.
1999-01-01
When it was installed,the Advanced Photon Source (APS) control system network was at the state-of-the-art. Different aspects of the system have been reported at previous meetings [1,2]. As loads on the controls network have increased due to newer and faster workstations and front-end computers, we have found performance of the system declining and have implemented an upgraded network. There have been dramatic advances in networking hardware in the last several years. The upgraded APS controls network replaces the original FDDI backbone and shared Ethernet hubs with redundant gigabit uplinks and fully switched 10/100 Ethernet switches with backplane fabrics in excess of 20 Gbits/s (Gbps). The central collapsed backbone FDDI concentrator has been replaced with a Gigabit Ethernet switch with greater than 30 Gbps backplane fabric. Full redundancy of the system has been maintained. This paper will discuss this upgrade and include performance data and performance comparisons with the original network
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International Nuclear Information System (INIS)
Steen, F.H.
1997-01-01
This document is the final report for tank 241-AP-107 grab samples. Three grab samples were collected from riser 1 on September 11, 1997. Analyses were performed on samples 7AP-97-1, 7AP-97-2 and 7AP-97-3 in accordance with the Compatibility Grab Sampling and Analysis Plan (TSAP) (Sasaki, 1997) and the Data Quality Objectives for Tank Farms Waste Compatibility Program (DQO) (Rev. 1: Fowler, 1995; Rev. 2: Mulkey and Nuier, 1997). The analytical results are presented in the data summary report (Table 1). A notification was made to East Tank Farms Operations concerning low hydroxide in the tank and a hydroxide (caustic) demand analysis was requested. The request for sample analysis (RSA) (Attachment 2) received for AP-107 indicated that the samples were polychlorinated biphenyl (PCB) suspects. Therefore, prior to performing the requested analyses, aliquots were made to perform PCB analysis in accordance with the 222-S Laboratory administrative procedure, LAP-101-100. The results of this analysis indicated that no PCBs were present at 50 ppm and analysis proceeded as non-PCB samples. The results and raw data for the PCB analysis will be included in a revision to this document. The sample breakdown diagrams (Attachment 1) are provided as a cross-reference for relating the tank farm customer identification numbers with the 222-S Laboratory sample numbers and the portion of sample analyzed
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International Nuclear Information System (INIS)
2016-09-01
A severe accident involving several units took place in Japan at Fukushima Daiichi nuclear power plant (NPP) in March 2011. The immediate cause of the accident was an earthquake followed by a tsunami coupled with inadequate provisions against the consequences of such events in the design. Opportunities to improve protection against a realistic design basis tsunami had not been taken. As a consequence of the tsunami, safety equipment and the related safety functions were lost at the plant, leading to core damage in three units and subsequently to large radioactive release. Several studies have already been performed to better understand the accident progression and detailed technical studies are still in progress in Japan and elsewhere. In the meantime, on-going studies on the behaviour of nuclear power plants in very severe situations, similar to Fukushima Daiichi, seek to identify potential vulnerabilities in plant design and operation; to suggest reasonably practicable upgrades; or to recommend enhanced regulatory requirements and guidance to address such situations. Likewise, agencies around the world that are responsible for regulating the design, construction and operation of AP1000 R plants are engaged in similar activities. The MDEP AP1000 R Working Group (AP1000 WG) members consist of members from Canada, China, the United Kingdom and the United States. Since the regulatory review of their AP1000 R applications have not been completed by all of these Countries yet, this paper identifies common preliminary approaches to address potential safety improvements for AP1000 R plants as related to lessons learned from the Fukushima Daiichi accident or Fukushima Daiichi-related issues. In seeking common position, regulators will provide input to this paper to reflect their safety conclusions regarding the AP1000 R design and how the design could be enhanced to address Fukushima Daiichi issues. The common preliminary approaches are organized into five sections
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The development of beam current monitors in the APS
International Nuclear Information System (INIS)
Wang, X.; Lenkszus, F.; Rotela, E.
1995-01-01
The Advanced Photon Source (APS) is a third-generation 7-GeV synchrotron radiation source. The precision measurement of beam current is a challenging task in high energy accelerators, such as the APS, with a wide range of beam parameters and complicated noise, radiation, and thermal environments. The beam pulses in the APS injector and storage ring have charge ranging from 50pC to 25nC with pulse durations varying from 30ps to 30ns. A total of nine non- intercepting beam current monitors have been installed in the APS facility (excluding those in the linac) for general current measurement. In addition, several independent current monitors with specially designed redundant interlock electronics are installed for personnel safety and machine protection. This paper documents the design and development of current monitors in the APS,. discusses the commissioning experience in the past year, and presents the results of recent operations
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Lessons from Early Medicaid Expansions Under Health Reform..
U.S. Department of Health & Human Services — Lessons from Early Medicaid Expansions Under Health Reform, Interviews with Medicaid Officials In a new study entitled Lessons from Early Medicaid Expansions Under...
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Solar System constraints on a cosmologically viable f(R) theory
Energy Technology Data Exchange (ETDEWEB)
Bisabr, Yousef, E-mail: y-bisabr@srttu.ed [Department of Physics, Shahid Rajaee Teacher Training University, Lavizan, Tehran 16788 (Iran, Islamic Republic of)
2010-01-18
Recently, a model f(R) theory is proposed (Miranda et al. (2009)) which is cosmologically viable and distinguishable from LAMBDACDM. We use chameleon mechanism to investigate viability of the model in terms of Solar System experiments.
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Study of Antigravity in an F(R) Model and in Brans-Dicke Theory with Cosmological Constant
Oikonomou, V. K.; Karagiannakis, N.
2014-01-01
We study antigravity, that is having an effective gravitational constant with a negative sign, in scalar-tensor theories originating from $F(R)$-theory and in a Brans-Dicke model with cosmological constant. For the $F(R)$ theory case, we obtain the antigravity scalar-tensor theory in the Jordan frame by using a variant of the Lagrange multipliers method and we numerically study the time dependent effective gravitational constant. As we shall demonstrate by using a specific $F(R)$ model, altho...
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Solar System constraints on a cosmologically viable f(R) theory
International Nuclear Information System (INIS)
Bisabr, Yousef
2010-01-01
Recently, a model f(R) theory is proposed (Miranda et al. (2009)) which is cosmologically viable and distinguishable from ΛCDM. We use chameleon mechanism to investigate viability of the model in terms of Solar System experiments.
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AP-1 Oligodeoxynucleotides Reduce Aortic Elastolysis in a Murine Model of Marfan Syndrome.
Arif, Rawa; Zaradzki, Marcin; Remes, Anca; Seppelt, Philipp; Kunze, Reiner; Schröder, Hannes; Schwill, Simon; Ensminger, Stephan M; Robinson, Peter N; Karck, Matthias; Müller, Oliver J; Hecker, Markus; Wagner, Andreas H; Kallenbach, Klaus
2017-12-15
Marfan syndrome is characterized by high expression of matrix metalloproteinases (MMPs) in aortic smooth muscle cells (AoSMCs) associated with medial elastolysis and aortic root aneurysm. We aimed to reduce aortic elastolysis through decrease of MMP expression with decoy oligodeoxynucleotides (dODNs) neutralizing the transcription factor activating factor-1 (AP-1). AP-1 abundance in nuclear extracts as well as MMP-2 and MMP-9 expression were significantly increased in isolated mAoSMC of mgR/mgR Marfan mice compared to wild-type cells. Exposure to AP-1 neutralizing dODNs resulted in a significant reduction of basal and interleukin-1β-stimulated MMP expression and activity in mAoSMCs. Moreover, increased migration and formation of superoxide radical anions was substantially decreased in mAoSMCs by AP-1 dODN treatment. Aortic grafts from donor Marfan mice were treated with AP-1- dODN ex vivo and implanted as infrarenal aortic interposition grafts in mgR/mgR mice. Pretreatment of aortic grafts with AP-1 dODN led to reduced elastolysis, macrophage infiltration, and MMP activity. Permeability of the endothelial monolayer was increased for dODN in mgR/mgR aortae with observed loss of tight junction proteins ZO-1 and occludin, enabling dODN to reach the tunica media. Targeting AP-1 activity offers a new potential strategy to treat the vascular phenotype associated with Marfan syndrome. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.
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Results from the Evaluation of the Massachusetts Nursing Home Connection Program
1989-10-01
For the rollovers, the midpoint data was collected at the time of transfer to the new system of care. The basic comparisons were from admission to...claims data from both the Medicare and Medicaid programs as well as nursing home data from the Massachusetts Medicaid Medical Information System ...Patients Rollovers )ieaes of nervus systern 13 15 Dementia 31 35 CVA 27 29 HIP 18 1 5 b Cancer 07 041) Neurologic disorders 6(30 62 )epression 03 04
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Directory of Open Access Journals (Sweden)
Drazen Čular
2018-05-01
Full Text Available Cycling test such Wingate anaerobic test (WAnT is used to measure anaerobic power (AP, but not anaerobic capacity (AC, i.e., the metabolic energy demand. However, in sports that do not involve cycling movements (Karate, the continuous jump for 30 s (vertical jumps for 30 s has been extensively used to measure anaerobic performance in all young athletes. Limited information’s are available concerning its validity and reliability especially in children. As such, the current study aimed to test validity and reliability of a continuous jumps test (the CJ30s, using WAnT as a reference. Thirteen female Karate kids (age: 11.07 ± 1.32 years; mass: 41.76 ± 15.32 kg; height: 152 ± 11.52 cm; training experience: 4.38 ± 2.14 years were tested on three separate sessions. The first and second sessions were used to assess the reliability using Intra-class correlation coefficient (ICC of CJ30s, whereas on the third session WAnT was administered. Following CJ30s and WAnT, we assessed AP (1/CJ30s, as jump height [JH], fatigue index [FI], and blood lactate [BL]; 2/WAnT, as mechanical power [P], FI, and BL and AC as the excess post-exercise oxygen consumption (EPOC. Large/highly significant correlations were found between CJ30s and WAnT EPOCs (r = 0.730, P = 0.003, and BLs (r = 0.713, P = 0.009. Moderate/significant correlations were found between CJ30s and WAnT FIs (r = 0.640, P = 0.014, CJ30s first four jumps mean JH and WAnT peak P (r = 0.572, P = 0.032, and CJ30s mean JH and WAnT mean P (r = 0.589, P = 0.021. CJ30s showed excellent and moderate reliability (ICC for AP (maximal JH 0.884, mean JH 0.742, FI 0.657, BL 0.653 and AC (EPOC 0.788, respectively. Correlations observed especially in terms of AC between CJ30s and WAnT provide evidence that former may adequately assess anaerobic performance for the young combat athlete. CJ30 is a reliable test and allow an easy assessment of AP and AC in karate children.
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75 FR 61101 - Closed Captioning of Video Programming
2010-10-04
... Captioning of Video Programming AGENCY: Federal Communications Commission. ACTION: Final rule; waiver of... (Bureau), waives in part the requirement that video programming distributors (VPDs) place contact... (2), published at 74 FR 1594, January 13, 2009, requiring video programming distributors to place...
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42 CFR 447.10 - Prohibition against reassignment of provider claims.
2010-10-01
..., if the agent's compensation for this service is— (1) Related to the cost of processing the billing.... 447.10 Section 447.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General...
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76 FR 26805 - Medicare Program; Hospice Wage Index for Fiscal Year 2012
2011-05-09
..., and hospices in low-wage index areas are unfairly advantaged. The commenter felt that our not wage... Medicare & Medicaid Services 42 CFR Part 418 Medicare Program; Hospice Wage Index for Fiscal Year 2012... [CMS-1355-P] RIN 0938-AQ31 Medicare Program; Hospice Wage Index for Fiscal Year 2012 AGENCY: Centers...
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Improving Science Teacher Preparation through the APS PhysTEC and NSF Noyce Programs
Williams, Tasha; Tyler, Micheal; van Duzor, Andrea; Sabella, Mel
2013-03-01
Central to the recruitment of students into science teaching at a school like CSU, is a focus on the professional nature of teaching. The purpose of this focus is twofold: it serves to change student perceptions about teaching and it prepares students to become teachers who value continued professional development and value the science education research literature. The Noyce and PhysTEC programs at CSU place the professional nature of teaching front and center by involving students in education research projects, paid internships, attendance at conferences, and participation in a new Teacher Immersion Institute and a Science Education Journal Reading Class. This poster will focus on specific components of our teacher preparation program that were developed through these two programs. In addition we will describe how these new components provide students with diverse experiences in the teaching of science to students in the urban school district. Supported by the NSF Noyce Program (0833251) and the APS PhysTEC Program.
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DEFF Research Database (Denmark)
Mailund, Thomas
Master functions and discover how to write functional programs in R. In this book, you'll make your functions pure by avoiding side-effects; you’ll write functions that manipulate other functions, and you’ll construct complex functions using simpler functions as building blocks. In Functional...... Programming in R, you’ll see how we can replace loops, which can have side-effects, with recursive functions that can more easily avoid them. In addition, the book covers why you shouldn't use recursion when loops are more efficient and how you can get the best of both worlds. Functional programming...... is a style of programming, like object-oriented programming, but one that focuses on data transformations and calculations rather than objects and state. Where in object-oriented programming you model your programs by describing which states an object can be in and how methods will reveal or modify...
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DEFF Research Database (Denmark)
Mailund, Thomas
2017-01-01
Master functions and discover how to write functional programs in R. In this book, you'll make your functions pure by avoiding side-effects; you’ll write functions that manipulate other functions, and you’ll construct complex functions using simpler functions as building blocks. In Functional...... Programming in R, you’ll see how we can replace loops, which can have side-effects, with recursive functions that can more easily avoid them. In addition, the book covers why you shouldn't use recursion when loops are more efficient and how you can get the best of both worlds. Functional programming...... is a style of programming, like object-oriented programming, but one that focuses on data transformations and calculations rather than objects and state. Where in object-oriented programming you model your programs by describing which states an object can be in and how methods will reveal or modify...
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International Nuclear Information System (INIS)
Neylan, A.J.; Brisbois, J.
1979-01-01
A significant R and D program (including in certain cases full-scale prototype tests) formed the basis for the design and key elements in the foregoing projects and is continuing to provide a basis for generic design development. HTGR R and D programs are both privately and government sponsored. This paper provides an overview of the background, current status and outstanding design issues/problems remaining in the area of NSS Plant, Materials and Fuel. The specific objectives and scope of all recently completed, ongoing and planned major HTGR R and D programs are presented
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Does Churning in Medicaid Affect Health Care Use?
Roberts, Eric T.; Pollack, Craig Evan
2017-01-01
Background Transitions into and out of Medicaid, termed churning, may disrupt access to and continuity of care. Low-income, working adults who became eligible for Medicaid under the Affordable Care Act are particularly susceptible to income and employment changes that lead to churning. Objective To compare health care use among adults who do and do not churn into and out of Medicaid. Data Longitudinal data from 6 panels of the Medical Expenditure Panel Survey. Methods We used differences-in-differences regression to compare health care use when adults reenrolled in Medicaid following a loss of coverage, to utilization in a control group of continuously enrolled adults. Outcome Measures Emergency department (ED) visits, ED visits resulting in an inpatient admission, and visits to office-based providers. Results During the study period, 264 adults churned into and out of Medicaid and 627 had continuous coverage. Churning adults had an average of approximately 0.05 Medicaid-covered office-based visits per month 4 months before reenrolling in Medicaid, significantly below the rate of approximately 0.20 visits in the control group. Visits to office-based providers did not reach the control group rate until several months after churning adults had resumed Medicaid coverage. Our comparisons found no evidence of significantly elevated ED and inpatient admission rates in the churning group following reenrollment. Conclusions Adults who lose Medicaid tend to defer their use of office-based care to periods when they are insured. Although this suggests that enrollment disruptions lead to suboptimal timing of care, we do not find evidence that adults reenroll in Medicaid with elevated acute care needs. PMID:26908088
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Access to Transportation and Health Care Visits for Medicaid Enrollees With Diabetes.
Thomas, Leela V; Wedel, Kenneth R; Christopher, Jan E
2018-03-01
Diabetes is a chronic condition that requires frequent health care visits for its management. Individuals without nonemergency medical transportation often miss appointments and do not receive optimal care. This study aims to evaluate the association between Medicaid-provided nonemergency medical transportation and diabetes care visits. A retrospective analysis was conducted of demographic and claims data obtained from the Oklahoma Medicaid program. Participants consisted of Medicaid enrollees with diabetes who made at least 1 visit for diabetes care in a year. The sample was predominantly female and white, with an average age of 46.38 years. Two zero-truncated Poisson regression models were estimated to assess the independent effect of transportation use on number of diabetes care visits. Use of nonemergency medical transportation is a significant predictor of diabetes care visits. Zero-truncated Poisson regression coefficients showed a positive association between the use of transportation and number of visits (0.6563, P urban; women made fewer visits than men (-0.09312; P transportation to Medicaid populations with diabetes, particularly in the rural areas where the prevalence of diabetes and complications are higher and the availability of medical resources lower than in the urban areas. © 2017 National Rural Health Association.
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Influence of f(R) models on the existence of anisotropic self-gravitating systems
Energy Technology Data Exchange (ETDEWEB)
Yousaf, Z.; Sharif, M.; Bhatti, M.Z. [University of the Punjab, Department of Mathematics, Lahore (Pakistan); Ilyas, M. [University of the Punjab, Centre for High Energy Physics, Lahore (Pakistan)
2017-10-15
This paper aims to explore some realistic configurations of anisotropic spherical structures in the background of metric f(R) gravity, where R is the Ricci scalar. The solutions obtained by Krori and Barua are used to examine the nature of particular compact stars with three different modified gravity models. The behavior of material variables is analyzed through plots and the physical viability of compact stars is investigated through energy conditions. We also discuss the behavior of different forces, equation of state parameter, measure of anisotropy and Tolman-Oppenheimer-Volkoff equation in the modeling of stellar structures. The comparison from our graphical representations may provide evidence for the realistic and viable f(R) gravity models at both theoretical and the astrophysical scale. (orig.)
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Association Between the 2014 Medicaid Expansion and US Hospital Finances.
Blavin, Fredric
2016-10-11
The Affordable Care Act expanded Medicaid eligibility for millions of low-income adults. The choice for states to expand Medicaid could affect the financial health of hospitals by decreasing the proportion of patient volume and unreimbursed expenses attributable to uninsured patients while increasing revenue from newly covered patients. To estimate the association between the Medicaid expansion in 2014 and hospital finances by assessing differences between hospitals in states that expanded Medicaid and in those states that did not expand Medicaid. Observational study with analysis of data for nonfederal general medical or surgical hospitals in fiscal years 2011 through 2014, using data from the American Hospital Association Annual Survey and the Health Care Cost Report Information System from the US Centers for Medicare & Medicaid Services. Multivariable difference-in-difference regression analyses were used to compare states with Medicaid expansion with states without Medicaid expansion. Hospitals in states that expanded Medicaid eligibility before January 2014 were excluded. Medicaid expansion in 2014, accounting for variation in fiscal year start dates. Hospital-reported information on uncompensated care, uncompensated care as a percentage of total hospital expenses, Medicaid revenue, Medicaid as a percentage of total revenue, operating margins, and excess margins. The sample included between 1200 and 1400 hospitals per fiscal year in 19 states with Medicaid expansion and between 2200 and 2400 hospitals per fiscal year in 25 states without Medicaid expansion (with sample size varying depending on the outcome measured). Expansion of Medicaid was associated with a decline of $2.8 million (95% CI, -$4.1 to -$1.6 million; P policy change on hospitals' overall finances.
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Marino, Leslie; Wissow, Lawrence S; Davis, Maryann; Abrams, Michael T; Dixon, Lisa B; Slade, Eric P
2016-12-01
To assess demographic and clinical predictors of outpatient mental health clinic follow-up after inpatient psychiatric hospitalization among Medicaid-enrolled young adults. Using logistic regression and administrative claims data from the Maryland public mental health system and Maryland Medicaid for young adults ages 18-26 who were enrolled in Medicaid (N = 1127), the likelihood of outpatient mental health follow-up within 30 days after inpatient psychiatric hospitalization was estimated . Only 51% of the young adults had any outpatient mental health follow-up visits within 30 days of discharge. Being black and having a co-occurring substance use disorder diagnosis were associated with a lower probability of having a follow-up visit (OR = 0.60, P young adults hospitalized for serious psychiatric conditions, half did not connect with an outpatient mental healthcare provider following their discharge. Outpatient transition supports may be especially needed for young adults who were not receiving outpatient services prior to being admitted for psychiatric inpatient care, as well as for young adults with substance use disorders and African Americans. © 2015 Wiley Publishing Asia Pty Ltd.
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Air pollution and emergency department visits for asthma among Ohi Medicaid recipients, 1991-1996
International Nuclear Information System (INIS)
Jaffe, Dena H.; Singer, Mendel E.; Rimm, Alfred
2003-01-01
We examined the effects of nitrogen dioxide (NO 2 ), ozone (O 3 ) particulate matter of 10 ), and sulfur dioxide (SO 2 ) on asthmatics ages 5-34 years enrolled in Medicaid i Cincinnati, Cleveland, and Columbus, OH (N=5416). Our study period was fo the summer months, June-August, from July 1, 1991 to June 30, 1996. W preformed Poisson regression analyses for the number of daily emergency department (ED) visits for asthma in each city and on the aggregate dat controlling for time trends and minimum temperature. We found a 12% increase likelihood of an asthma ED visit per 50 μg/m 3 increase in PM 10 i Cleveland [95% confidence interval (CI)=0-27%] and a 35% increase per 5 μg/m 3 increase in SO 2 in Cincinnati (95% CI=9-21%). When data wer analyzed for all three cities combined, the risk of an ED visit increased fo all pollutant increases and specifically by 12% (95% CI=1-23%) per 5 μg/m 3 increase in SO 2 . Attributable risk estimates show a five time greater impact on Cleveland over Cincinnati or Columbus. Between 1991 an 1996, air pollutants in Cincinnati, Cleveland, and Columbus increased E visits for asthmatics enrolled in Medicaid
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Constraining models of f(R) gravity with Planck and WiggleZ power spectrum data
International Nuclear Information System (INIS)
Dossett, Jason; Parkinson, David; Hu, Bin
2014-01-01
In order to explain cosmic acceleration without invoking ''dark'' physics, we consider f(R) modified gravity models, which replace the standard Einstein-Hilbert action in General Relativity with a higher derivative theory. We use data from the WiggleZ Dark Energy survey to probe the formation of structure on large scales which can place tight constraints on these models. We combine the large-scale structure data with measurements of the cosmic microwave background from the Planck surveyor. After parameterizing the modification of the action using the Compton wavelength parameter B 0 , we constrain this parameter using ISiTGR, assuming an initial non-informative log prior probability distribution of this cross-over scale. We find that the addition of the WiggleZ power spectrum provides the tightest constraints to date on B 0 by an order of magnitude, giving log 10 (B 0 ) < −4.07 at 95% confidence limit. Finally, we test whether the effect of adding the lensing amplitude A Lens and the sum of the neutrino mass ∑m ν is able to reconcile current tensions present in these parameters, but find f(R) gravity an inadequate explanation
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Newcomer, Robert J.; Kang, Taewoon; Doty, Pamela
2012-01-01
Purpose of the Study: Medicaid service use and expenditure and quality of care outcomes in California's personal care program known as In-Home Supportive Service (IHSS) are described. Analyses investigated Medicaid expenditures, hospital use, and nursing home stays, comparing recipients who have paid spouse caregivers with those having other…
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AP600 - an ALWR conceptual design
International Nuclear Information System (INIS)
Bruce, R.A.; Vijuk, R.P.
1988-01-01
The Electric Power Research Institute is spearheading an effort to develop utility requirements for the Advanced Light Water Reactor (ALWR) plants which will become the next generation nuclear power plants for the U.S. This EPRI ALWR Program involves utilities, the U.S. Department of Energy, the U.S. Nuclear Regulatory Commission, and various industry suppliers. The ALWR Program is aimed at ALWR plants which incorporate step improvements in safety, reliability, operability and power generation costs. As part of the ALWR efforts, a Westinghouse team is conducting conceptual design development of a PWR plant design called the AP600, reflecting advanced passive safety features and the chosen 600 MWe plant output. The AP600 conceptual design provides significant improvements while employing proven component technology. This paper describes the basic reactor and primary coolant system features, the passive safety system features, and plant arrangement/construction features of AP600
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Shrank, William
2013-04-01
The Affordable Care Act established the Center for Medicare and Medicaid Innovation to test innovative payment and service delivery models. The goal is to reduce program expenditures while preserving or improving the quality of care provided to beneficiaries of Medicare, Medicaid, and the Children's Health Insurance Program. Central to the success of the Innovation Center is a new, rapid-cycle approach to evaluation. This article describes that approach--setting forth how the Rapid Cycle Evaluation Group aims to deliver frequent feedback to providers in support of continuous quality improvement, while rigorously evaluating the outcomes of each model tested. This article also describes the relationship between the group's work and that of the Office of the Actuary at the Centers for Medicare and Medicaid Services, which plays a central role in the assessment of new models.
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The Effect of Medicaid Expansion on Utilization in Maryland Emergency Departments.
Klein, Eili Y; Levin, Scott; Toerper, Matthew F; Makowsky, Michael D; Xu, Tim; Cole, Gai; Kelen, Gabor D
2017-11-01
A proposed benefit of expanding Medicaid eligibility under the Patient Protection and Affordable Care Act (ACA) was a reduction in emergency department (ED) utilization for primary care needs. Pre-ACA studies found that new Medicaid enrollees increased their ED utilization rates, but the effect on system-level ED visits was less clear. Our objective was to estimate the effect of Medicaid expansion on aggregate and individual-based ED utilization patterns within Maryland. We performed a retrospective cross-sectional study of ED utilization patterns across Maryland, using data from Maryland's Health Services Cost Review Commission. We also analyzed utilization differences between pre-ACA (July 2012 to December 2013) uninsured patients who returned post-ACA (July 2014 to December 2015). The total number of ED visits in Maryland decreased by 36,531 (-1.2%) between the 6 quarters pre-ACA and the 6 quarters post-ACA. Medicaid-covered ED visits increased from 23.3% to 28.9% (159,004 additional visits), whereas uninsured patient visits decreased from 16.3% to 10.4% (181,607 fewer visits). Coverage by other insurance types remained largely stable between periods. We found no significant relationship between Medicaid expansion and changes in ED volume by hospital. For patients uninsured pre-ACA who returned post-ACA, the adjusted visits per person during 6 quarters was 2.38 (95% confidence interval 2.35 to 2.40) for those newly enrolled in Medicaid post-ACA compared with 1.66 (95% confidence interval 1.64 to 1.68) for those remaining uninsured. There was a substantial increase in patients covered by Medicaid in the post-ACA period, but this did not significantly affect total ED volume. Returning patients newly enrolled in Medicaid visited the ED more than their uninsured counterparts; however, this cohort accounted for only a small percentage of total ED visits in Maryland. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights
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Unified cosmic history in modified gravity: From F(R) theory to Lorentz non-invariant models
Nojiri, Shin'Ichi; Odintsov, Sergei D.
2011-08-01
The classical generalization of general relativity is considered as the gravitational alternative for a unified description of the early-time inflation with late-time cosmic acceleration. The structure and cosmological properties of a number of modified theories, including traditional F(R) and Hořava-Lifshitz F(R) gravity, scalar-tensor theory, string-inspired and Gauss-Bonnet theory, non-local gravity, non-minimally coupled models, and power-counting renormalizable covariant gravity are discussed. Different representations of and relations between such theories are investigated. It is shown that some versions of the above theories may be consistent with local tests and may provide a qualitatively reasonable unified description of inflation with the dark energy epoch. The cosmological reconstruction of different modified gravities is provided in great detail. It is demonstrated that eventually any given universe evolution may be reconstructed for the theories under consideration, and the explicit reconstruction is applied to an accelerating spatially flat Friedmann-Robertson-Walker (FRW) universe. Special attention is paid to Lagrange multiplier constrained and conventional F(R) gravities, for latter F(R) theory, the effective ΛCDM era and phantom divide crossing acceleration are obtained. The occurrences of the Big Rip and other finite-time future singularities in modified gravity are reviewed along with their solutions via the addition of higher-derivative gravitational invariants.
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Programming Graphical User Interfaces in R
Verzani, John
2012-01-01
Programming Graphical User Interfaces with R introduces each of the major R packages for GUI programming: RGtk2, qtbase, Tcl/Tk, and gWidgets. With examples woven through the text as well as stand-alone demonstrations of simple yet reasonably complete applications, the book features topics especially relevant to statisticians who aim to provide a practical interface to functionality implemented in R. The book offers: A how-to guide for developing GUIs within R The fundamentals for users with limited knowledge of programming within R and other languages GUI design for specific functions or as l
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Gravitational radiation in quadratic f(R) gravity
International Nuclear Information System (INIS)
Naef, Joachim; Jetzer, Philippe
2011-01-01
We investigate the gravitational radiation emitted by an isolated system for gravity theories with Lagrange density f(R)=R+aR 2 . As a formal result, we obtain leading order corrections to the quadrupole formula in general relativity. We make use of the analogy of f(R) theories with scalar-tensor theories, which in contrast to general relativity feature an additional scalar degree of freedom. Unlike general relativity, where the leading order gravitational radiation is produced by quadrupole moments, the additional degree of freedom predicts gravitational radiation of all multipoles, in particular, monopoles and dipoles, as this is the case for the most alternative gravity theories known today. An application to a hypothetical binary pulsar moving in a circular orbit yields the rough limit a 17 m 2 by constraining the dipole power to account at most for 1% of the quadrupole power as predicted by general relativity.
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Medicaid prospective payment: Case-mix increase
Baker, Samuel L.; Kronenfeld, Jennie J.
1990-01-01
South Carolina Medicaid implemented prospective payment by diagnosis-related group (DRG) for inpatient care. The rate of complications among newborns and deliveries doubled immediately. The case-mix index for newborns increased 66.6 percent, which increased the total Medicaid hospital expenditure 5.5 percent. Outlier payments increased total expenditure further. DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high weights. States adopting a DRG-based payment system for Medicaid should anticipate a greater increase in case mix than Medicare experienced. PMID:10113463
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Solar system and equivalence principle constraints on f(R) gravity by the chameleon approach
International Nuclear Information System (INIS)
Capozziello, Salvatore; Tsujikawa, Shinji
2008-01-01
We study constraints on f(R) dark energy models from solar system experiments combined with experiments on the violation of the equivalence principle. When the mass of an equivalent scalar field degree of freedom is heavy in a region with high density, a spherically symmetric body has a thin shell so that an effective coupling of the fifth force is suppressed through a chameleon mechanism. We place experimental bounds on the cosmologically viable models recently proposed in the literature that have an asymptotic form f(R)=R-λR c [1-(R c /R) 2n ] in the regime R>>R c . From the solar system constraints on the post-Newtonian parameter γ, we derive the bound n>0.5, whereas the constraints from the violations of the weak and strong equivalence principles give the bound n>0.9. This allows a possibility to find the deviation from the Λ-cold dark matter (ΛCDM) cosmological model. For the model f(R)=R-λR c (R/R c ) p with 0 -10 , which shows that this model is hardly distinguishable from the ΛCDM cosmology
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Cervera, R; Tektonidou, M G; Espinosa, G; Cabral, A R; González, E B; Erkan, D; Vadya, S; Adrogué, H E; Solomon, M; Zandman-Goddard, G; Shoenfeld, Y
2011-02-01
The objectives of the 'Task Force on Catastrophic Antiphospholipid Syndrome (APS) and Non-criteria APS Manifestations' were to assess the clinical utility of the international consensus statement on classification criteria and treatment guidelines for the catastrophic APS, to identify and grade the studies that analyse the relationship between the antiphospholipid antibodies and the non-criteria APS manifestations and to present the current evidence regarding the accuracy of these non-criteria APS manifestations for the detection of patients with APS. This article summarizes the studies analysed on the catastrophic APS, APS nephropathy and heart valve lesions, and presents the recommendations elaborated by the Task Force after this analysis.
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The Economic Impact of Medicaid Expansion on Pennsylvania.
Price, Carter C; Donohue, Julie M; Saltzman, Evan; Woods, Dulani; Eibner, Christine
2013-01-01
The Affordable Care Act is a substantial reform of the U.S. health care insurance system. Using the RAND COMPARE model, researchers assessed the act's potential economic effects on Pennsylvania, factoring in an optional expansion of Medicaid, and found the state would enjoy significant net benefits. With or without the expansion of Medicaid, the act will increase insurance coverage to hundreds of thousands of Pennsylvanians, but the COMPARE model estimates that the expansion of Medicaid eligibility would cover an additional 350,000 people and bring more than $2 billion in federal spending into the state annually than if the state did not expand. Should the state expand Medicaid, the additional spending will add more than $3 billion a year to the state's GDP and support 35,000 jobs. But Medicaid expansion is not without cost for the state; the estimated cumulative effect on Pennsylvania's Medicaid spending will be $180 million higher with the expansion than without between 2014 and 2020. Substantial reductions in uncompensated care costs for hospitals are possible even without expansion, but savings to hospitals for uncompensated care funding are even larger with the Medicaid expansion, amounting to $550 million or more each year.
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77 FR 6619 - Community Advantage Pilot Program
2012-02-08
... access to capital for small businesses and entrepreneurs in underserved markets, SBA is issuing this... (``CA Pilot Program'') (76 FR 9626). The CA Pilot Program was introduced to increase SBA-guaranteed... small businesses and entrepreneurs in underserved markets, SBA is issuing this Notice to revise several...
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VizieR Online Data Catalog: FARGO_THORIN 1.0 hydrodynamic code (Chrenko+, 2017)
Chrenko, O.; Broz, M.; Lambrechts, M.
2017-07-01
This archive contains the source files, documentation and example simulation setups of the FARGO_THORIN 1.0 hydrodynamic code. The program was introduced, described and used for simulations in the paper. It is built on top of the FARGO code (Masset, 2000A&AS..141..165M, Baruteau & Masset, 2008ApJ...672.1054B) and it is also interfaced with the REBOUND integrator package (Rein & Liu, 2012A&A...537A.128R). THORIN stands for Two-fluid HydrOdynamics, the Rebound integrator Interface and Non-isothermal gas physics. The program is designed for self-consistent investigations of protoplanetary systems consisting of a gas disk, a disk of small solid particles (pebbles) and embedded protoplanets. Code features: I) Non-isothermal gas disk with implicit numerical solution of the energy equation. The implemented energy source terms are: Compressional heating, viscous heating, stellar irradiation, vertical escape of radiation, radiative diffusion in the midplane and radiative feedback to accretion heating of protoplanets. II) Planets evolved in 3D, with close encounters allowed. The orbits are integrated using the IAS15 integrator (Rein & Spiegel, 2015MNRAS.446.1424R). The code detects the collisions among planets and resolve them as mergers. III) Refined treatment of the planet-disk gravitational interaction. The code uses a vertical averaging of the gravitational potential, as outlined in Muller & Kley (2012A&A...539A..18M). IV) Pebble disk represented by an Eulerian, presureless and inviscid fluid. The pebble dynamics is affected by the Epstein gas drag and optionally by the diffusive effects. We also implemented the drag back-reaction term into the Navier-Stokes equation for the gas. Archive summary: ------------------------------------------------------------------------- directory/file Explanation ------------------------------------------------------------------------- /in_relax Contains setup of the first example simulation /in_wplanet Contains setup of the second
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International Nuclear Information System (INIS)
1977-01-01
The X and neutron dosimetry measurement near the magnetic confinement device for hot plasma, called T.F.R. (Tokamak, Fontenay-aux-Roses) are presented. The biological shielding consists of an ordinary concrete wall 30 cm thick; the dose rate is thus limited at 10 -1 mrem per discharge (corresponding to 10 mrem per day) in the whole area frequented by people during T.F.R. operation. A numerical calculation, taking into account the true geometry and X ray reflexion by the walls and roof, and normalized to the measurements, gives some indications on the electron beam which produces X rays. The photoneutron source (up to 10 10 neutrons per dischage) and the activation of the vacuum vessel result from high energy electrons (>= 10 MeV) supporting a 10 to 1,000 A current [fr
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DEFF Research Database (Denmark)
Mailund, Thomas
Master functions and discover how to write functional programs in R. In this book, you'll make your functions pure by avoiding side-effects; you’ll write functions that manipulate other functions, and you’ll construct complex functions using simpler functions as building blocks. In Functional...... Programming in R, you’ll see how we can replace loops, which can have side-effects, with recursive functions that can more easily avoid them. In addition, the book covers why you shouldn't use recursion when loops are more efficient and how you can get the best of both worlds. Functional programming...... functions by combining simpler functions. You will: Write functions in R including infix operators and replacement functions Create higher order functions Pass functions to other functions and start using functions as data you can manipulate Use Filer, Map and Reduce functions to express the intent behind...
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1990-09-13
Chem. Soc., Faraday Trans. [5] S. T. Abdel-Halim, M. H. Abdel-Kader, and U. E. Steiner , J. 2, 83, 1941 (1987), Phys. Chem 92, 4324 (1988). [29] W...December 5th, 1990) Zusammensetzung, Eigenschaften und Anwendungen Mesomorpher Tensidphasen RUDOLF HEUSCH Leverkusen, Paul-Klee-StraBe 85 (Received on...Institut f~r Anorganisehe Chemnie der Universitiit Rudower Chaussee 5, 0-1199 Physikalisehe Chemie) Rudolf - Bern, Freie Stra~e 3, CH-3000 Bern, be- Berlin
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Dental Student, Resident, and Faculty Attitudes Toward Treating Medicaid Patients.
Behar-Horenstein, Linda S; Feng, Xiaoying
2017-11-01
Failure to receive proper oral health care including both prevention and maintenance is influenced by myriad and complex social, economic, and dental factors, including access to care. Reducing oral health disparities requires changes in the preparation of future dentists as well as measuring and influencing the attitudes and knowledge of practicing dentists. The aim of this study was to determine the likelihood that future dentists (students and residents) and faculty members at one U.S. dental school would treat Medicaid participants. Attitudes were measured using the Deamonte Driver scenario survey, which assesses factors affecting dentists' participation in Medicaid. In October 2012, all 113 full-time faculty members were invited to participate, and 60 completed the survey, for a response rate of 53.1%. In January and February 2013, all 18 residents in the dental clinics and university hospital were invited to participate, and 16 completed the survey, for a response rate of 88.9%. From 2013 to 2015, all 267 students in three classes were invited to participate: first-year students in the Classes of 2017 and 2018 and fourth-year students in the Class of 2015. A total of 255 students completed the survey, for an overall student response rate of 95.5%. The results showed that the students were more likely to participate in caring for Medicaid patients than the faculty and residents. The white and male students had stronger negative stereotypes about Medicaid patients than the females and underrepresented minority students, while residents had stronger negative stereotypes about Medicaid patients than the students and faculty. Overall, the cultural competency skills, beliefs, and attitudes of these faculty members and residents were less developed than those of their students, signaling a need for broad educational and faculty development programs to fully prepare the future dental workforce to care for these patients.
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Kenney, Genevieve; Cook, Allison; Dubay, Lisa
2009-01-01
The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 gave states additional resources and tools aimed at improving participation in Medicaid and the Children's Health Insurance Program (CHIP). In 2007, five million uninsured children were eligible for Medicaid or CHIP, constituting 64 percent of all uninsured children.…
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77 FR 15966 - Ohio: Final Authorization of State Hazardous Waste Management Program Revision
2012-03-19
... Hazardous Waste Management Program Revision AGENCY: Environmental Protection Agency (EPA). ACTION: Final..., 1989 (54 FR 27170) to implement the RCRA hazardous waste management program. We granted authorization... Combustors; Final Rule, Checklist 198, February 14, 2002 (67 FR 6968); Hazardous Waste Management System...
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Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost
Directory of Open Access Journals (Sweden)
Evan S. Cole
2016-09-01
state Medicaid programs should carefully consider reimbursement policies for long-term acute care hospitals, including bundled payments that cover both the original hospitalization and long-term acute care hospital admission.
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Expansion of Medicaid Covered Smoking Cessation Services
U.S. Department of Health & Human Services — Expansionof Medicaid Covered Smoking Cessation Services - Maternal Smoking and Birth Outcomes. To assess whether Medicaid coverage of smoking cessation services...
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2014-01-16
This final rule amends the Medicaid regulations to define and describe state plan section 1915(i) home and community-based services (HCBS) under the Social Security Act (the Act) amended by the Affordable Care Act. This rule offers states new flexibilities in providing necessary and appropriate services to elderly and disabled populations. This rule describes Medicaid coverage of the optional state plan benefit to furnish home and community based-services and draw federal matching funds. This rule also provides for a 5-year duration for certain demonstration projects or waivers at the discretion of the Secretary, when they provide medical assistance for individuals dually eligible for Medicaid and Medicare benefits, includes payment reassignment provisions because state Medicaid programs often operate as the primary or only payer for the class of practitioners that includes HCBS providers, and amends Medicaid regulations to provide home and community-based setting requirements related to the Affordable Care Act for Community First Choice State plan option. This final rule also makes several important changes to the regulations implementing Medicaid 1915(c) HCBS waivers.
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76 FR 31338 - Agency Information Collection Activities: Proposed Collection; Comment Request
2011-05-31
... Medicare program and Medicare plans design and monitor patient-centered quality improvement initiatives... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier CMS-10147, CMS-10396 and CMS-R-246] Agency Information Collection Activities: Proposed Collection...
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Florida's model of nursing home Medicaid reimbursement for disaster-related expenses.
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.