WorldWideScience

Sample records for traditional fee-for-service ffs

  1. Two Wrongs Do Not Make a Right: Flaws in Alternatives to Fee-for-Service Payment Plans Do Not Mean Fee-for-Service Is a Good Solution to Rising Prices Comment on "Fee-for-Service Payment - An Evil Practice That Must Be Stamped Out?".

    Science.gov (United States)

    Koppel, Ross

    2015-05-11

    Professor Naoki Ikegami's "Fee-for-service payment - an evil practice that must be stamped out" summarizes many of the failings of alternatives to fee-for-service (FFS) payment systems. His article also offers several suggestions for improving FFS systems. However, even powerful arguments against many of the alternatives to FFS, does not make a convincing argument for FFS systems. In addition, there are significant misunderstandings in Professor Ikegami's presentation of and use of United States payment methods, the role of private vs. public insurance systems, and the increasing role of "accountable care organizations. © 2015 by Kerman University of Medical Sciences.

  2. Association between fee-for-service expenditures and morbidity burden in primary care

    DEFF Research Database (Denmark)

    Kristensen, Troels; Olsen, Kim Rose; Schroll, Henrik

    2014-01-01

    BACKGROUND: In primary care, fee-for-services (FFS) tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated FFS expenditures has not previously been examined. OBJECTIVES...... fees are based on average costing. However, our results indicate that there may be room for improvement of the association between politically negotiated FFS expenditures and morbidity in primary care....

  3. Less Intense Postacute Care, Better Outcomes For Enrollees In Medicare Advantage Than Those In Fee-For-Service.

    Science.gov (United States)

    Huckfeldt, Peter J; Escarce, José J; Rabideau, Brendan; Karaca-Mandic, Pinar; Sood, Neeraj

    2017-01-01

    Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure. After accounting for differences in patient characteristics at discharge, we found lower intensity of postacute care for Medicare Advantage patients compared to FFS Medicare patients discharged from the same hospital, across all three conditions. Medicare Advantage patients also exhibited better outcomes than their FFS Medicare counterparts, including lower rates of hospital readmission and higher rates of return to the community. These findings suggest that payment reforms such as bundling in FFS Medicare may reduce the intensity of postacute care without adversely affecting patient health. Project HOPE—The People-to-People Health Foundation, Inc.

  4. Medicare Advantage and Fee-for-Service Performance on Clinical Quality and Patient Experience Measures: Comparisons from Three Large States.

    Science.gov (United States)

    Timbie, Justin W; Bogart, Andy; Damberg, Cheryl L; Elliott, Marc N; Haas, Ann; Gaillot, Sarah J; Goldstein, Elizabeth H; Paddock, Susan M

    2017-12-01

    To compare performance between Medicare Advantage (MA) and Fee-for-Service (FFS) Medicare during a time of policy changes affecting both programs. Performance data for 16 clinical quality measures and 6 patient experience measures for 9.9 million beneficiaries living in California, New York, and Florida. We compared MA and FFS performance overall, by plan type, and within service areas associated with contracts between CMS and MA organizations. Case mix-adjusted analyses (for measures not typically adjusted) were used to explore the effect of case mix on MA/FFS differences. Performance measures were submitted by MA organizations, obtained from the nationwide fielding of the Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) Survey, or derived from claims. Overall, MA outperformed FFS on all 16 clinical quality measures. Differences were large for HEDIS measures and small for Part D measures and remained after case mix adjustment. MA enrollees reported better experiences overall, but FFS beneficiaries reported better access to care. Relative to FFS, performance gaps were much wider for HMOs than PPOs. Excluding HEDIS measures, MA/FFS differences were much smaller in contract-level comparisons. Medicare Advantage/Fee-for-Service differences are often large but vary in important ways across types of measures and contracts. © Health Research and Educational Trust.

  5. Varied Differences in the Health Status Between Medicare Advantage and Fee-for-Service Enrollees

    Directory of Open Access Journals (Sweden)

    Yunjie Song PhD

    2014-12-01

    Full Text Available This article examines the differences in mortality measured health status between the Medicare Advantage (MA program and Fee-for-Service (FFS program from 1999 to 2007. At the national level, differences in mortality rates were associated with MA market share. In some counties, enrollees in the MA program were 40% less likely to die than their peers in the FFS program, but in other counties, they were 20% more likely to die. Cost shifting between the two programs could bias county classifications of average FFS spending, and enlarged disparities in health status could make it difficult to evaluate risk adjusters.

  6. Risk bearing and use of fee-for-service billing among accountable care organizations.

    Science.gov (United States)

    Muhlestein, David B; Croshaw, Andrew A; Merrill, Thomas P

    2013-07-01

    To determine the willingness of accountable care organizations (ACOs) to bear financial risk for the healthcare they provide. Structured interviews conducted between January and June 2012 with 57 ACOs led by hospitals and physician groups located throughout the United States. Findings are based on the 38 ACOs that were actively providing care under an ACO payment arrangement at the time of the interview. Among these ACOs, 71% cover a portion of their ACO population with contracts that put the ACOs at some financial risk, while 45% have risk-based contracts for their entire ACO population. Payments based on fee-for-service (FFS) billing still dominate, as 92% of ACOs use FFS-based billing for at least a portion of their ACO population and 71% are fully reimbursed using FFS-based billing. Under the auspices of an ACO, providers are accepting some financial risk for their accountable care patient population. There is still strong reliance on FFS-based billing methods as providers experiment with different payment models.

  7. Fee-for-service payment - an evil practice that must be stamped out?

    Science.gov (United States)

    Ikegami, Naoki

    2015-02-01

    Co-opting physicians to regulate Fee-for-Service (FFS) payment is more feasible and simpler to administer than capitation, Diagnosis-Related Groups (DRGs) and pay-for-performance. The key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. Adherence to these regulations must be strictly audited in order to control volume and costs, and to assure quality. The fee schedule requires periodic revisions on an item-by-item basis in order to maintain balance among the providers, to list new drugs, devices and equipment, and to reflect the lower market prices of existing ones. Implementing the fee schedule will facilitate the control of balance billing and extra billing, and the introduction of more sophisticated methods of payment in the future.

  8. Fee-for-Service Payment – An Evil Practice that Must be Stamped Out?

    Directory of Open Access Journals (Sweden)

    Naoki Ikegami

    2015-02-01

    Full Text Available Co-opting physicians to regulate Fee-for-Service (FFS payment is more feasible and simpler to administer than capitation, Diagnosis-Related Groups (DRGs and pay-for-performance. The key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. Adherence to these regulations must be strictly audited in order to control volume and costs, and to assure quality. The fee schedule requires periodic revisions on an item-by-item basis in order to maintain balance among the providers, to list new drugs, devices and equipment, and to reflect the lower market prices of existing ones. Implementing the fee schedule will facilitate the control of balance billing and extra billing, and the introduction of more sophisticated methods of payment in the future.

  9. Patient characteristics in relation to dental care payment model: capitation vs fee for service.

    Science.gov (United States)

    Hakeberg, M; Wide Boman, U

    2016-12-01

    To analyse patient profiles in two payment models, the capitation (DCH) and the fee-for-service (FFS) systems, in relation to socioeconomic status, self-reported health and health behavior, as well as patient attitudes to and satisfaction with the DCH model in the Public Dental Service (PDS) in Sweden. The present survey included a random national sample of the adult population in Sweden. A telemarketing company, TNS SIFO, was responsible for the sample selection and telephone interviews conducted in May 2013. The 3,500 adults (aged =19 years) included in the sample gave a participation rate of 49.7%. Individuals choosing DCH were younger. FFS patients rated their health as less good, were less physically active, were more often smokers and had a lower household income. The DCH patients were more satisfied with their payment model than the FFS patients (98% vs 85%). A multivariate analysis showed that three of the variables significantly contributed to the model predicting DCH patients: age, with an odds ratio of 0.95, household income (OR=1.85) and importance of oral health for well-being (OR=2.05). There was a pattern of dimensions indicating the choice of payment model among adult patients in the Swedish Public Dental Service. The patients in DCH had higher socioeconomic position, were younger, rated their oral health as better and were more satisfied with the payment model (DCH) than the patients in the FFS system. Copyright© 2016 Dennis Barber Ltd

  10. Proportion and Patterns of Hospice Discharges in Medicare Advantage Compared to Medicare Fee-for-Service.

    Science.gov (United States)

    Teno, Joan M; Christian, Thomas J; Gozalo, Pedro; Plotzke, Michael

    2018-03-01

    When Medicare Advantage (MA) patients elect hospice, all covered services are reimbursed under the Medicare fee-for-service (FFS) program. This financial arrangement may incentivize MA plans to refer persons to hospice near end of life when costs of care typically rise. To characterize hospice discharge patterns for MA versus FFS patients and examine whether patterns differ by MA concentration across hospital referral regions (HRRs). The rate and pattern of live discharges and length of stay (LOS) between FFS and MA patients were examined. A multivariate mixed-effects model examined whether hospice patients in MA versus FFS had differential patterns of discharges. In addition, we tested whether concentrations of MA hospice patients in a patient's HRR were associated with different patterns of discharges. In fiscal year 2014, there were 1,199,533 hospice discharges with 331,142 MA patients having a slightly higher live discharge rate (15.8%) compared to 868,391 FFS hospice discharges (15.4%). After controlling for patient characteristics, the adjusted odds ratio (AOR) was 1.01 (95% CI 0.99-1.02). MA patients were less likely to have early live discharges (AOR 0.87 95% CI 0.84-0.91) and burdensome transitions (AOR 0.61 95% CI 0.58-0.64) but did not differ in live discharges post 210 days. Among hospice deaths, MA hospice patients were less likely to have a three-day or less LOS (AOR 0.95 95% 0.94-0.96) and a LOS exceeding 180 days (AOR 0.97 95% 0.96-0.99). The concentration of MA patients in a HRR had minimal impact. MA hospice patients' discharge patterns raised less concerns than FFS.

  11. Comparing the Health Care Experiences of Medicare Beneficiaries with and without Depressive Symptoms in Medicare Managed Care versus Fee-for-Service.

    Science.gov (United States)

    Martino, Steven C; Elliott, Marc N; Haviland, Amelia M; Saliba, Debra; Burkhart, Q; Kanouse, David E

    2016-06-01

    To compare patient experiences and disparities for older adults with depressive symptoms in managed care (Medicare Advantage [MA]) versus Medicare Fee-for-Service (FFS). Data came from the 2010 Medicare CAHPS survey, to which 220,040 MA and 135,874 FFS enrollees aged 65 and older responded. Multivariate linear regression was used to test whether case-mix-adjusted associations between depressive symptoms and patient experience differed for beneficiaries in MA versus FFS. Dependent measures included four measures of beneficiaries' experiences with doctors (e.g., reports of doctor communication) and seven measures of beneficiaries' experiences with plans (e.g., customer service). Beneficiaries with depressive symptoms reported worse experiences than those without depressive symptoms regardless of coverage type. For measures assessing interactions with the plan (but not for measures assessing interactions with doctors), the disadvantage for beneficiaries with versus without depressive symptoms was larger in MA than in FFS. Disparities in care experienced by older Medicare beneficiaries with depressive symptoms tend to be more negative in managed care than in FFS. Efforts are needed to identify and address the barriers these beneficiaries encounter to help them better traverse the managed care environment. © Health Research and Educational Trust.

  12. Reaching Urban Poor Hypertensive Patients: A Novel Model of Chronic Disease Care Versus a Traditional Fee-for-Service Approach.

    Science.gov (United States)

    Sanders, Jim; Guse, Clare E

    2016-08-09

    There is a significant disparity in hypertensive treatment rates between those with and without health insurance. If left untreated, hypertension leads to significant morbidity and mortality. The uninsured face numerous barriers to access chronic disease care. We developed the Community-based Chronic Disease Management (CCDM) clinics specifically for the uninsured with hypertension utilizing nurse-led teams, community-based locations, and evidence-based clinical protocols. All services, including laboratory and medications, are provided on-site and free of charge. In order to ascertain if the CCDM model of care was as effective as traditional models of care in achieving blood pressure goals, we compared CCDM clinics' hypertensive care outcomes with 2 traditional fee-for-service physician-led clinics. All the clinics are located near one another in poor urban neighborhoods of Milwaukee, Wisconsin. Patients seen at the CCDM clinics and at 1 of the 2 traditional clinics showed a statistically significant improvement in reaching blood pressure goal at 6 months (P fee-for-service clinics when compared with the CCDM clinics. The CCDM model of care is at least as effective in controlling hypertension as more traditional fee-for-service models caring for the same population. The CCDM model of care to treat hypertension may offer another approach for engaging the urban poor in chronic disease care. © The Author(s) 2016.

  13. Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model.

    Science.gov (United States)

    Basu, Sanjay; Phillips, Russell S; Song, Zirui; Landon, Bruce E; Bitton, Asaf

    2016-09-01

    We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. We estimated practices' changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours. Under the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (-$53,500, 95% CI, -$69,700 to -$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased. PCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding. © 2016 Annals of Family Medicine, Inc.

  14. The fee-for-service shift to bundled payments: financial considerations for hospitals.

    Science.gov (United States)

    Scamperle, Keely

    2013-01-01

    Skyrocketing health care costs are forcing payers to demand delivery efficiencies that preserve and promote quality care while reducing costs. Hospitals are challenged to meet the pressure from payers to deliver value and outcome-based health care while preserving sufficient financial margins. The fee-for-service (FFS) model with its perverse incentives to incur high-volume services is no longer, if ever, sufficient to ensure quality, cost-efficient health care. In response, payers have sought to force the issue through accelerated efforts to bundle payments to providers. It is theorized that by tying together providers throughout the continuum or episode of care for a patient, efficiencies in delivery inclusive of cost reductions will be obtained. This article examines the bundled payment models and the financial considerations for hospital facility providers.

  15. Managed care and the diffusion of endoscopy in fee-for-service Medicare.

    Science.gov (United States)

    Mobley, Lee Rivers; Subramanian, Sujha; Koschinsky, Julia; Frech, H E; Trantham, Laurel Clayton; Anselin, Luc

    2011-12-01

    To determine whether Medicare managed care penetration impacted the diffusion of endoscopy services (sigmoidoscopy, colonoscopy) among the fee-for-service (FFS) Medicare population during 2001-2006. We model utilization rates for colonoscopy or sigmoidoscopy as impacted by both market supply and demand factors. We use spatial regression to perform ecological analysis of county-area utilization rates over two time intervals (2001-2003, 2004-2006) following Medicare benefits expansion in 2001 to cover colonoscopy for persons of average risk. We examine each technology in separate cross-sectional regressions estimated over early and later periods to assess differential effects on diffusion over time. We discuss selection factors in managed care markets and how failure to control perfectly for market selection might impact our managed care spillover estimates. Areas with worse socioeconomic conditions have lower utilization rates, especially for colonoscopy. Holding constant statistically the socioeconomic factors, we find that managed care spillover effects onto FFS Medicare utilization rates are negative for colonoscopy and positive for sigmoidoscopy. The spatial lag estimates are conservative and interpreted as a lower bound on true effects. Our findings suggest that managed care presence fostered persistence of the older technology during a time when it was rapidly being replaced by the newer technology. © Health Research and Educational Trust.

  16. Does a global budget superimposed on fee-for-service payments mitigate hospitals' medical claims in Taiwan?

    Science.gov (United States)

    Hsu, Pi-Fem

    2014-12-01

    Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.

  17. Long-term effect of fee-for-service-based reimbursement cuts on processes and outcomes of care for stroke: interrupted time-series study from Taiwan.

    Science.gov (United States)

    Tung, Yu-Chi; Chang, Guann-Ming; Cheng, Shou-Hsia

    2015-01-01

    As healthcare spending continues to increase, reimbursement cuts have become 1 type of healthcare reform to contain costs. Little is known about the long-term impact of cuts in reimbursement, especially under a global budget cap with fee-for-service (FFS) reimbursement, on processes and outcomes of care. The FFS-based reimbursement cuts have been implemented since July 2002 in Taiwan. We examined the long-term association of FFS-based reimbursement cuts with trends in processes and outcomes of care for stroke. We analyzed all 411,487 patients with stroke admitted to general acute care hospitals in Taiwan during the period 1997 to 2010 through Taiwan's National Health Insurance Research Database. We used a quasi-experimental design with quarterly measures of healthcare utilization and outcomes and used segmented autoregressive integrated moving average models for the analysis. After accounting for secular trends and other confounders, the implementation of the FFS-based reimbursement cuts was associated with trend changes in computed tomography/magnetic resonance imaging scanning (0.31% per quarter; P=0.013), antiplatelet/anticoagulant use (-0.20% per quarter; Pprocesses and outcomes of care over time. However, the reimbursement cuts from the FFS-based global budget cap are associated with trend changes in processes and outcomes of care for stroke. The FFS-based reimbursement cuts may have long-term positive and negative associations with stroke care. © 2014 American Heart Association, Inc.

  18. Fee-for-Service Is Dead. Long Live Fee for Service?

    Science.gov (United States)

    Greene, Jan

    2017-09-01

    The move to a value-based payment system was supposed to end perverse incentives that pay doctors more for delivering often unnecessary services. But things are changing slowly and the market is still 95% fee for service. There's talk of reworking the Medicare fee schedule so docs are paid more for the things that work, and less for those that don't.

  19. FEE-SCHEDULE INCREASES IN CANADA: IMPLICATION FOR SERVICE VOLUMES AMONG FAMILY AND SPECIALIST PHYSICIANS.

    Science.gov (United States)

    Ariste, Ruolz

    2015-01-01

    Physician spending has substantially increased over the last few years in Canada to reach $27.4 billion in 2010. Total clinical payment to physicians has grown at an average annual rate of 7.6% from 2004 to 2010. The key policy question is whether or not this additional money has bought more physician services. So, the purpose of this study is to understand if we are paying more for the same amount of medical services in Canada or we are getting more bangs for our buck. At the same time, the paper attempts to find out whether or not there is a productivity difference between family physician services and surgical procedures. Using the Baumol theory and data from the National Physician Database for the period 2004-2010, the paper breaks down growth in physician remuneration into growth in unit cost and number of services, both from the physician and the payer perspectives. After removing general inflation and population growth from the 7.6% growth in total clinical payment, we found that real payment per service and volume of services per capita grew at an average annual rate of 3.2% and 1.4% respectively, suggesting that payment per service was the main cost driver of physician remuneration at the national level. Taking the payer perspective, it was found that, for the fee-for-service (FFS) scheme, volume of services per physician decreased at an average annual rate of -0.6%, which is a crude indicator that labour productivity of physicians on FFS has fallen during the period. However, the situation differs for the surgical procedures. Results also vary by province. Overall, our finding is consistent with the Baumol theory, which hypothesizes higher productivity growth in technology-driven sectors.

  20. Diagnosis-related group (DRG)-based case-mix funding system, a promising alternative for fee for service payment in China.

    Science.gov (United States)

    Zhao, Cuirong; Wang, Chao; Shen, Chengwu; Wang, Qian

    2018-05-13

    Fee for services (FFS) is the prevailing method of payment in most Chinese public hospitals. Under this retrospective payment system, medical care providers are paid based on medical services and tend to over-treat to maximize their income, thereby contributing to rising medical costs and uncontrollable health expenditures to a large extent. Payment reform needs to be promptly implemented to move to a prospective payment plan. The diagnosis-related group (DRG)-based case-mix payment system, with its superior efficiency and containment of costs, has garnered increased attention and it represents a promising alternative. This article briefly describes the DRG-based case-mix payment system, it comparatively analyzes differences between FFS and case-mix funding systems, and it describes the implementation of DRGs in China. China's social and economic conditions differ across regions, so establishment of a national payment standard will take time and involve difficulties. No single method of provider payment is perfect. Measures to monitor and minimize the negative ethical implications and unintended effects of a DRG-based case-mix payment system are essential to ensuring the lasting social benefits of payment reform in Chinese public hospitals.

  1. Monte Carlo simulation to analyze the cost-benefit of radioactive seed localization versus wire localization for breast-conserving surgery in fee-for-service health care systems compared with accountable care organizations.

    Science.gov (United States)

    Loving, Vilert A; Edwards, David B; Roche, Kevin T; Steele, Joseph R; Sapareto, Stephen A; Byrum, Stephanie C; Schomer, Donald F

    2014-06-01

    In breast-conserving surgery for nonpalpable breast cancers, surgical reexcision rates are lower with radioactive seed localization (RSL) than wire localization. We evaluated the cost-benefit of switching from wire localization to RSL in two competing payment systems: a fee-for-service (FFS) system and a bundled payment system, which is typical for accountable care organizations. A Monte Carlo simulation was developed to compare the cost-benefit of RSL and wire localization. Equipment utilization, procedural workflows, and regulatory overhead differentiate the cost between RSL and wire localization. To define a distribution of possible cost scenarios, the simulation randomly varied cost drivers within fixed ranges determined by hospital data, published literature, and expert input. Each scenario was replicated 1000 times using the pseudorandom number generator within Microsoft Excel, and results were analyzed for convergence. In a bundled payment system, RSL reduced total health care cost per patient relative to wire localization by an average of $115, translating into increased facility margin. In an FFS system, RSL reduced total health care cost per patient relative to wire localization by an average of $595 but resulted in decreased facility margin because of fewer surgeries. In a bundled payment system, RSL results in a modest reduction of cost per patient over wire localization and slightly increased margin. A fee-for-service system suffers moderate loss of revenue per patient with RSL, largely due to lower reexcision rates. The fee-for-service system creates a significant financial disincentive for providers to use RSL, although it improves clinical outcomes and reduces total health care costs.

  2. Comparing the Quality of Ambulatory Surgical Care for Skin Cancer in a Veterans Affairs Clinic and a Fee-For-Service Practice Using Clinical and Patient-Reported Measures.

    Science.gov (United States)

    Dizon, Matthew P; Linos, Eleni; Arron, Sarah T; Hills, Nancy K; Chren, Mary-Margaret

    2017-01-01

    The Institute of Medicine has identified serious deficiencies in the measurement of cancer care quality, including the effects on quality of life and patient experience. Moreover, comparisons of quality in Veterans Affairs Medical Centers (VA) and other sites are timely now that many Veterans can choose where to seek care. To compare quality of ambulatory surgical care for keratinocyte carcinoma (KC) between a VA and fee-for-service (FFS) practice, we used unique clinical and patient-reported data from a comparative effectiveness study. Patients were enrolled in 1999-2000 and followed for a median of 7.2 years. The practices differed in a few process measures (e.g., median time between biopsy and treatment was 7.5 days longer at VA) but there were no substantial or consistent differences in clinical outcomes or a broad range of patient-reported outcomes. For example, 5-year tumor recurrence rates were equally low (3.6% [2.3-5.5] at VA and 3.4% [2.3-5.1] at FFS), and similar proportions of patients reported overall satisfaction at one year (78% at VA and 80% at FFS, P = 0.69). These results suggest that the quality of care for KC can be compared comprehensively in different health care systems, and suggest that quality of care for KC was similar at a VA and FFS setting.

  3. 7 CFR 785.5 - Fees for mediation services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Fees for mediation services. 785.5 Section 785.5... AGRICULTURE SPECIAL PROGRAMS CERTIFIED STATE MEDIATION PROGRAM § 785.5 Fees for mediation services. A requirement that non-USDA parties who elect to participate in mediation pay a fee for mediation services will...

  4. 31 CFR 270.4 - Fees for services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Fees for services. 270.4 Section 270.4 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE AVAILABILITY OF RECORDS § 270.4 Fees for services...

  5. Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data

    Science.gov (United States)

    Guerino, Paul; Ewald, Erin; Laffan, Alison M.

    2017-01-01

    Abstract Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research. Methods: Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229). Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs. Conclusion: This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age. PMID:29125908

  6. Fee-based services in sci-tech libraries

    CERN Document Server

    Mount, Ellis

    2013-01-01

    This timely and important book explores how fee-based services have developed in various types of sci-tech libraries. The authoritative contributors focus on the current changing financial aspects of the sci-tech library operation and clarify for the reader how these changes have brought about conditions in which traditional methods of funding are no longer adequate. What new options are open and how they are best being applied in today's sci-tech libraries is fully and clearly explained and illustrated. Topics explored include cost allocation and cost recovery, fees for computer searching, an

  7. 7 CFR 62.300 - Fees and other costs for service.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees and other costs for service. 62.300 Section 62...) Quality Systems Verification Programs Definitions Charges for Service § 62.300 Fees and other costs for service. Fees and other charges will be levied based on the following provisions: (a) Fees for service...

  8. 77 FR 35355 - User Fee Schedule for Trade Promotion Services

    Science.gov (United States)

    2012-06-13

    ...-XA17 User Fee Schedule for Trade Promotion Services AGENCY: U.S. & Foreign Commercial Service... promotion services under the current fee structure. ITA provides a wide range of trade promotion information... these more intensive trade promotion services. The fee revenue is expected to continue to contribute to...

  9. Cost Effectiveness of Genotype-Guided Warfarin Dosing in Patients with Mechanical Heart Valve Replacement Under the Fee-for-Service System.

    Science.gov (United States)

    Kim, Dong-Jin; Kim, Ho-Sook; Oh, Minkyung; Kim, Eun-Young; Shin, Jae-Gook

    2017-10-01

    Although studies assessing the cost effectiveness of genotype-guided warfarin dosing for the management of atrial fibrillation, deep vein thrombosis, and pulmonary embolism have been reported, no publications have addressed genotype-guided warfarin therapy in mechanical heart valve replacement (MHVR) patients or genotype-guided warfarin therapy under the fee-for-service (FFS) insurance system. The aim of this study was to evaluate the cost effectiveness of genotype-guided warfarin dosing in patients with MHVR under the FFS system from the Korea healthcare sector perspective. A decision-analytic Markov model was developed to evaluate the cost effectiveness of genotype-guided warfarin dosing compared with standard dosing. Estimates of clinical adverse event rates and health state utilities were derived from the published literature. The outcome measure was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY). One-way and probabilistic sensitivity analyses were performed to explore the range of plausible results. In a base-case analysis, genotype-guided warfarin dosing was associated with marginally higher QALYs than standard warfarin dosing (6.088 vs. 6.083, respectively), at a slightly higher cost (US$6.8) (year 2016 values). The ICER was US$1356.2 per QALY gained. In probabilistic sensitivity analysis, there was an 82.7% probability that genotype-guided dosing was dominant compared with standard dosing, and a 99.8% probability that it was cost effective at a willingness-to-pay threshold of US$50,000 per QALY gained. Compared with only standard warfarin therapy, genotype-guided warfarin dosing was cost effective in MHVR patients under the FFS insurance system.

  10. 21 CFR 80.10 - Fees for certification services.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Fees for certification services. 80.10 Section 80.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL COLOR...) Method of payment. All deposits and fees required by this section shall be paid by money order, bank...

  11. 22 CFR 92.89 - Fees for service of legal process.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Fees for service of legal process. 92.89 Section 92.89 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES NOTARIAL AND RELATED SERVICES Quasi-Legal Services § 92.89 Fees for service of legal process. No charge should be made for...

  12. An Elastic Charging Service Fee-Based Load Guiding Strategy for Fast Charging Stations

    Directory of Open Access Journals (Sweden)

    Shu Su

    2017-05-01

    Full Text Available Compared with the traditional slow charging loads, random integration of large scale fast charging loads will exert more serious impacts on the security of power network operation. Besides, to maximize social benefits, effective scheduling strategies guiding fast charging behaviors should be formulated rather than simply increasing infrastructure construction investments on the power grid. This paper first analyzes the charging users’ various responses to an elastic charging service fee, and introduces the index of charging balance degree to a target region by considering the influence of fast charging loads on the power grid. Then, a multi-objective optimization model of the fast charging service fee is constructed, whose service fee can be further optimized by employing a fuzzy programming method. Therefore, both users’ satisfaction degree and the equilibrium of charging loads can be maintained simultaneously by reasonably guiding electric vehicles (EVs to different fast charging stations. The simulation results demonstrate the effectiveness of the proposed dynamic charging service pricing and the corresponding fast charging load guidance strategy.

  13. Impact of Medicaid Managed Care on Illinois's Acute Health Services Expenditures for Adults with Intellectual and Developmental Disabilities

    Science.gov (United States)

    Yamaki, Kiyoshi; Wing, Coady; Mitchell, Dale; Owen, Randall; Heller, Tamar

    2018-01-01

    States have increasingly transitioned Medicaid enrollees with disabilities from fee-for-service (FFS) to Medicaid Managed Care (MMC), intending to reduce state Medicaid spending and to provide better access to health services. Yet, previous studies on the impact of MMC are limited and findings are inconsistent. We analyzed the impact of MMC on…

  14. 7 CFR 160.204 - Fees for extra cost and hourly rate service.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees for extra cost and hourly rate service. 160.204... STORES REGULATIONS AND STANDARDS FOR NAVAL STORES Specific Fees Payable for Services Rendered § 160.204 Fees for extra cost and hourly rate service. The fees specified in §§ 160.201 and 160.202 apply to the...

  15. 22 CFR 72.31 - Fees for consular death and estates services.

    Science.gov (United States)

    2010-04-01

    ... personal estates of all officers and employees of the United States who die abroad while on official duty... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Fees for consular death and estates services... PROPERTY AND ESTATES DEATHS AND ESTATES Fees § 72.31 Fees for consular death and estates services. (a) Fees...

  16. 14 CFR Appendix B to Part 187 - Fees for FAA Services for Certain Flights

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Fees for FAA Services for Certain Flights B... (CONTINUED) ADMINISTRATIVE REGULATIONS FEES Pt. 187, App. B Appendix B to Part 187—Fees for FAA Services for... pay a fee for the FAA's rendering or providing certain services, including but not limited to the...

  17. User fees and maternity services in Ethiopia.

    Science.gov (United States)

    Pearson, Luwei; Gandhi, Meena; Admasu, Keseteberhan; Keyes, Emily B

    2011-12-01

    To examine user fees for maternity services and how they relate to provision, quality, and use of maternity services in Ethiopia. The national assessment of emergency obstetric and newborn care (EmONC) examined user fees for maternity services in 751 health facilities that provided childbirth services in 2008. Overall, only about 6.6% of women gave birth in health facilities. Among facilities that provided delivery care, 68% charged a fee in cash or kind for normal delivery. Health centers should be providing maternity services free of charge (the healthcare financing proclamation), yet 65% still charge for some aspect of care, including drugs and supplies. The average cost for normal and cesarean delivery was US $7.70 and US $51.80, respectively. Nineteen percent of these facilities required payment in advance for treatment of an obstetric emergency. The health facilities that charged user fees had, on average, more delivery beds, deliveries (normal and cesarean), direct obstetric complications treated, and a higher ratio of skilled birth attendants per 1000 deliveries than those that did not charge. The case fatality rate was 3.8% and 7.1% in hospitals that did and did not charge user fees, respectively. Utilization of maternal health services is extremely low in Ethiopia and, although there is a government decree against charging for maternity service, 65% of health centers do charge for some aspects of maternal care. As health facilities are not reimbursed by the government for the costs of maternity services, this loss of revenue may account for the more and better services offered in facilities that continue to charge user fees. User fees are not the only factor that determines utilization in settings where the coverage of maternity services is extremely low. Additional factors include other out-of-pocket payments such as cost of transport and food and lodging for accompanying relatives. It is important to keep quality of care in mind when user fees are under

  18. 31 CFR 223.22 - Fees for services of the Treasury Department.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Fees for services of the Treasury Department. 223.22 Section 223.22 Money and Finance: Treasury Regulations Relating to Money and Finance... BUSINESS WITH THE UNITED STATES § 223.22 Fees for services of the Treasury Department. (a) Fees shall be...

  19. Fee-for-service will remain a feature of major payment reforms, requiring more changes in Medicare physician payment.

    Science.gov (United States)

    Ginsburg, Paul B

    2012-09-01

    Many health policy analysts envision provider payment reforms currently under development as replacements for the traditional fee-for-service payment system. Reforms include per episode bundled payment and elements of capitation, such as global payments or accountable care organizations. But even if these approaches succeed and are widely adopted, the core method of payment to many physicians for the services they provide is likely to remain fee-for-service. It is therefore critical to address the current shortcomings in the Medicare physician fee schedule, because it will affect physician incentives and will continue to play an important role in determining the payment amounts under payment reform. This article reviews how the current payment system developed and is applied, and it highlights areas that require careful review and modification to ensure the success of broader payment reform.

  20. Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.

    Science.gov (United States)

    van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W

    2015-02-01

    To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008-June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition. Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008. Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices. This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care. © Health Research and Educational Trust.

  1. Using fee-for-service testing to generate revenue for the 21st century public health laboratory.

    Science.gov (United States)

    Loring, Carol; Neil, R Brock; Gillim-Ross, Laura; Bashore, Matthew; Shah, Sandip

    2013-01-01

    The decrease in appropriations for state public health laboratories (SPHLs) has become a major concern as tax revenues and, subsequently, state and federal funding, have decreased. These reductions have forced SPHLs to pursue revenue-generating opportunities to support their work. We describe the current state of funding in a sampling of SPHLs and the challenges these laboratories face as they implement or expand fee-for-service testing. We conducted surveys of SPHLs to collect data concerning laboratory funding sources, test menus, fee-for-service testing, and challenges to implementing fee-for-service testing. Most SPHLS receive funding through three revenue sources: state appropriation, federal funding, and fee-for-service testing (cash funds). Among SPHLs, state appropriations ranged from $0 to more than $6 per capita, federal funding ranged from $0.10 to $5 per capita, and revenue from fee-for-service testing ranged from $0 to $4 per capita. The tests commonly performed on a fee-for-service basis included assays for sexually transmitted diseases, mycobacterial cultures, newborn screening, and water testing. We found that restrictive legislation, staffing shortages, inadequate software for billing fee-for-service testing, and regulations on how SPHLs use their generated revenue are impediments to implementing fee-for-service testing. Some SPHLs are considering implementing or expanding fee-for-service testing as a way to recapture funds lost as a result of state and federal budget cuts. This analysis revealed many of the obstacles to implementing fee-for-service testing in SPHLs and the potential impact on SPHLs of continued decreases in funding.

  2. Use of fees to fund local public health services in Western Massachusetts.

    Science.gov (United States)

    Shila Waritu, A; Bulzacchelli, Maria T; Begay, Michael E

    2015-01-01

    Recent budget cuts have forced many local health departments (LHDs) to cut staff and services. Setting fees that cover the cost of service provision is one option for continuing to fund certain activities. To describe the use of fees by LHDs in Western Massachusetts and determine whether fees charged cover the cost of providing selected services. A cross-sectional descriptive analysis was used to identify the types of services for which fees are charged and the fee amounts charged. A comparative cost analysis was conducted to compare fees charged with estimated costs of service provision. Fifty-nine LHDs in Western Massachusetts. Number of towns charging fees for selected types of services; minimum, maximum, and mean fee amounts; estimated cost of service provision; number of towns experiencing a surplus or deficit for each service; and average size of deficits experienced. Enormous variation exists both in the types of services for which fees are charged and fee amounts charged. Fees set by most health departments did not cover the cost of service provision. Some fees were set as much as $600 below estimated costs. These results suggest that considerations other than costs of service provision factor into the setting of fees by LHDs in Western Massachusetts. Given their limited and often uncertain funding, LHDs could benefit from examining their fee schedules to ensure that the fee amounts charged cover the costs of providing the services. Cost estimates should include at least the health agent's wage and time spent performing inspections and completing paperwork, travel expenses, and cost of necessary materials.

  3. Medicare Advantage Rates and Statistics - FFS Data (1998-...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare fee-for-service data for each county broken out by aged, disabled, and ESRD beneficiaries including data on total Medicare fee-for-service reimbursement and...

  4. 28 CFR 549.72 - Services provided without fees.

    Science.gov (United States)

    2010-07-01

    ... care; (f) Diagnosis or treatment of chronic infectious diseases; (g) Mental health care; or (h... Section 549.72 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Fees for Health Care Services § 549.72 Services provided without fees. We will not charge...

  5. Medicare Advantage Rates and Statistics - FFS Data 2008-2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare fee-for-service data for each county broken out by aged, disabled, and ESRD beneficiaries including data on total Medicare fee-for-service reimbursement and...

  6. COMPARISON OF MEDICAL COSTS AND CARE OF APPENDECTOMY PATIENTS BETWEEN FEE-FOR-SERVICE AND SET FEE FOR DIAGNOSIS-RELATED GROUP SYSTEMS IN 20 CHINESE HOSPITALS.

    Science.gov (United States)

    Zhang, Yin-hua; He, Guo-ping; Liu, Jing-wei

    2016-09-01

    The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

  7. Some optics alternatives for the FFS

    Science.gov (United States)

    Spencer, J. E.

    1984-03-01

    The evolution of the SLC Final Focus System (FFS) was discussed in the SLC Red Books and various collider notes. Bulos and Brown and Murray were able to achieve small (BETA)'s with large I1's (the distance between the IP and the effective field boundary of the first quad). However, all current solutions which are compatible with the known constraints of the total path length, aperture and spot size require high gradient, superconducting quads. Such quads are not expected to provide very good inherent field quality (i.e., without correction windings) but expected to be comparatively expensive to build and operate simply. The purpose of this note is to present a more general solution for the FFS telescope which is compatible with the known constraints of detectors, magnet types, available space and the ingoing and outgoing phase space expectations. While a number of different solutions were found, the ones presented provide comparable performance, simpler operation and lower costs.

  8. 7 CFR 160.66 - Fees for inspection services.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) NAVAL STORES REGULATIONS AND... with the cost of the service rendered. Such fees and charges may be announced to the trade in such...

  9. 76 FR 57014 - Award Fee for Service and End-Item Contracts

    Science.gov (United States)

    2011-09-15

    ... next payment voucher for the amount of such overpayment or refund the difference to the Government, as... evaluation score, the Contractor will either credit the next payment voucher for the amount of such... the Award Fee for Service Contracts clause to allow the contracting officer to withhold fee payments...

  10. Fee-for-service cancer rehabilitation programs improve health-related quality of life.

    Science.gov (United States)

    Kirkham, A A; Neil-Sztramko, S E; Morgan, J; Hodson, S; Weller, S; McRae, T; Campbell, K L

    2016-08-01

    Rigorously applied exercise interventions undertaken in a research setting result in improved health-related quality of life (hrqol) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine the effect of fee-for-service cancer rehabilitation programs in the community on hrqol and on self-reported physical activity and its correlates. After enrolment and 17 ± 4 weeks later, new clients (n = 48) to two fee-for-service cancer rehabilitation programs completed the 36-Item Short Form Health Survey (rand-36: rand Corporation, Santa Monica, CA, U.S.A.), the Godin Leisure-Time Exercise Questionnaire, and questions about physical activity correlates. Normal fee-for-service operations were maintained, including a fitness assessment and individualized exercise programs supervised in a group or one-on-one setting, with no minimum attendance required. Fees were associated with the assessment and with each exercise session. Of the 48 participants, 36 (75%) completed both questionnaires. Improvements in the physical functioning, role physical, pain, and energy/fatigue scales on the rand-36 exceeded minimally important differences and were of a magnitude similar to improvements reported in structured, rigorously applied, and free research interventions. Self-reported levels of vigorous-intensity (p = 0.021), but not moderate-intensity (p = 0.831) physical activity increased. The number of perceived barriers to exercise (p = 0.035) and the prevalence of fatigue as a barrier (p = 0.003) decreased. Exercise self-efficacy improved only in participants who attended 11 or more sessions (p = 0.002). Exercise enjoyment did not change (p = 0.629). Enrolment in fee-for-service cancer rehabilitation programs results in meaningful improvements in hrqol comparable to those reported by research interventions, among other benefits. The fee-for-service model could be an effective model for

  11. 78 FR 22151 - Fees for Official Inspection and Official Weighing Services Under the United States Grain...

    Science.gov (United States)

    2013-04-15

    ... Inspection Service (FGIS) with the authority to charge and collect reasonable fees to cover the cost of performing official services. The fees also cover the costs associated with managing the program. After a... associated administrative and supervisory costs. The fees for official inspection and weighing services were...

  12. 49 CFR 1510.11 - Handling of security service fees.

    Science.gov (United States)

    2010-10-01

    ... air carrier holds neither legal nor equitable interest in the security service fees except for the... 49 Transportation 9 2010-10-01 2010-10-01 false Handling of security service fees. 1510.11 Section 1510.11 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY...

  13. 31 CFR 1.7 - Fees for services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Fees for services. 1.7 Section 1.7 Money and Finance: Treasury Office of the Secretary of the Treasury DISCLOSURE OF RECORDS Freedom of... Department shall charge for search time at the salary rate(s) (basic pay plus 16 percent) of the employee(s...

  14. Payments and Utilization of Immunization Services Among Children Enrolled in Fee-for-Service Medicaid.

    Science.gov (United States)

    Tsai, Yuping

    2018-01-01

    To examine the association between state Medicaid vaccine administration fees and children's receipt of immunization services. The study used the 2008-2012 Medicaid Analytic eXtract data and included children aged 0-17 years and continuously enrolled in a Medicaid fee-for-service plan in each study year. Analyses were restricted to 8 states with a Medicaid managed-care penetration rate Medicaid vaccine administration fees, age group, sex, race/ethnicity, state unemployment rate, state managed-care penetration rate, and state and year-fixed effects. A total of 1,678,288 children were included. In 2008-2012, the average proportion of children making ≥1 vaccination visit per year was 31% and the mean number of vaccination visits was 0.9. State Medicaid reimbursements for vaccine administration was positively associated with immunization service utilization; for every $1 increase in the payment amount, the probability of children making ≥1 vaccination visit increased by 0.72 percentage point (95% confidence interval, 0.23-1.21; P=0.01), representing a 2% increase from the mean and the number of vaccination visits increased by 0.03 (95% confidence interval, -0.00 to 0.06; PMedicaid reimbursements for vaccine administration were associated with increased proportion of children receiving immunization services.

  15. 20 CFR 404.1720 - Fee for a representative's services.

    Science.gov (United States)

    2010-04-01

    ... DISABILITY INSURANCE (1950- ) Representation of Parties § 404.1720 Fee for a representative's services. (a... you or your representative from contacting us in person or in writing. (B) There was a death or...

  16. 78 FR 21862 - Revision to United States Marshals Service Fees for Services

    Science.gov (United States)

    2013-04-12

    ....). List of Subjects in 28 CFR Part 0 Authority delegations (Government agencies), Government employees... Marshals Service employee, agent, or contractor. This proposed fee increase reflects the current costs to.... Marshals Service employee, agent, or contractor, plus travel costs and any other out-of- pocket expenses...

  17. 20 CFR 416.1520 - Fee for a representative's services.

    Science.gov (United States)

    2010-04-01

    ... AGED, BLIND, AND DISABLED Representation of Parties § 416.1520 Fee for a representative's services. (a... you or your representative from contacting us in person or in writing. (B) There was a death or...

  18. Fluorescence fluctuation spectroscopy (FFS)

    CERN Document Server

    Tetin, Sergey

    2012-01-01

    This new volume of Methods in Enzymology continues the legacy of this premier serial with quality chapters authored by leaders in the field. This volume covers fluorescence fluctuation spectroscopy and includes chapters on such topics as Förster resonance energy transfer (fret) with fluctuation algorithms, protein corona on nanoparticles by FCS, and FFS approaches to the study of receptors in live cells. Continues the legacy of this premier serial with quality chapters authored by leaders in the field Covers fluorescence fluctuation spectroscopy Contains chapters on such topics as Förster resonance energy transfer (fret) with fluctuation algorithms, protein corona on nanoparticles by FCS, and FFS approaches to the study of receptors in live cells.

  19. 47 CFR 1.1155 - Schedule of regulatory fees and filing locations for cable television services.

    Science.gov (United States)

    2010-10-01

    ... locations for cable television services. 1.1155 Section 1.1155 Telecommunication FEDERAL COMMUNICATIONS... Schedule of regulatory fees and filing locations for cable television services. Fee amount Address 1. Cable Television Relay Service $315 FCC, Cable, P.O. Box 979084, St. Louis, MO 63197-9000 2. Cable TV System (per...

  20. 78 FR 2627 - Fees for Official Inspection and Official Weighing Services Under the United States Grain...

    Science.gov (United States)

    2013-01-14

    ... authority to charge and collect reasonable fees to cover the cost of performing official services. These fees also cover the costs associated with managing the program. After a financial review of GIPSA's Fees for Official Inspection and Weighing Services, including a comparison of the costs and revenues...

  1. 32 CFR 1900.13 - Fees for record services.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Fees for record services. 1900.13 Section 1900.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY PUBLIC...-printed (if available) Per 100 pages 5.00 Published (if available) Per item NTIS (2) Application of...

  2. 13 CFR 107.900 - Management fees for services provided to a Small Business by Licensee or its Associate.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Management fees for services... Licensees Management Services and Fees § 107.900 Management fees for services provided to a Small Business... apply to management services that you or your Associate provide to a Small Business that you do not...

  3. The impact of the fee-for-service reimbursement system on the ...

    African Journals Online (AJOL)

    The impact of the fee-for-service reimbursement system on the utilisation of health services: Part III. A comparison of caesarean section rates in white nulliparous women in the private and public sectors.

  4. Disease management for chronically ill beneficiaries in traditional Medicare.

    Science.gov (United States)

    Bott, David M; Kapp, Mary C; Johnson, Lorraine B; Magno, Linda M

    2009-01-01

    We summarize the Centers for Medicare and Medicaid Services' (CMS's) experience with disease management (DM) in fee-for-service Medicare. Since 1999, the CMS has conducted seven DM demonstrations involving some 300,000 beneficiaries in thirty-five programs. Programs include provider-based, third-party, and hybrid models. Reducing costs sufficient to cover program fees has proved particularly challenging. Final evaluations on twenty programs found three with evidence of quality improvement at or near budget-neutrality, net of fees. Interim monitoring covering at least twenty-one months on the remaining fifteen programs suggests that four are close to covering their fees. Characteristics of the traditional Medicare program present a challenge to these DM models.

  5. Is There Variation in Procedural Utilization for Lumbar Spine Disorders Between a Fee-for-Service and Salaried Healthcare System?

    Science.gov (United States)

    Schoenfeld, Andrew J; Makanji, Heeren; Jiang, Wei; Koehlmoos, Tracey; Bono, Christopher M; Haider, Adil H

    2017-12-01

    Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified. Patients were divided into two groups based on whether the surgery was performed in the fee-for-service setting (beneficiaries receive care at a civilian facility with expenses covered by TRICARE insurance) or at a Department of Defense facility (direct care). There were 28,344 patients in the entire study, 21,290 treated in fee-for-service and 7054 treated in Department of Defense facilities. Differences in the rates of fusion-based procedures, discectomy, and decompression between both healthcare settings were assessed using multinomial logistic regression to adjust for differences in case-mix and surgical indication. TRICARE beneficiaries treated for lumbar spinal disorders in the fee-for-service setting had higher odds of receiving interbody fusions (fee-for-service: 7267 of 21,290 [34%], direct care: 1539 of 7054 [22%], odds ratio [OR]: 1.25 [95% confidence interval 1.20-1.30], p fee-for-service setting irrespective of the underlying diagnosis. These results speak to the existence of provider inducement within the field of spine surgery. This reality portends poor performance for surgical practices and hospitals in Accountable Care Organizations and bundled payment programs in which provider inducement is allowed

  6. The impact of the fee-for-service reimbursement system on the ...

    African Journals Online (AJOL)

    three medical aid schemes in which providers are paid on a fee-far-service basis. ... The majority of health care providers in the private sector in. South Mrica are ... hospital, which bills the HMO for all services and accommo- dation expenses.

  7. 76 FR 76619 - International Mail: New Prices and Fee Changes-Mailing Services

    Science.gov (United States)

    2011-12-08

    ... fraction thereof)......... 0.80 Duplicate copy of PS Form 3606 1.15 * * * * * International Business Reply Service (382) [For each country that offers International Business Reply Service, revise the fees to read... POSTAL SERVICE 39 CFR Part 20 International Mail: New Prices and Fee Changes--Mailing Services...

  8. Some optics alternatives for the FFS

    International Nuclear Information System (INIS)

    Spencer, J.E.

    1984-01-01

    The evolution of the SLC Final Focus System (FFS) has been discussed in the SLC Red Books and various collider notes. Bulos and Brown and Murray were able to achieve small β's with large l 1 's (the distance between the IP and the effective field boundary of the first quad). However, all current solutions which are compatible with the known constraints of the total path length, aperture and spot size require high gradient, superconducting quads. Such quads cannot be expected to provide very good inherent field quality (i.e., without correction windings) but can be expected to be comparatively expensive to build and operate simply. The purpose of this note is to present a more general solution for the FFS telescope which is compatible with the known constraints of detectors, magnet types, available space and the ingoing and outgoing phase space expectations. While a number of different solutions were found, the ones presented provide comparable performance, simpler operation and lower costs. The gradients are sufficiently low to allow the use of conventional electromagnets, intrinsic or cryostable superconducting or rare earth permanent (REP) magnets or any arbitary combination of all of these magnet types. 8 references, 9 figures, 1 table

  9. 9 CFR 130.19 - User fees for other veterinary diagnostic services or materials provided at NVSL (excluding FADDL).

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for other veterinary... User fees for other veterinary diagnostic services or materials provided at NVSL (excluding FADDL). (a) User fees for other veterinary diagnostic services or materials available from NVSL (excluding FADDL...

  10. 78 FR 77571 - Fees for Certification Services and Approvals Performed Outside the United States; Technical...

    Science.gov (United States)

    2013-12-24

    ...-27043; Amdt. No. 61-132] RIN 2120-AI77 Fees for Certification Services and Approvals Performed Outside..., 2007 (72 FR 18556). In that rule, the FAA amended its regulations to revise the fee requirement for... direct final rule revising the fee requirement of 14 CFR 61.13 for the issuance of an airman certificate...

  11. 20 CFR 402.175 - Fees for providing information and related services for non-program purposes.

    Science.gov (United States)

    2010-04-01

    ... rendered. (d) Fee for copies of printed materials. When extra copies of printed material are available, the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Fees for providing information and related services for non-program purposes. 402.175 Section 402.175 Employees' Benefits SOCIAL SECURITY...

  12. Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data.

    Science.gov (United States)

    Lix, L M; Kuwornu, J P; Kroeker, K; Kephart, G; Sikdar, K C; Smith, M; Quan, H

    2016-03-01

    Changes in physician reimbursement policies may hinder the collection of billing claims in administrative data; this can result in biased estimates of disease prevalence and incidence. However, the magnitude of data loss is largely unknown. The purpose of this study was to estimate completeness of capture of disease cases for Manitoba physicians paid by fee-for-service (FFS) and non-fee-for-service (NFFS) methods. Manitoba's administrative data were used to identify a cohort (≥ 20 years) with a new diabetes medication between 1 April, 2007, and 31 March, 2009. Cohort members were classified by payment method of the prescribing physician (i.e. FFS vs. NFFS). The cohort was then classified as missing or not missing a diabetes diagnosis using physician claims and hospital records. Then, χ2 statistics were used to test for differences in the characteristics of the two groups. The cohort consisted of 12 394 individuals; 86.4% had a prescription for a diabetes medication from an FFS physician. A total of 1172 physicians (81.8% FFS) prescribed these medications for the cohort. Cohort members with a prescription from an FFS physician were older and more likely to reside in the urban Winnipeg health region than those with a prescription from a NFFS physician. A greater percentage of NFFS physicians' cases were missing a diabetes diagnosis (18.7%vs. 14.9% for FFS physicians). The results suggest minimal loss of physician claims associated with remuneration policies in Manitoba. This method of assessing data completeness could be applied to other chronic diseases and jurisdictions to estimate completeness.

  13. 13 CFR 108.900 - Fees for management services provided to a Small Business by a NMVC Company or its Associate.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Fees for management services... Small Businesses by NMVC Companies Management Services and Fees § 108.900 Fees for management services... management services that you or your Associate provide to a Small Business during the term of a Financing or...

  14. Medicare annual preventive care visits: use increased among fee-for-service patients, but many do not participate.

    Science.gov (United States)

    Chung, Sukyung; Lesser, Lenard I; Lauderdale, Diane S; Johns, Nicole E; Palaniappan, Latha P; Luft, Harold S

    2015-01-01

    Under the Affordable Care Act (ACA), Medicare coverage expanded in 2011 to fully cover annual preventive care visits. We assessed the impact of coverage expansion, using 2007-13 data from primary care patients of Medicare-eligible age at the Palo Alto Medical Foundation (204,388 patient-years), which serves people in four counties near San Francisco, California. We compared trends in preventive visits and recommended preventive services among Medicare fee-for-service and Medicare health maintenance organization (HMO) patients as well as non-Medicare patients ages 65-75 who were covered by private fee-for-service and private HMO plans. Among Medicare fee-for-service patients, the annual use of preventive visits rose from 1.4 percent before the implementation of the ACA to 27.5 percent afterward. This increase was significantly larger than was seen for patients in the other insurance groups. Nevertheless, rates of annual preventive care visit use among Medicare fee-for-service patients remained 10-20 percentage points lower than was the case for people with private coverage (43-44 percent) or those in a Medicare HMO (53 percent). ACA policy changes led to increased preventive service use by Medicare fee-for-service beneficiaries, which suggests that Medicare coverage expansion is an effective way to increase seniors' use of preventive services. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Impact of FFS on farmer's adoption of IPM options for tomato: A case study from the Gezira State, Sudan

    Directory of Open Access Journals (Sweden)

    Ahmed Mirghani Abdel Rahman

    2012-09-01

    Full Text Available In Sudan pests and diseases are the major problem of vegetables production. Tomato crop is considered as the most important vegetable crop in the country according to its economic and nutrition value. There are many pest and diseases retarding tomato production such as whitefly, American bollworm, TYLCV and powdery mildew. Therefore some IPM options for tomato and onion were validated in FFS in order to help farmers in controlling the most important pests and diseases. The main objective of this study was to determine the impact of FFS on farmer's adoption of IPM options for tomato in the Gezira State, Sudan. Field survey was used to collect data from three Farmer Field Schools in the Gezira State namely: Um Dagarsi, Hantoub and Faris in the 2009/2010 growing season. All FFS participants were used, i.e. 30 FFS- participants from each school. Equal number of non-FFS participants (90 was used for comparison, by using the simple random sampling technique. The collected data were statistically analyzed and interpreted using percentage, frequency distribution and chi-square test. The results showed that the FFS schools were positively affected farmer's adoption of IPM options for tomato. It can be concluded that the FFS approach is very efficient in the transfer of farm technology for vegetable farmers through their participation in various activities of FFS schools. Thus, FFS approach must become national policy, share authority of extension organizations in control and execution of FFS activities with farmer unions for more effective participations of clientele in all activities of the schools and More efforts should be exerted in distribution of all inputs to farmers with reasonable prices through various agricultural centres.

  16. 47 CFR 1.1153 - Schedule of annual regulatory fees and filing locations for mass media services.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Schedule of annual regulatory fees and filing locations for mass media services. 1.1153 Section 1.1153 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... of annual regulatory fees and filing locations for mass media services. Radio [AM and FM] (47 CFR...

  17. An Academic Library's Experience with Fee-Based Services.

    Science.gov (United States)

    Hornbeck, Julia W.

    1983-01-01

    Profile of fee-based information services offered by the Information Exchange Center of Georgia Institute of Technology notes history and background, document delivery to commercial clients and on-campus faculty, online and manual literature searching, staff, cost analysis, fee schedule, operating methods, client relations, marketing, and current…

  18. Fitness-for-service and defect tolerance assessment - solutions for cracked components to remain in service

    International Nuclear Information System (INIS)

    Nguyen, Ninh; De Beer, Eric

    2013-01-01

    This paper describes the application of the FFS/DTA methodology to assist plant asset managers in dealing with cracks that have been detected in in-service components, particularly those in the power, petrochemical, mining and transport industries. Several state-of-the-art structural integrity assessment proce-dures such as AS/NZS 3788, BS7910, R5-R6 and API-579-1/ ASME FFS-1 are described and discussed; and their application to practical situations using the principles of FFS/DTA is illustrated through a series of selected case studies. The usefulness, effectiveness and versatility of this fracture-mechanics based methodology for examination of in-service cracked components is amply demonstrated.

  19. 22 CFR 92.68 - Foreign Service fees and incidental costs in the taking of evidence.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service fees and incidental costs in... SERVICES NOTARIAL AND RELATED SERVICES Depositions and Letters Rogatory § 92.68 Foreign Service fees and incidental costs in the taking of evidence. The fees for the taking of evidence by officers of the Foreign...

  20. 42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

    Science.gov (United States)

    2010-10-01

    ... teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.172 Physician fee schedule payment for services of teaching physicians. (a...

  1. The impact of the fee-for-service reimbursement system on the ...

    African Journals Online (AJOL)

    In the local fee-for-service sector, 'third-party payment' means that both doctors and patients have little awareness of the direct costs of services. In other systems, such as HMOs, there is a strong cost consciousness on the part of practitioners. These differences in practice setting account in part for the different patterns of ...

  2. Cost analysis, cost recovery, marketing and fee-based services a guide for the health sciences librarian

    CERN Document Server

    Wood, M Sandra

    2013-01-01

    This outstanding volume won the 1986 Ida and George Eliot Prize--awarded by the Medical Library Association for the work judged most effective in furthering medical librarianship. Library professionals review the controversy behind fee-for-service programs and provide a rationale for incorporating them into contemporary library philosophies of service. Some fee-based services are necessary for survival in a society that treats information as a marketable commodity; this comprehensive book gives practical advice on cost analysis, cost recovery and marketing of reference services, and presents i

  3. Costs of health care across primary care models in Ontario.

    Science.gov (United States)

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-08-01

    The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the

  4. Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data

    Directory of Open Access Journals (Sweden)

    L. M. Lix

    2016-03-01

    Full Text Available Introduction: Changes in physician reimbursement policies may hinder the collection of billing claims in administrative data; this can result in biased estimates of disease prevalence and incidence. However, the magnitude of data loss is largely unknown. The purpose of this study was to estimate completeness of capture of disease cases for Manitoba physicians paid by fee-for-service (FFS and non-fee-for-service (NFFS methods. Methods: Manitoba’s administrative data were used to identify a cohort (Z 20 years with a new diabetes medication between 1 April, 2007, and 31 March, 2009. Cohort members were classified by payment method of the prescribing physician (i.e. FFS vs. NFFS. The cohort was then classified as missing or not missing a diabetes diagnosis using physician claims and hospital records. Then, w2 statistics were used to test for differences in the characteristics of the two groups. Results: The cohort consisted of 12 394 individuals; 86.4% had a prescription for a diabetes medication from an FFS physician. A total of 1172 physicians (81.8% FFS prescribed these medications for the cohort. Cohort members with a prescription from an FFS physician were older and more likely to reside in the urban Winnipeg health region than those with a prescription from a NFFS physician. A greater percentage of NFFS physicians’ cases were missing a diabetes diagnosis (18.7%vs. 14.9%for FFS physicians. Conclusion: The results suggest minimal loss of physician claims associated with remuneration policies in Manitoba. This method of assessing data completeness could be applied to other chronic diseases and jurisdictions to estimate completeness.

  5. Calculating the Fee-Based Services of Library Institutions: Theoretical Foundations and Practical Challenges

    Directory of Open Access Journals (Sweden)

    Sysіuk Svitlana V.

    2017-05-01

    Full Text Available The article is aimed at highlighting features of the provision of the fee-based services by library institutions, identifying problems related to the legal and regulatory framework for their calculation, and the methods to implement this. The objective of the study is to develop recommendations to improve the calculation of the fee-based library services. The theoretical foundations have been systematized, the need to develop a Provision for the procedure of the fee-based services by library institutions has been substantiated. Such a Provision would protect library institution from errors in fixing the fee for a paid service and would be an informational source of its explicability. The appropriateness of applying the market pricing law based on demand and supply has been substantiated. The development and improvement of accounting and calculation, taking into consideration both industry-specific and market-based conditions, would optimize the costs and revenues generated by the provision of the fee-based services. In addition, the complex combination of calculation leverages with development of the system of internal accounting together with use of its methodology – provides another equally efficient way of improving the efficiency of library institutions’ activity.

  6. Payment mechanism and GP self-selection: capitation versus fee for service.

    Science.gov (United States)

    Allard, Marie; Jelovac, Izabela; Léger, Pierre-Thomas

    2014-06-01

    This paper analyzes the consequences of allowing gatekeeping general practitioners (GPs) to select their payment mechanism. We model GPs' behavior under the most common payment schemes (capitation and fee for service) and when GPs can select one among them. Our analysis considers GP heterogeneity in terms of both ability and concern for their patients' health. We show that when the costs of wasteful referrals to costly specialized care are relatively high, fee for service payments are optimal to maximize the expected patients' health net of treatment costs. Conversely, when the losses associated with failed referrals of severely ill patients are relatively high, we show that either GPs' self-selection of a payment form or capitation is optimal. Last, we extend our analysis to endogenous effort and to competition among GPs. In both cases, we show that self-selection is never optimal.

  7. The impact of the fee-for-service reimbursement system on the ...

    African Journals Online (AJOL)

    1990-08-04

    Aug 4, 1990 ... The fee-for-service system, as it is structured in South. Africa, thus leads to ..... Conclusion. The design of an appropriate method of paying providers is ... Physician induced demand; an empirical analysis of the consumer ...

  8. Dental care for the elderly through a Capped-fee funding model: Optimising outcomes for primary government dental services.

    Science.gov (United States)

    Conquest, Jennifer H; Skinner, John; Kruger, Estie; Tennant, Marc

    2017-12-01

    The objectives of this study were to (i) compare a Capped Payment formula for adults, to the fee-for-service model and the New South Wales Government services payment model; (ii) identify the presenting oral health needs of a 65+ years of age cohort during the period January 2011 to March 2015. Australia faces an ageing population with the vast majority accessing free market dental care, whilst the poor access Government services. This cohort retains most of their dentition increasing demand on Government services. The analysis of New South Wales Government adult de-identified patients' record unit data was from 2011 to 2015, for the three payment models and undertaken in three stages; (i) development of the Capped Payment Model; (ii) evaluation of twenty (20) case studies of adults 65+ years of age; (iii) analyse the cost efficiency of the three payment models. This study found that the Government model was the most cost effective. The Capped-fee model performed less efficiently, particularly in the 75+ age group, with the fee-for-service model generally more costly. It was $2580 (85%) more costly for the 65-74 age cohort, and $4619 (66%) for the 75+ age cohort. Policy makers in partnership with Government and private service providers should seek to develop partnerships with Government, private services and universities, scope opportunities in applying a Capped-fee funding model, and one that helps address the oral needs of the elderly. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  9. Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities.

    Science.gov (United States)

    DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

    2017-07-01

    Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in

  10. 7 CFR 91.39 - Premium hourly fee rates for overtime and legal holiday service.

    Science.gov (United States)

    2010-01-01

    ... legal holidays or what constitutes overtime service at a particular Science and Technology laboratory is... Premium hourly fee rates for overtime and legal holiday service. (a) When analytical testing in a Science... overtime work. When analytical testing in a Science and Technology facility requires the services of...

  11. Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

    Science.gov (United States)

    Arunasalam, Mark; Paulson, Albert; Wallace, William

    2003-01-01

    Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

  12. Fee-for-service, Capitation and Health Provider Choice with Private Contracts

    NARCIS (Netherlands)

    Boone, J.

    2014-01-01

    Contracts between health insurers and providers are private; i.e. not public. By modelling this explicitly, we find the following. Insurers with bigger provider networks,pay higher fee-for-service rates to providers. This makes it more likely that a patient is treated and hence health care costs

  13. How to Buy a Medical Home? Policy Options and Practical Questions

    OpenAIRE

    Berenson, Robert A.; Rich, Eugene C.

    2010-01-01

    In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for “new” PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment re...

  14. 15 CFR 200.115 - Description of services and list of fees, incorporation by reference.

    Science.gov (United States)

    2010-01-01

    ... COMMERCE MEASUREMENT SERVICES POLICIES, SERVICES, PROCEDURES, AND FEES § 200.115 Description of services.... Department of Commerce. (4) Federal Depository Libraries. (c) Revisions of SP 250 will be issued from time to... concerning policies, procedures, services, and fees may be obtained by writing the Office of Measurement...

  15. Bundled payment and enhanced recovery after surgery.

    Science.gov (United States)

    Huang, Jeffrey

    2015-01-01

    Medicare's fee-for-service (FFS) payment model may contribute to unsustainable spending growth. Payers are turning to alternative payment methods. The leading alternative payment model to the FFS problem is bundled payment. The Centers for Medicare & Medicaid Services (CMS) is taking another step to improve healthcare quality at lower cost. The CMS's Center for Medicare and Medicaid Innovation developed four models of bundled payments and 48 discrete clinical condition episodes. Many surgical care procedures are included in the 48 different clinical condition episodes.

  16. 7 CFR 3550.153 - Fees.

    Science.gov (United States)

    2010-01-01

    ... DIRECT SINGLE FAMILY HOUSING LOANS AND GRANTS Regular Servicing § 3550.153 Fees. RHS may assess reasonable fees including a tax service fee, fees for late payments, and fees for checks returned for...

  17. Effects of user fee exemptions on the provision and use of maternal health services: a review of literature.

    Science.gov (United States)

    Hatt, Laurel E; Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M

    2013-12-01

    User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality

  18. 7 CFR 800.71 - Fees assessed by the Service.

    Science.gov (United States)

    2010-01-01

    ... representative plus an administrative fee per hundredweight) (CWT) 0.04 (iii) Lots sampled online during loading... service representative) 510.00 (5) Online customized data EGIS service: (i) One data file per week for 1...), 79a(1)), as amended by Pub. L. 97-35, 95 Stat. 371, 372) [45 FR 15810, Mar. 11, 1980; 45 FR 55119, Aug...

  19. Doing More for More: Unintended Consequences of Financial Incentives for Oncology Specialty Care.

    Science.gov (United States)

    O'Neil, Brock; Graves, Amy J; Barocas, Daniel A; Chang, Sam S; Penson, David F; Resnick, Matthew J

    2016-02-01

    Specialty care remains a significant contributor to health care spending but largely unaddressed in novel payment models aimed at promoting value-based delivery. Bladder cancer, chiefly managed by subspecialists, is among the most costly. In 2005, Centers for Medicare and Medicaid Services (CMS) dramatically increased physician payment for office-based interventions for bladder cancer to shift care from higher cost facilities, but the impact is unknown. This study evaluated the effect of financial incentives on patterns of fee-for-service (FFS) bladder cancer care. Data from a 5% sample of Medicare beneficiaries from 2001-2013 were evaluated using interrupted time-series analysis with segmented regression. Primary outcomes were the effects of CMS fee modifications on utilization and site of service for procedures associated with the diagnosis and treatment of bladder cancer. Rates of related bladder cancer procedures that were not affected by the fee change were concurrent controls. Finally, the effect of payment changes on both diagnostic yield and need for redundant procedures were studied. All statistical tests were two-sided. Utilization of clinic-based procedures increased by 644% (95% confidence interval [CI] = 584% to 704%) after the fee change, but without reciprocal decline in facility-based procedures. Procedures unaffected by the fee incentive remained unchanged throughout the study period. Diagnostic yield decreased by 17.0% (95% CI = 12.7% to 21.3%), and use of redundant office-based procedures increased by 76.0% (95% CI = 59% to 93%). Financial incentives in bladder cancer care have unintended and costly consequences in the current FFS environment. The observed price sensitivity is likely to remain a major issue in novel payment models failing to incorporate procedure-based specialty physicians. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Design and Use of a Full Flow Sampling System (FFS) for the Quantification of Methane Emissions.

    Science.gov (United States)

    Johnson, Derek R; Covington, April N; Clark, Nigel N

    2016-06-12

    The use of natural gas continues to grow with increased discovery and production of unconventional shale resources. At the same time, the natural gas industry faces continued scrutiny for methane emissions from across the supply chain, due to methane's relatively high global warming potential (25-84x that of carbon dioxide, according to the Energy Information Administration). Currently, a variety of techniques of varied uncertainties exists to measure or estimate methane emissions from components or facilities. Currently, only one commercial system is available for quantification of component level emissions and recent reports have highlighted its weaknesses. In order to improve accuracy and increase measurement flexibility, we have designed, developed, and implemented a novel full flow sampling system (FFS) for quantification of methane emissions and greenhouse gases based on transportation emissions measurement principles. The FFS is a modular system that consists of an explosive-proof blower(s), mass airflow sensor(s) (MAF), thermocouple, sample probe, constant volume sampling pump, laser based greenhouse gas sensor, data acquisition device, and analysis software. Dependent upon the blower and hose configuration employed, the current FFS is able to achieve a flow rate ranging from 40 to 1,500 standard cubic feet per minute (SCFM). Utilization of laser-based sensors mitigates interference from higher hydrocarbons (C2+). Co-measurement of water vapor allows for humidity correction. The system is portable, with multiple configurations for a variety of applications ranging from being carried by a person to being mounted in a hand drawn cart, on-road vehicle bed, or from the bed of utility terrain vehicles (UTVs). The FFS is able to quantify methane emission rates with a relative uncertainty of ± 4.4%. The FFS has proven, real world operation for the quantification of methane emissions occurring in conventional and remote facilities.

  1. Design and Use of a Full Flow Sampling System (FFS) for the Quantification of Methane Emissions

    Science.gov (United States)

    Johnson, Derek R.; Covington, April N.; Clark, Nigel N.

    2016-01-01

    The use of natural gas continues to grow with increased discovery and production of unconventional shale resources. At the same time, the natural gas industry faces continued scrutiny for methane emissions from across the supply chain, due to methane's relatively high global warming potential (25-84x that of carbon dioxide, according to the Energy Information Administration). Currently, a variety of techniques of varied uncertainties exists to measure or estimate methane emissions from components or facilities. Currently, only one commercial system is available for quantification of component level emissions and recent reports have highlighted its weaknesses. In order to improve accuracy and increase measurement flexibility, we have designed, developed, and implemented a novel full flow sampling system (FFS) for quantification of methane emissions and greenhouse gases based on transportation emissions measurement principles. The FFS is a modular system that consists of an explosive-proof blower(s), mass airflow sensor(s) (MAF), thermocouple, sample probe, constant volume sampling pump, laser based greenhouse gas sensor, data acquisition device, and analysis software. Dependent upon the blower and hose configuration employed, the current FFS is able to achieve a flow rate ranging from 40 to 1,500 standard cubic feet per minute (SCFM). Utilization of laser-based sensors mitigates interference from higher hydrocarbons (C2+). Co-measurement of water vapor allows for humidity correction. The system is portable, with multiple configurations for a variety of applications ranging from being carried by a person to being mounted in a hand drawn cart, on-road vehicle bed, or from the bed of utility terrain vehicles (UTVs). The FFS is able to quantify methane emission rates with a relative uncertainty of ± 4.4%. The FFS has proven, real world operation for the quantification of methane emissions occurring in conventional and remote facilities. PMID:27341646

  2. 15 CFR 230.7 - Description of services and list of fees, incorporation by reference.

    Science.gov (United States)

    2010-01-01

    ... STANDARD REFERENCE MATERIALS STANDARD REFERENCE MATERIALS Description of Services and List of Fees § 230.7 Description of services and list of fees, incorporation by reference. (a) The text of NIST Special Publication... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Description of services and list of...

  3. Medicaid Expenditures for Fee-for-Service Enrollees with Behavioral Diagnoses: Findings from a 50 State Claims Analysis.

    Science.gov (United States)

    Ward, Martha C; Lally, Cathy; Druss, Benjamin G

    2017-01-01

    Medicaid is an important funder of care for individuals with behavioral (psychiatric and/or substance use) diagnoses, and expenditures will likely increase with expansion of services under the Affordable Care Act. This study provides national estimates of Medicaid expenditures using a comprehensive sample of fee-for-service Medicaid enrollees with behavioral diagnoses. Data for analysis came from 2003 to 2004 Medicaid Analytic eXtract (MAX) files for 50 states and the District of Columbia. Individuals with behavioral diagnoses had high rates of chronic medical comorbidities, and expenditures for medical (non-behavioral) diagnoses accounted for 74 % of their health care expenditures. Total Medicaid expenditure was approximately 15 billion dollars (equivalent to 18.91 billion in 2016 dollars) for individuals with any behavioral diagnosis. Medicaid fee-for-service beneficiaries with behavioral diagnoses have a high treated prevalence of individual medical comorbid conditions, and the majority of health care expenditures in these individuals are for medical, rather than behavioral health, services.

  4. Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999-2008.

    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

  5. Exploring Massachusetts Health Care Reform Impact on Fee-for-Service-Funded Substance Use Disorder Treatment Providers.

    Science.gov (United States)

    Fields, Dail; Pruett, Jana; Roman, Paul M

    2015-01-01

    The Affordable Care Act (ACA) is forecast to increase the demand for and utilization of substance use disorder (SUD) treatment. Massachusetts implemented health reforms similar to the ACA in 2006-2007 that included expanding coverage for SUD treatment. This study explored the impact of Massachusetts health reforms from 2007 to 2010 on SUD treatment providers in Massachusetts, who relied on fee-for-service billings for more than 50% of their revenue. The changes across treatment facilities located in Massachusetts were compared to changes in other similar fee-for-service-funded SUD treatment providers in Northeast states bordering Massachusetts and in all other states across the US. From 2007-2010, the percentage changes for Massachusetts based providers were significantly different from the changes among providers located in the rest of the US for admissions, outpatient census, average weeks of outpatient treatment, residential/in-patient census, detoxification census, length of average inpatient and outpatient stays, and provision of medication-assisted treatment. Contrary to previous studies of publicly funded treatment providers, the results of this exploratory study of providers dependent on fee-for-service revenues were consistent with some predictions for the overall effects of the ACA.

  6. Higher fees paid to US physicians drive higher spending for physician services compared to other countries.

    Science.gov (United States)

    Laugesen, Miriam J; Glied, Sherry A

    2011-09-01

    Higher health care prices in the United States are a key reason that the nation's health spending is so much higher than that of other countries. Our study compared physicians' fees paid by public and private payers for primary care office visits and hip replacements in Australia, Canada, France, Germany, the United Kingdom, and the United States. We also compared physicians' incomes net of practice expenses, differences in financing the cost of medical education, and the relative contribution of payments per physician and of physician supply in the countries' national spending on physician services. Public and private payers paid somewhat higher fees to US primary care physicians for office visits (27 percent more for public, 70 percent more for private) and much higher fees to orthopedic physicians for hip replacements (70 percent more for public, 120 percent more for private) than public and private payers paid these physicians' counterparts in other countries. US primary care and orthopedic physicians also earned higher incomes ($186,582 and $442,450, respectively) than their foreign counterparts. We conclude that the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher US spending, particularly in orthopedics.

  7. 32 CFR 1700.6 - Fees for records services.

    Science.gov (United States)

    2010-07-01

    ... INTELLIGENCE PROCEDURES FOR DISCLOSURE OF RECORDS PURSUANT TO THE FREEDOM OF INFORMATION ACT § 1700.6 Fees for... for fee waivers or reductions may be appealed to the Director of the Intelligence Staff, or his... Photocopy (standard or legal) Per page .10 Microfiche Per frame .20 Pre-printed (if available) Per 100 pages...

  8. Price adjustment for traditional Chinese medicine procedures: Based on a standardized value parity model.

    Science.gov (United States)

    Wang, Haiyin; Jin, Chunlin; Jiang, Qingwu

    2017-11-20

    Traditional Chinese medicine (TCM) is an important part of China's medical system. Due to the prolonged low price of TCM procedures and the lack of an effective mechanism for dynamic price adjustment, the development of TCM has markedly lagged behind Western medicine. The World Health Organization (WHO) has emphasized the need to enhance the development of alternative and traditional medicine when creating national health care systems. The establishment of scientific and appropriate mechanisms to adjust the price of medical procedures in TCM is crucial to promoting the development of TCM. This study has examined incorporating value indicators and data on basic manpower expended, time spent, technical difficulty, and the degree of risk in the latest standards for the price of medical procedures in China, and this study also offers a price adjustment model with the relative price ratio as a key index. This study examined 144 TCM procedures and found that prices of TCM procedures were mainly based on the value of medical care provided; on average, medical care provided accounted for 89% of the price. Current price levels were generally low and the current price accounted for 56% of the standardized value of a procedure, on average. Current price levels accounted for a markedly lower standardized value of acupuncture, moxibustion, special treatment with TCM, and comprehensive TCM procedures. This study selected a total of 79 procedures and adjusted them by priority. The relationship between the price of TCM procedures and the suggested price was significantly optimized (p based on a standardized value parity model is a scientific and suitable method of price adjustment that can serve as a reference for other provinces and municipalities in China and other countries and regions that mainly have fee-for-service (FFS) medical care.

  9. Costs of health care across primary care models in Ontario

    OpenAIRE

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-01-01

    Background The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients? primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Methods Utilization data for a one year period was measured using administrative databases for a 1...

  10. Department of Energy report on fee for spent nuclear fuel storage and disposal services

    International Nuclear Information System (INIS)

    1980-10-01

    Since the July 1978 publication of an estimated fee for storage and disposal, several changes have occurred in the parameters which impact the spent fuel fee. DOE has mounted a diversified program of geologic investigations that will include locating and characterizing a number of potential repository sites in a variety of different geologic environments with diverse rock types. As a result, the earliest operation date of a geologic repository is now forecast for 1997. Finally, expanded spent fuel storage capabilities at reactors have reduced the projected quantities of fuel to be stored and disposed of. The current estimates for storage and disposal are presented. This fee has been developed from DOE program information on spent fuel storage requirements, facility availability, facility cost estimates, and research and development programs. The discounted cash flow technique has used the most recent estimates of cost of borrowing by the Federal Government. This estimate has also been used in calculating the Federal charge for uranium enrichment services. A prepayment of a percentage of the storage portion of the fee is assumed to be required 5 years before spent fuel delivery. These funds and the anticipated $300 million in US Treasury borrowing authority should be sufficient to finance the acquisition of storage facilities. Similarly, a prepayment of a percentage of the disposal portion would be collected at the same time and would be used to offset disposal research and development expenditures. The balance of the storage and disposal fees will be collected upon spent fuel delivery. If disposal costs are different from what was estimated, there will be a final adjustment of the disposal portion of the fee when the spent fuel is shipped from the AFR for permanent disposal. Based on current spent fuel storage requirements, at least a 30 percent prepayment of the fee will be required

  11. Home Health Care for California's Injured Workers: Options for Implementing a Fee Schedule.

    Science.gov (United States)

    Wynn, Barbara O; Boustead, Anne

    2015-07-15

    The California Department of Industrial Relations/Division of Worker's Compensation asked RAND to provide technical assistance in developing a fee schedule for home health services provided to injured workers. The fee schedule needs to address the full spectrum of home health services ranging from skilled nursing and therapy services to unskilled personal care or chore services that may be provided by family members. RAND researchers consulted with stakeholders in the California workers' compensation system to outline issues the fee schedule should address, reviewed home health fee schedules used by other payers, and conducted interviews with WC administrators from other jurisdictions to elicit their experiences. California stakeholders identified unskilled attendant services as most problematic in determining need and payment rates, particularly services furnished by family members. RAND researchers concentrated on fee schedule options that would result in a single fee schedule covering the full range of home health care services furnished to injured workers and made three sets of recommendations. The first set pertains to obtaining additional information that would highlight the policy issues likely to occur with the implementation of the fee schedule and alternatives for assessing an injured worker's home health care needs. Another approach conforms most closely with the Labor Code requirements. It would integrate the fee schedules used by Medicare, In-Home Health Supportive Services, and the federal Office of Workers' Compensation. The third approach would base the home health fee schedule on rules used by the federal Office of Workers' Compensation.

  12. 76 FR 78950 - FBI Criminal Justice Information Services Division; Revised User Fee Schedule

    Science.gov (United States)

    2011-12-20

    ... amounts for volunteers, as explained at 75 FR 18752, and Centralized Billing Service Providers (CBSPs), as... Information Services Division; Revised User Fee Schedule AGENCY: Federal Bureau of Investigation (FBI.... Enourato, Section Chief, Resources Management Section, Criminal Justice Information Services Division, FBI...

  13. Michigan's fee-for-value physician incentive program reduces spending and improves quality in primary care.

    Science.gov (United States)

    Lemak, Christy Harris; Nahra, Tammie A; Cohen, Genna R; Erb, Natalie D; Paustian, Michael L; Share, David; Hirth, Richard A

    2015-04-01

    As policy makers and others seek to reduce health care cost growth while improving health care quality, one approach gaining momentum is fee-for-value reimbursement. This payment strategy maintains the traditional fee-for-service arrangement but includes quality and spending incentives. We examined Blue Cross Blue Shield of Michigan's Physician Group Incentive Program, which uses a fee-for-value approach focused on primary care physicians. We analyzed the program's impact on quality and spending from 2008 to 2011 for over three million beneficiaries in over 11,000 physician practices. Participation in the incentive program was associated with approximately 1.1 percent lower total spending for adults (5.1 percent lower for children) and the same or improved performance on eleven of fourteen quality measures over time. Our findings contribute to the growing body of evidence about the potential effectiveness of models that align payment with cost and quality performance, and they demonstrate that it is possible to transform reimbursement within a fee-for-service framework to encourage and incentivize physicians to provide high-quality care, while also reducing costs. Project HOPE—The People-to-People Health Foundation, Inc.

  14. 20 CFR 410.686b - Fee for services performed for an individual before the Social Security Administration.

    Science.gov (United States)

    2010-04-01

    ... Representation of Parties § 410.686b Fee for services performed for an individual before the Social Security... person or in writing; (ii) There was a death or serious illness in the individual's family; (iii...

  15. Timely Health Service Utilization of Older Foster Youth by Insurance Type.

    Science.gov (United States)

    Day, Angelique; Curtis, Amy; Paul, Rajib; Allotey, Prince Addo; Crosby, Shantel

    2016-01-01

    To evaluate the impact of a policy change for older foster care youth from a fee-for-service (FFS) Medicaid program to health maintenance organization (HMO) providers on the timeliness of first well-child visits (health care physicals). A three-year retrospective study using linked administrative data collected by the Michigan Departments of Human Services and Community Health of 1,657 youth, ages 10-20 years, who were in foster care during the 2009-2012 study period was used to examine the odds of receiving a timely well-child visit within the recommended 30-day time frame controlling for race, age, days from foster care entry to Medicaid enrollment, and number of foster care placements. Youth entering foster care during the HMO period were more likely to receive a timely well-child visit than those in the FFS period (odds ratio, 2.46; 95% confidence interval, 1.84-3.29; p foster care during the FFS period to 29 days for the HMO period. Among the other factors examined, more than 14 days to Medicaid enrollment, being non-Hispanic black and having five or more placements were negatively associated with receipt of a timely first well-child visit. Those youth who entered foster care during the HMO period had significantly greater odds of receiving a timely first well-child visit; however, disparities in access to preventive health care remain a concern for minority foster care youth, those who experience delayed Medicaid enrollment and those who experienced multiple placements. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. 48 CFR 1852.216-76 - Award Fee for service contracts.

    Science.gov (United States)

    2010-10-01

    ... payments exceed the final evaluation score, the Contractor will either credit the next payment voucher for... [insert payment office] will make payment based on [Insert method of authorizing award fee payment, e.g... fee has been paid, the Contracting Officer may direct the withholding of further payment of award fee...

  17. Early results of pediatric appendicitis after adoption of diagnosis-related group-based payment system in South Korea

    Directory of Open Access Journals (Sweden)

    Moon SB

    2015-11-01

    Full Text Available Suk-Bae MoonDepartment of Surgery, Kangwon National University Hospital, Kangwon National School of Medicine, Kangwon National University, Chuncheon, South KoreaPurpose: As an alternative to the existing fee-for-service (FFS system, a diagnosis-related group (DRG-based payment system has been suggested. The aim of this study was to investigate the early results of pediatric appendicitis treatment under the DRG system, focusing on health care expenditure and quality of health care services.Patients and methods: The medical records of 60 patients, 30 patients before (FFS group, and 30 patients after adoption of the DRG system (DRG, were reviewed retrospectively.Results: Mean hospital stay was shortened, but the complication and readmission rates did not worsen in the DRG. Overall health care expenditure and self-payment decreased from Korean Won (KRW 2,499,935 and KRW 985,540, respectively, in the FFS group to KRW 2,386,552 and KRW 492,920, respectively, in the DRG. The insurer’s payment increased from KRW 1,514,395 in the FFS group to KRW 1,893,632 in the DRG. For patients in the DRG, calculation by the DRG system yielded greater overall expenditure (KRW 2,020,209 vs KRW 2,386,552 but lower self-payment (KRW 577,803 vs KRW 492,920 than calculation by the FFS system.Conclusion: The DRG system worked well in pediatric patients with acute appendicitis in terms of cost-effectiveness over the short term. The gradual burden on the national health insurance fund should be taken into consideration.Keywords: appendicitis, child, fee-for-service plans, diagnosis-related groups, quality of health care, health care expenditures

  18. Evaluation of Medicare Health Support chronic disease pilot program.

    Science.gov (United States)

    Cromwell, Jerry; McCall, Nancy; Burton, Joe

    2008-01-01

    The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries. In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings. Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

  19. 42 CFR 4.7 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Fees. 4.7 Section 4.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.7 Fees. The Director may charge reasonable fees for any service provided by the Library under this part...

  20. 42 CFR 415.170 - Conditions for payment on a fee schedule basis for physician services in a teaching setting.

    Science.gov (United States)

    2010-10-01

    ... physician services in a teaching setting. 415.170 Section 415.170 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.170 Conditions for payment on a fee schedule basis...

  1. In Madagascar, Use Of Health Care Services Increased When Fees Were Removed: Lessons For Universal Health Coverage.

    Science.gov (United States)

    Garchitorena, Andres; Miller, Ann C; Cordier, Laura F; Ramananjato, Ranto; Rabeza, Victor R; Murray, Megan; Cripps, Amber; Hall, Laura; Farmer, Paul; Rich, Michael; Orlan, Arthur Velo; Rabemampionona, Alexandre; Rakotozafy, Germain; Randriantsimaniry, Damoela; Gikic, Djordje; Bonds, Matthew H

    2017-08-01

    Despite overwhelming burdens of disease, health care access in most developing countries is extremely low. As governments work toward achieving universal health coverage, evidence on appropriate interventions to expand access in rural populations is critical for informing policies. Using a combination of population and health system data, we evaluated the impact of two pilot fee exemption interventions in a rural area of Madagascar. We found that fewer than one-third of people in need of health care accessed treatment when point-of-service fees were in place. However, when fee exemptions were introduced for targeted medicines and services, the use of health care increased by 65 percent for all patients, 52 percent for children under age five, and over 25 percent for maternity consultations. These effects were sustained at an average direct cost of US$0.60 per patient. The pilot interventions can become a key element of universal health care in Madagascar with the support of external donors. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Linkage of a Population-Based Cohort With Primary Data Collection to Medicare Claims: The Reasons for Geographic and Racial Differences in Stroke Study.

    Science.gov (United States)

    Xie, Fenglong; Colantonio, Lisandro D; Curtis, Jeffrey R; Safford, Monika M; Levitan, Emily B; Howard, George; Muntner, Paul

    2016-10-01

    We described the linkage of primary data with administrative claims using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and Medicare. REGARDS study data were linked with Medicare claims by use of Social Security numbers. We compared REGARDS participants by Medicare linkage status, having fee-for-service (FFS) coverage or not, and with a 5% sample of Medicare beneficiaries who had FFS coverage in 2005, overall, by age (45-64 and ≥65 years), and by race. Among REGARDS participants who were ≥65 years of age, 80% had data linked to Medicare on their study-visit date (64% with FFS coverage). No differences except race and sex were present between REGARDS participants without Medicare linkage and those with data linked to Medicare with and without FFS coverage. After the age-sex-race adjustment, comorbid conditions and health-care utilization were similar for those with FFS coverage in the REGARDS study and the 5% sample of Medicare beneficiaries. Among REGARDS participants aged 45-64 years, 11% had FFS coverage on their study-visit date. In this age group, differences were present between participants with and without FFS coverage and the Medicare 5% sample with FFS coverage. In conclusion, REGARDS participants aged ≥65 years with FFS coverage are representative of the study cohort and the US population aged ≥65 years with FFS coverage. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. 7 CFR 28.122 - Fee for practical classing examination.

    Science.gov (United States)

    2010-01-01

    ... 28.122 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... Standards Act Fees and Costs § 28.122 Fee for practical classing examination. The fee for the practical...

  4. Author fees for online publication

    Science.gov (United States)

    Like the journals themselves, AGU publication fees have been restructured to accommodate the new online, publish-as-ready approach. The new fee structure is based on authors' providing electronic files of their text and art in acceptable formats (Word, WordPerfect, and LaTeX for text, and .eps or .tif for digital art). However, if you are unable to supply electronic files, you can opt for a higher-charge, full-service route in which AGU will create electronic files from hard copy. All authors for AGU journals are expected to support the journal archive through fees based on number as well as size of article files. The revenue from these fees is set aside for the "Perpetual Care Trust Fund," which will support the migration of the journal archive to new formats or media as technology changes. For several journals, excess length fees remain in place to encourage submission of concisely written articles. During this first transition year, most author fees are based on the number of print page equivalents (pdf) in an article; in the future, however, charges are expected to be associated with file size. The specific fees for each journal are posted on AGU's Web site under Publications-Tools for Authors.

  5. The introduction of service fees by travel agencies: A case study in Bloemfontein

    Directory of Open Access Journals (Sweden)

    AJ Strydom

    2004-07-01

    Full Text Available Travel agencies normally receive commission from airlines, tour operators, accommodation establishments and car hire companies in exchange for bookings. Global trends in this commission structure indicate dramatic changes, especially regarding airlines. The majority of them have introduced a system of commission capping, whereby commission paid to travel agencies has been reduced and expectations are that it might even become zero in future. Against this background, travel agencies are considering introducing a system of service fees. It implies that clients will have to pay for services such as the preparation of quotations for national and/or international holidays or business trips. This paper discusses the results of research that was undertaken amongst the middle to higher income classes of the residents of Bloemfontein regarding the introduction of service fees by travel agencies.

  6. 77 FR 18704 - Fees

    Science.gov (United States)

    2012-03-28

    ... LIBRARY OF CONGRESS Copyright Office 37 CFR Part 201 [Docket No. RM 2011-9] Fees AGENCY: Copyright... is publishing a final rule establishing an additional fee for a particular service: Travel expenses... Copyright Office's schedule of fees by adding a fee for travel expenses in connection with participation by...

  7. 77 FR 21684 - User Fees for 2012 Crop Cotton Classification Services to Growers

    Science.gov (United States)

    2012-04-11

    ... while meeting minimum reserve requirements set by the Agricultural Marketing Service, which require... proposed fee and the existing reserve are sufficient to cover the costs of providing classification... requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612), AMS has considered the...

  8. 78 FR 18898 - User Fees for 2013 Crop Cotton Classification Services to Growers

    Science.gov (United States)

    2013-03-28

    ... expected to meet minimum reserve requirements set by the Agricultural Marketing Service, which require... proposed fee and the existing reserve are sufficient to cover the costs of providing classification... requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612), AMS has considered the...

  9. Federal fees and contracts for storage and disposal of spent LWR fuel

    International Nuclear Information System (INIS)

    Clark, H.J.

    1979-01-01

    The methodology for establishing a fee for federal spent fuel storage and disposal services is explained along with a presentation of the cost centers and cost data used to calculate the fee. Results of the initial fee calculation and the attendant sensitivity studies are also reviewed. The current status of the fee update is presented. The content of the proposed contract for federal services is briefly reviewed

  10. 37 CFR 384.3 - Royalty fees for ephemeral recordings.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fees for ephemeral... BUSINESS ESTABLISHMENT SERVICES § 384.3 Royalty fees for ephemeral recordings. (a) Basic royalty rate. For... minimum fees shall be nonrefundable, but shall be fully creditable to royalty payments due under paragraph...

  11. 75 FR 58961 - U.S. Citizenship and Immigration Services Fee Schedule

    Science.gov (United States)

    2010-09-24

    .... Service Improvement and Fees. 2. Multiple Biometric Data Requests. 3. Transformation. 4. Increases... Reform Act. C. Small Business Regulatory Enforcement Fairness Act. D. Executive Order 12866. E. Executive...

  12. Fees and Therapy: Clarification of the Relationship of Payment Source to Service Utilization.

    Science.gov (United States)

    DeMuth, Nancy Marwick; Kamis, Edna

    1980-01-01

    Fee, sociodemographic, and provider characteristics contributed little unique variance to explaining the volume of services used. Clinical considerations were, as predicted, most important in explaining service utilization. Implications for national health insurance are also discussed, since public third-party reimbursement did not lead to…

  13. 7 CFR 4290.900 - Management fees for services provided to an Enterprise by RBIC or its Associate.

    Science.gov (United States)

    2010-01-01

    ... AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM Financing of Enterprises by RBICs Limitations on Disposition of Assets § 4290.900 Management fees for services provided to an Enterprise by RBIC or... management services that you or your Associate provide to an Enterprise that you do not finance. (b) The...

  14. 19 CFR 24.22 - Fees for certain services.

    Science.gov (United States)

    2010-04-01

    ... arriving as passengers on board a commercial vessel traveling only between ports that are within the... passenger space and issue non-carrier tickets or travel documents must collect the fee in the same manner as... commercial vessels—(1) Vessels of 100 net tons or more—(i) Fee. Except as provided in paragraphs (b)(2) and...

  15. Social impacts of IPM-FFS on urban and peri-urban vegetable ...

    African Journals Online (AJOL)

    social relations, social empowerment and sharing of IPM information, and sustainability and institutionalization of IPM) for vegetable producers in an integrated pest management (IPM) project using farmer field schools (FFS) in Cotonou.

  16. 25 CFR 170.916 - May tribes impose taxes or fees on those performing IRR Program services?

    Science.gov (United States)

    2010-04-01

    ... Indian Preference § 170.916 May tribes impose taxes or fees on those performing IRR Program services? Yes... 25 Indians 1 2010-04-01 2010-04-01 false May tribes impose taxes or fees on those performing IRR Program services? 170.916 Section 170.916 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR...

  17. The effect of health payment reforms on cost containment in Taiwan hospitals: the agency theory perspective.

    Science.gov (United States)

    Chang, Li

    2011-01-01

    This study aims to determine whether the Taiwanese government's implementation of new health care payment reforms (the National Health Insurance with fee-for-service (NHI-FFS) and global budget (NHI-GB)) has resulted in better cost containment. Also, the question arises under the agency theory whether the monitoring system is effective in reducing the risk of information asymmetry. This study uses panel data analysis with fixed effects model to investigate changes in cost containment at Taipei municipal hospitals before and after adopting reforms from 1989 to 2004. The results show that the monitoring system does not reduce information asymmetry to improve cost containment under the NHI-FFS. In addition, after adopting the NHI-GB system, health care costs are controlled based on an improved monitoring system in the policymaker's point of view. This may suggest that the NHI's fee-for-services system actually causes health care resource waste. The GB may solve the problems of controlling health care costs only on the macro side.

  18. Mr. Ngao's proposal: introducing client fees. Case scenarios for training and group discussion.

    Science.gov (United States)

    1992-01-01

    In this supplement to the issue of "The Family Planning Manager" devoted to fees, a hypothetical case scenario is presented to illustrate the introduction of client fees to a family planning program. Managers are instructed to prepare a plan that includes the necessary information for deciding what to charge for, who to charge, and how much to charge; identifies the administrative changes involved in charging fees; and outlines steps that clinic managers should take before introducing client fees. Decisions should be based on factors such as the objectives of fee charging, client willingness and ability to pay, client perception of the quality of current services, services for which clients would be most willing to pay, estimated cost of providing services, and the cost of new administrative procedures inherent in a fee-for-service approach. Administrative procedures for collecting, handling, and accounting for cash; reporting income and expenses; and implementing a fair and flexible system of waivers and exemptions must be defined. Clients should be informed well in advance of fee introduction, and staff trained to manage potential client complaints.

  19. 75 FR 69851 - U.S. Citizenship and Immigration Services Fee Schedule; Correction

    Science.gov (United States)

    2010-11-16

    ...] RIN 1615-AB80 U.S. Citizenship and Immigration Services Fee Schedule; Correction AGENCY: U.S. Citizenship and Immigration Services, DHS. ACTION: Final rule; correction. SUMMARY: The Department of Homeland Security corrects an inadvertent error in the amendatory language of the final rule U.S. Citizenship and...

  20. Financing Public Service Broadcasting

    DEFF Research Database (Denmark)

    Berg, Christian Edelvold; Lund, Anker Brink

    2012-01-01

    Broadcasting (PSB) financing regimes in Europe, concluding that Denmark, Finland, Iceland, Norway, and Sweden may still be considered conventional, licence fee PSB countries, but with some interesting differences in relation to competitive and market oriented alternatives of resource provision......Recently several European countries have abolished the traditional public service licence fee system, replacing it with direct public funding. But except for Iceland, the Nordic countries have not followed suit. The article discusses this development within a comparative framework of Public Service...

  1. 42 CFR 1008.31 - OIG fees for the cost of advisory opinions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false OIG fees for the cost of advisory opinions. 1008.31... SERVICES OIG AUTHORITIES ADVISORY OPINIONS BY THE OIG Advisory Opinion Fees § 1008.31 OIG fees for the cost of advisory opinions. (a) Responsibility for fees. The requestor is responsible for paying a fee...

  2. Trends in Medicare Service Volume for Cataract Surgery and the Impact of the Medicare Physician Fee Schedule.

    Science.gov (United States)

    Gong, Dan; Jun, Lin; Tsai, James C

    2017-08-01

    To calculate the associations between Medicare payment and service volume for complex and noncomplex cataract surgeries. The 2005-2009 CMS Part B National Summary Data Files, CMS Part B Carrier Summary Data Files, and the Medicare Physician Fee Schedule. Conducting a retrospective, longitudinal analysis using a fixed-effects model of Medicare Part B carriers representing all 50 states and the District of Columbia from 2005 to 2009, we calculated the Medicare payment-service volume elasticities for noncomplex (CPT 66984) and complex (CPT 66982) cataract surgeries. Service volume data were extracted from the CMS Part B National Summary and Carrier Summary Data Files. Payment data were extracted from the Medicare Physician Fee Schedule. From 2005 to 2009, the proportion of total cataract services billed as complex increased from 3.2 to 6.7 percent. Every 1 percent decrease in Medicare payment was associated with a nonsignificant change in noncomplex cataract service volume (elasticity = 0.15, 95 percent CI [-0.09, 0.38]) but a statistically significant increase in complex cataract service volume (elasticity = -1.12, 95 percent CI [-1.60, -0.63]). Reduced Medicare payment was associated with a significant increase in complex cataract service volume but not in noncomplex cataract service volume, resulting in a shift toward performing a greater proportion of complex cataract surgeries from 2005 to 2009. © Health Research and Educational Trust.

  3. 7 CFR 205.640 - Fees and other charges for accreditation.

    Science.gov (United States)

    2010-01-01

    ... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Administrative Fees § 205.640 Fees and other charges for accreditation. Fees and other charges equal as nearly as may be to the cost of the...

  4. Clinical Laboratory Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...

  5. 76 FR 6381 - Fee-Generating Cases

    Science.gov (United States)

    2011-02-04

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services...) proposes to amend the Legal Services Corporation's regulation on fee-generating cases to clarify that it... intended. LSC's regulation at 45 CFR part 1609, Fee- Generating Cases, is based on Sec. 1007(b)(1) of the...

  6. 7 CFR 58.39 - Fees for holiday or other nonworktime.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees for holiday or other nonworktime. 58.39 Section... Dairy Products Fees and Charges § 58.39 Fees for holiday or other nonworktime. If an applicant requests that inspection or grading service be performed on a holiday, Saturday, or Sunday or in excess of each...

  7. The effectiveness of Farmer Field School (FFS) training on farmers ...

    African Journals Online (AJOL)

    The effectiveness of Farmer Field School (FFS) training on farmers competence in Integrated Pest Management (IPM) of Cocoa in Ondo state, Nigeria. ... of years of cocoa farming (b=1.785) and participation in Farmer Field School training (b ...

  8. 5 CFR 1204.12 - Fees.

    Science.gov (United States)

    2010-01-01

    .... The Board will charge the requester fees for services provided in processing requests for information... limits for making a decision on the new or pending request. (e) Fee schedule. (1) Fees for document... of the information is not primarily in the commercial interest of the requester. This decision will...

  9. 78 FR 57445 - Charging Standard Administrative Fees for Nonprogram-Related Information

    Science.gov (United States)

    2013-09-18

    ... the Federal Register a schedule of standardized administrative fees we charge to recover the full cost... fee schedule is outdated and incongruent with the agency's current costs for this service. New... new standard fee on our most recent cost calculations for supplying this information and the standard...

  10. Fee Schedules - General Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers-suppliers. This comprehensive listing of fee maximums is used to...

  11. 28 CFR 549.73 - Appealing the fee.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Appealing the fee. 549.73 Section 549.73 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Fees for Health Care Services § 549.73 Appealing the fee. You may seek review of issues related to...

  12. Developing an equitable fee structure for gas processing services: JP-90 and beyond

    International Nuclear Information System (INIS)

    Kingsbury, J.D.; Moller, I.

    1996-01-01

    The Joint Industry Gas Processing Fee Task Force Report, JP-90, was designed to promote negotiation of gas processing fees that are based on principles of equity and fairness for both natural gas producers and processors. Another purpose of the JP-90 was to develop an effective dispute resolution process for use in those cases where negotiations have failed. At its inception, JP-90 was the only guideline for unregulated fee practices in the oil and gas sector in North America. Today PJVA-95, the revised version of JP-90, is in its final draft. It addresses the changing focus of the gas processing business, and changing regulatory roles in Alberta and British Columbia. A number of other fee mechanisms also have been described, such as the jumping pound formula, fixed fees, fees based on price, wellhead purchases, and others. These mechanisms developed over time to allow the processor and the producer to share the price risk. The changing role of regulatory agencies in fee dispute resolution was also discussed briefly

  13. Development of residual stress analysis procedure for fitness-for-service assessment of welded structure

    International Nuclear Information System (INIS)

    Kim, Jong Sung; Jin, Tae Eun; Dong, P.; Prager, M.

    2003-01-01

    In this study, a state of art review of existing residual stress analysis techniques and representative solutions is presented in order to develop the residual stress analysis procedure for Fitness-For-Service(FFS) assessment of welded structure. Critical issues associated with existing residual stress solutions and their treatments in performing FFS are discussed. It should be recognized that detailed residual stress evolution is an extremely complicated phenomenon that typically involves material-specific thermomechanical/metallurgical response, welding process physics, and structural interactions within a component being welded. As a result, computational procedures can vary significantly from highly complicated numerical techniques intended only to elucidate a small part of the process physics to cost-effective procedures that are deemed adequate for capturing some of the important features in a final residual stress distribution. Residual stress analysis procedure for FFS purposes belongs to the latter category. With this in mind, both residual stress analysis techniques and their adequacy for FFS are assessed based on both literature data and analyses performed in this investigation

  14. 78 FR 53726 - Notice of New Fee Site

    Science.gov (United States)

    2013-08-30

    ... DEPARTMENT OF AGRICULTURE Forest Service Notice of New Fee Site AGENCY: Monongahela National Forest, USDA Forest Service. ACTION: Notice of New Fee Site. SUMMARY: The Monongahela National Forest is... amenities. Fees for overnight use will be used for the continued operation and maintenance of Island...

  15. 76 FR 76032 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2011-12-06

    ... proposed changes to the Schedule of Fees for Consular Services (Schedule) for nonimmigrant visa and border... (Machine-Readable Visas or MRVs) and adult Border Crossing Cards (BCCs). The rule also provides new tiers... these visas under the current cost structure. The Department endeavors to recover the cost of providing...

  16. 78 FR 60208 - Oil and Gas and Sulphur Operations in the Outer Continental Shelf-Adjustment of Service Fees

    Science.gov (United States)

    2013-10-01

    ... the IPD-GDP from 2007 through 2012, thus reflecting the rate of inflation over 5 years. The inflation... establish the 2013 cost recovery service fee. While BEA may revise the inflation rate in the future, BSEE... will periodically adjust fees for inflation according to changes in the Implicit Price Deflator for...

  17. 12 CFR 4.17 - Fees for services.

    Science.gov (United States)

    2010-01-01

    ... behalf of, or a free-lance journalist who reasonably expects to have his or her work product published or... search, review, and duplication. A requester in this category does not receive any free search, review... free pages. (iii) All other requesters. The OCC assesses a fee for a requester who does not fit into...

  18. Impact of the Korean Diagnosis-Related Groups payment system on the outcomes of adenotonsillectomy: A single center experience.

    Science.gov (United States)

    Kwak, Sang Hyun; Kim, Ji Hoon; Kim, Da Hee; Kim, Jung Min; Byeon, Hyung Kwon; Kim, Won Shik; Koh, Yoon Woo; Kim, Se-Heon; Choi, Eun Chang

    2018-06-01

    To report outcomes with regard to clinical aspects and medical costs of adenotonsillectomy and tonsillectomy at a single institution before and after implementation of the Diagnosis-Related Groups (DRG) payment system in Korea. We retrospectively reviewed the records of patients treated with adenotonsillectomy or tonsillectomy between July 2012 and June 2014. The Korean DRG payment system was applied to seven groups of specific diseases and surgeries including adenotonsillectomy and tonsillectomy from July 2013 at all hospitals in Korea. We divided patients into four groups according whether the fee-for-service (FFS) or DRG payment system was implemented and operation type (FFS-adenotonsillectomy (AT), DRG-AT, FFS-tonsillectomy (T), and DRG-T). A total of 1402 patients were included (485 FFS-AT, 490 DRG-AT, 203 FFS-T, and 223 DRG-T). The total medical cost of the DRG-AT group was significantly lower than that of the FFS-AT group (1191±404 vs. 1110±279 USD, PDRG system for adenotonsillectomy and tonsillectomy reduced medical costs and clinical outcomes were not significantly altered by the adoption of the DRG system. 4. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Refining Spectrum Fee to Increase Utilization Efficiency by Adopting ITU-R SM 2012-2 Case Study: Cellular Service in Indonesia

    Directory of Open Access Journals (Sweden)

    Ismail

    2010-05-01

    Full Text Available The spectrum fees called as “Biaya Hak Pengguna Frekuensi” (BHP-F for cellular services in Indonesia are currently calculated based on apparatus, proportionally to the number of transceiver stations and radio channels. Unfortunately, the formula cannot promote the efficiency of frequency spectrum efficiency. ITU-R SM 2012-2 recommended the spectrum fee formula that can promote the efficiency; Administrative Incentives Price (AIP also claims to promote the effectiveness of the radio spectrum utilization. By combining ITU-R SM 2012-2 with AIP, the frequency fee formula can promote not only the efficiency but also the effectiveness of spectrum utilization. This paper will explain and discus the modification of ITU-R SM 2012-2 with AIP in designing the spectrum fees for cellular services in Indonesia.

  20. 47 CFR 1.339 - Witness fees.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Witness fees. 1.339 Section 1.339....339 Witness fees. Witnesses who are subpenaed and respond thereto are entitled to the same fees, including mileage, as are paid for like service in the courts of the United States. Fees shall be paid by...

  1. Who benefits from removing user fees for facility-based delivery services? Evidence on socioeconomic differences from Ghana, Senegal and Sierra Leone.

    Science.gov (United States)

    McKinnon, Britt; Harper, Sam; Kaufman, Jay S

    2015-06-01

    Coverage of skilled delivery care has been increasing across most low-income countries; however, it remains far from universal and is very unequally distributed according to socioeconomic position. In an effort to increase coverage of skilled delivery care and reduce socioeconomic inequalities, governments of several countries in sub-Saharan Africa have recently adopted policies that remove user fees for facility-based delivery services. There is little rigorous evidence of the impact of these policies and few studies have examined effects on socioeconomic inequalities. This study investigates the impact of recent delivery fee exemption policies in Ghana, Senegal, and Sierra Leone on socioeconomic differences in the use of facility-based delivery services. Using Demographic and Health Survey data from nine sub-Saharan African countries, we evaluated the user fee policy changes using a difference-in-differences approach that accounts for underlying common secular trends and time invariant differences among countries, and allows for differential effects of the policy by socioeconomic position. Removing user fees was consistent with meaningful increases in facility deliveries across all categories of household wealth and maternal education. We found little evidence of differential effects of removing user fees across quartiles of household wealth, with increases of 5.4 facility deliveries per hundred live births (95% CI: 2.1, 8.8) among women in the poorest quartile and 6.8 per hundred live births (95% CI: 4.0, 9.7) for women in the richest quartile. However, our results suggest that educated women benefited more from removing user fees compared to women with no education. For women with at least some secondary education, the estimated effect was 8.6 facility deliveries per hundred live births (95% CI: 5.4, 11.9), but only 4.6 per hundred live births (95% CI: 2.2, 7.0) for women with no education (heterogeneity p-value = 0.04). Thus, while removing fees at the point

  2. 78 FR 14960 - Notice of New Fee Site

    Science.gov (United States)

    2013-03-08

    ... DEPARTMENT OF AGRICULTURE Forest Service Notice of New Fee Site AGENCY: Kaibab National Forest, USDA Forest Service, Arizona. ACTION: Notice of New Fee Sites. SUMMARY: The Kaibab National Forest is proposing to charge fees for the overnight rental of three historic facilities on the North Kaibab Ranger...

  3. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2017-01-01

    Full Text Available Background This paper aims to investigate the development trend of traditional Chinese medicine (TCM hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM at TCM hospitals. Methods Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field.

  4. 42 CFR 411.375 - Fees for the cost of advisory opinions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Fees for the cost of advisory opinions. 411.375... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.375 Fees for the cost... revised the amount of the initial fee in a program issuance, in which case, the requestor must include the...

  5. 7 CFR 28.116 - Amounts of fees for classification; exemption.

    Science.gov (United States)

    2010-01-01

    ... Section 28.116 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... Standards Act Fees and Costs § 28.116 Amounts of fees for classification; exemption. (a) For the...

  6. Sensitivity of the federal fee for managing spent fuel to financial and logistical variations

    International Nuclear Information System (INIS)

    White, M.K.; Lewallen, M.A.; Merrill, E.T.; Fleischman, R.M.

    1978-06-01

    Three types of fees for federal spent fuel management service were calculated for a reference case and a number of variations. These fee types are a uniform fee applicable to all customers, a fee for disposal of spent fuel, and a fee for interim storage plus disposal of spent fuel. Results ranged from $124/kg to $256/kg for the uniform fee, $112/kg to $213/kg for the disposal fee, and $144/kg to $319/kg for the storage plus disposal fee. The reference case assumed that spent fuel would first be received by the government in 1983 at a 5,000 MT away-from-reactor (AFR) basin. The first repository (45,000 MT) was assumed ready for fuel in 1988, and the second (100,000 MT) in 1997. The reference case results in fees of $129/kg for the uniform fee, $117/kg for disposal, and $232/kg for storage plus disposal. The sensitivity cases were grouped in five general categories of variations from the reference case assumptions: demand for storage/disposal services, facility schedules and characteristics, methodology for calculating the fee, discount rate and AFR financing, and delays or failure of the first repository

  7. Effect of fee-for-service air-conditioning management in balancing thermal comfort and energy usage.

    Science.gov (United States)

    Chen, Chen-Peng; Hwang, Ruey-Lung; Shih, Wen-Mei

    2014-11-01

    Balancing thermal comfort with the requirement of energy conservation presents a challenge in hot and humid areas where air-conditioning (AC) is frequently used in cooling indoor air. A field survey was conducted in Taiwan to demonstrate the adaptive behaviors of occupants in relation to the use of fans and AC in a school building employing mixed-mode ventilation where AC use was managed under a fee-for-service mechanism. The patterns of using windows, fans, and AC as well as the perceptions of students toward the thermal environment were examined. The results of thermal perception evaluation in relation to the indoor thermal conditions were compared to the levels of thermal comfort predicted by the adaptive models described in the American Society of Heating, Refrigerating, and Air-Conditioning Engineers Standard 55 and EN 15251 and to that of a local model for evaluating thermal adaption in naturally ventilated buildings. A thermal comfort-driven adaptive behavior model was established to illustrate the probability of fans/AC use at specific temperature and compared to the temperature threshold approach to illustrate the potential energy saving the fee-for-service mechanism provided. The findings of this study may be applied as a reference for regulating the operation of AC in school buildings of subtropical regions.

  8. 76 FR 44014 - Generic Drug User Fee; Public Meeting; Request for Comments

    Science.gov (United States)

    2011-07-22

    ... generic drug user fees. New legislation would be required for FDA to establish and collect user fees for... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS...

  9. 7 CFR 28.117 - Fee for new memorandum or certificate.

    Science.gov (United States)

    2010-01-01

    ... 28.117 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... Standards Act Fees and Costs § 28.117 Fee for new memorandum or certificate. For each new memorandum or...

  10. 76 FR 23502 - Fee-Generating Cases

    Science.gov (United States)

    2011-04-27

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services... on fee-generating cases to clarify that it applies only to LSC and private non-LSC funds. DATES: This... fee-generating cases to clarify that it applies only to LSC and private non-LSC funds. 76 FR 6381. On...

  11. 20 CFR 501.9 - Representation; appearances and fees.

    Science.gov (United States)

    2010-04-01

    ... be recognized unless the Representative withdraws or abandons such capacity or the Appellant directs... stipulated fee or on a contingent fee basis will be approved by the Board. No fee for service will be...) Usefulness of the Representative's services; (2) The nature and complexity of the appeal; (3) The capacity in...

  12. 42 CFR 414.620 - Publication of the ambulance fee schedule.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Publication of the ambulance fee schedule. 414.620... SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedule for Ambulance Services § 414.620 Publication of the ambulance fee schedule. Changes in payment rates resulting...

  13. 7 CFR 505.2 - Fees for loans of materials in library collections.

    Science.gov (United States)

    2010-01-01

    ....00 processing fee. (d) All services in this section will incur a billing surcharge per invoice... RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL AGRICULTURAL LIBRARY FEES FOR LOANS AND COPYING § 505....00, is billed as a direct cost recovery based on charges to the library by the billing vendor...

  14. Informal payments for healthcare services and short-term effects of the introduction of visit fee on these payments in Hungary.

    Science.gov (United States)

    Baji, Petra; Pavlova, Milena; Gulácsi, László; Zsófia, Homolyáné Csete; Groot, Wim

    2012-01-01

    The objective of this paper is to study the short-term effects of the introduction of the visit fee in Hungary in 2007 on informal patient payments. We present the pattern of informal payments in primary, out-patient specialist and in in-patient care in the period before and shortly after the visit fee was introduced. We also analyse whether in the short run, the introduction of visit fee decreased the probability of paying informally. For the analysis, we use a dataset for a representative sample of 2500 respondents collected in 2007 shortly after the introduction of the visit fee, which contains data on informal payments for healthcare services. According to our results, 9% of the patients paid informally during their last visit to GP (2 Euros on average), 14% paid informally for specialist care (35 Euros on average) and 50% paid informally for hospitalisation (58 Euros on average). We find a significant reduction in the probability of paying informally only for elderly patients in case of in-patient care. Our results suggest that informal payments are widely spread in Hungary, especially in in-patient care. The short run potential of the introduction of the visit fee to reduce informal payments seems to be minor. Copyright © 2011 John Wiley & Sons, Ltd.

  15. 75 FR 75170 - APHIS User Fee Web Site

    Science.gov (United States)

    2010-12-02

    ...] APHIS User Fee Web Site AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Notice. SUMMARY: The Animal and Plant Health Inspection Service charges user fees, as authorized by law, to... contains information about the Agency's user fees. ADDRESSES: The Agency's user fee Web site is located at...

  16. Comments on the Law on CSN Fees and Public Prices

    International Nuclear Information System (INIS)

    Azuara, J. A.

    1999-01-01

    The article reviews the main modifications introduced by the Law on CSN Fees in the agency's financing system which is based on charging service rendering fees. The new regulations adjust the fees to the actual cost of services and lays down conditions for setting the fees in each case. (Author)

  17. 76 FR 10498 - Exchange Visitor Program-Fees and Charges

    Science.gov (United States)

    2011-02-25

    ...--Fees and Charges AGENCY: Department of State. ACTION: Final rule. SUMMARY: The Department of State is amending its regulations regarding fees and charges for Exchange Visitor Program services. The fees permit the Department to recoup the cost of providing such Exchange Visitor Program services. DATES...

  18. Impact of managed care on the treatment, costs, and outcomes of fee-for-service Medicare patients with acute myocardial infarction.

    Science.gov (United States)

    Bundorf, M Kate; Schulman, Kevin A; Stafford, Judith A; Gaskin, Darrell; Jollis, James G; Escarce, José J

    2004-02-01

    To examine the effects of market-level managed care activity on the treatment, cost, and outcomes of care for Medicare fee-for-service acute myocardial infarction (AMI) patients. Patients from the Cooperative Cardiovascular Project (CCP), a sample of Medicare beneficiaries discharged from nonfederal acute-care hospitals with a primary discharge diagnosis of AMI from January 1994 to February 1996. We estimated models of patient treatment, costs, and outcomes using ordinary least squares and logistic regression. The independent variables of primary interest were market-area managed care penetration and competition. The models included controls for patient, hospital, and other market area characteristics. We merged the CCP data with Medicare claims and other data sources. The study sample included CCP patients aged 65 and older who were admitted during 1994 and 1995 with a confirmed AMI to a nonrural hospital. Rates of revascularization and cardiac catheterization for Medicare fee-for-service patients with AMI are lower in high-HMO penetration markets than in low-penetration ones. Patients admitted in high-HMO-competition markets, in contrast, are more likely to receive cardiac catheterization for treatment of their AMI and had higher treatment costs than those admitted in low-competition markets. The level of managed care activity in the health care market affects the process of care for Medicare fee-for-service AMI patients. Spillovers from managed care activity to patients with other types of insurance are more likely when managed care organizations have greater market power.

  19. 15 CFR 50.5 - Fee structure for age search and citizenship information.

    Science.gov (United States)

    2010-01-01

    ... THE CENSUS § 50.5 Fee structure for age search and citizenship information. Type of service Fee... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Fee structure for age search and citizenship information. 50.5 Section 50.5 Commerce and Foreign Trade Regulations Relating to Commerce and...

  20. Quality of care provided to patients with diabetes mellitus in Puerto Rico; managed care versus fee-for-service experience.

    Science.gov (United States)

    Rodríguez-Vigil, Efraín; Kianes-Pérez, Zaira

    2005-01-01

    To evaluate and compare the quality of diabetes care in a large managed care system and fee-for-service payment system in Puerto Rico. This retrospective cross-sectional study assessed the adherence to standards of diabetes care in 1,687,202 subjects--226,210 from a fee-for-service population and 1,460,992 from a managed care group. Patients with diabetes mellitus were identified from insurance claims reports. Type of health-care provider, service location, number of visits, and laboratory utilization were also assessed. From the analysis, we identified 90,616 patients with diabetes (5.4% of the overall study group). Of these, 66,587 (73.5%) were found to have at least one encounter with a physician in a medical visit. Of the 66,586 patients with diabetes who visited a physician, only 4% were treated by an endocrinologist. General laboratory utilization was 34% for the entire population of patients with diabetes studied. In the group of patients with documented laboratory tests, 93% had a documented fasting blood glucose test; in contrast, hemoglobin A lc testing was performed in only 9% of the patients. The fee-for-service group had a higher rate of visits to medical specialists and general laboratory utilization, whereas the managed care group had a higher rate of hospital admissions and emergency department visits. The quality of diabetes management and the subsequent outcomes are related to patient and health-care provider adherence to standards of care. In this analysis, we found that patients and physicians are responsible for low compliance with recognized standards of diabetes care in Puerto Rico. The lack of adequate management will lead to increased mortality, development and severity of chronic complications, and increased emergency department utilization. Therefore, health-care providers and payers should find ways to achieve more effective promotion of adherence to accepted standards of care for patients with diabetes.

  1. Do client fees help or hurt?

    Science.gov (United States)

    Barnett, B

    1998-01-01

    This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics.

  2. Spillover effects of Medicare fee reductions: evidence from ophthalmology.

    Science.gov (United States)

    Mitchell, Jean M; Hadley, Jack; Gaskin, Darrell J

    2002-09-01

    Relatively little research has examined physicians' supply responses to Medicare fee cuts especially whether fee reductions for specific procedures have "spillover" effects that cause physicians to increase the supply of other services they provide. In this study we investigate whether ophthalmologist changed their provision of non-cataract services to Medicare patients over the time period 1992-1994, when the Medicare Fee Schedule (MFS) resulted in a 17.4% reduction in the average fee paid for a cataract extraction. Following the McGuire-Pauly model of physician behavior (McGuire and Pauly, 1991), we estimated a supply function for non-cataract procedures that included three price variables (own-price, a Medicare cross-price and a private cross-price) and an income effect. The Medicare cross-price and income variables capture spillover effects. Consistent with the model's predictions, we found that the Medicare cross-price is significant and negative, implying that a 10% reduction in the fee for a cataract extraction will cause ophthalmologists to supply about 5% more non-cataract services. Second, the income variable is highly significant, but its impact on the supply of non-cataract services is trivial. The suggests that physicians behave more like profit maximizing firms than target income seekers. We also found that the own-price and the private cross-price variables are highly significant and have the expected positive and negative effects on the volume of non-cataract services respectively. Our results demonstrate the importance of evaluating volume responses to fee changes for the array of services the physician performs, not just the procedure whose fee has been reduced. Focusing only on the procedure whose fee has been cut will yield an incomplete picture of how fee reductions for specific procedures affect physician supply decisions.

  3. On the types of franchise fees

    Directory of Open Access Journals (Sweden)

    Miljković Strahinja D.

    2016-01-01

    Full Text Available By accessing a franchising network at the moment of contracting a franchising agreement, a franchisor concedes the franchise package of rights to a franchisee. Making use of the benefits provided by business operations in a developed and market-recognizable franchise network, the franchisee has certain contractual obligations which are embodied in financial compensation to the franchisor. The franchisee is obliged to pay the franchisor certain fees, such as: 1 the initial franchise fee; 2 the continuing franchise fee and 3 the advertising fee. The initial franchise fee may be regarded as 'an entry fee', i.e. a ticket to a franchising network. The continual fee is an active revenue which allows a franchisor to finance the activities of rendering a wide range of services to a franchisee and, concurrently, to make profit. The advertising fee is paid to a franchisor by a franchisee for services rendered in the field of advertising business. In the author's opinion, the professional public in the country should pay considerable attention to this topic, with specific reference to the experiences of countries with developed franchising business practices.

  4. 50 CFR 221.47 - What are the requirements for subpoenas and witness fees?

    Science.gov (United States)

    2010-10-01

    ... and witness fees? 221.47 Section 221.47 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE... requirements for subpoenas and witness fees? (a) Request for subpoena. (1) Except as provided in paragraph (a... return it to the party on whose behalf the subpoena was served. (c) Witness fees. (1) A party who...

  5. 7 CFR 28.115 - Fees and costs; payment.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Fees and costs; payment. 28.115 Section 28.115... Fees and Costs § 28.115 Fees and costs; payment. All charges for practical forms of cotton standards and all fees and expenses for services of inspection of bales and supervision of sampling...

  6. 7 CFR 51.44 - Disposition of fees.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... Schedule of Fees and Charges at Destination Markets § 51.44 Disposition of fees. (a) The fees collected for...

  7. 78 FR 16830 - Notice of New Fee Site

    Science.gov (United States)

    2013-03-19

    ... New Fee Site AGENCY: Rio Grande National Forest, USDA Forest Service. ACTION: Notice of New Fee Site... Forest is proposing to add a cabin for rent to the public for a $50 fee for the overnight rental. It was.... People are invited to comment on this proposal. DATES: Send any comments about these fee proposals by...

  8. 7 CFR 28.119 - Fee when request for classification is withdrawn.

    Science.gov (United States)

    2010-01-01

    ....119 Section 28.119 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND... Cotton Standards Act Fees and Costs § 28.119 Fee when request for classification is withdrawn. When the...

  9. 78 FR 48136 - Notice of New Recreation Fee

    Science.gov (United States)

    2013-08-07

    ... DEPARTMENT OF AGRICULTURE Forest Service Notice of New Recreation Fee AGENCY: Prescott National Forest, Southwestern Region, USDA Forest Service. ACTION: Notice of New Recreation Fee. SUMMARY: The Prescott National Forest is proposing to charge a fee at the new Eagle Ridge Group Campground near Prescott...

  10. Shifting Away From Fee-For-Service: Alternative Approaches to Payment in Gastroenterology.

    Science.gov (United States)

    Patel, Kavita; Presser, Elise; George, Meaghan; McClellan, Mark

    2016-04-01

    Fee-for-service payments encourage high-volume services rather than high-quality care. Alternative payment models (APMs) aim to realign financing to support high-value services. The 2 main components of gastroenterologic care, procedures and chronic care management, call for a range of APMs. The first step for gastroenterologists is to identify the most important conditions and opportunities to improve care and reduce waste that do not require financial support. We describe examples of delivery reforms and emerging APMs to accomplish these care improvements. A bundled payment for an episode of care, in which a provider is given a lump sum payment to cover the cost of services provided during the defined episode, can support better care for a discrete procedure such as a colonoscopy. Improved management of chronic conditions can be supported through a per-member, per-month (PMPM) payment to offer extended services and care coordination. For complex chronic conditions such as inflammatory bowel disease, in which the gastroenterologist is the principal care coordinator, the PMPM payment could be given to a gastroenterology medical home. For conditions in which the gastroenterologist acts primarily as a consultant for primary care, such as noncomplex gastroesophageal reflux or hepatitis C, a PMPM payment can support effective care coordination in a medical neighborhood delivery model. Each APM can be supplemented with a shared savings component. Gastroenterologists must engage with and be early leaders of these redesign discussions to be prepared for a time when APMs may be more prevalent and no longer voluntary. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  11. 24 CFR 214.313 - Housing counseling fees.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Housing counseling fees. 214.313... HOUSING COUNSELING PROGRAM Program Administration § 214.313 Housing counseling fees. (a) Participating agencies may charge reasonable and customary fees for housing education and counseling services, as long as...

  12. 7 CFR 28.118 - When no fee collected for new certificate or memorandum.

    Science.gov (United States)

    2010-01-01

    ... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY... United States Cotton Standards Act Fees and Costs § 28.118 When no fee collected for new certificate or...

  13. Inequities in accessibility to and utilisation of maternal health services in Ghana after user-fee exemption: a descriptive study.

    Science.gov (United States)

    Ganle, John K; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon

    2014-11-01

    Inequities in accessibility to, and utilisation of maternal healthcare services impede progress towards attainment of the maternal health-related Millennium Development Goals. The objective of this study is to examine the extent to which maternal health services are utilised in Ghana, and whether inequities in accessibility to and utilization of services have been eliminated following the implementation of a user-fee exemption policy, that aims to reduce financial barriers to access, reduce inequities in access, and improve access to and use of birthing services. We analyzed data from the 2007 Ghana Maternal Health Survey for inequities in access to and utilization of maternal health services. In measuring the inequities, frequency tables and cross-tabulations were used to compare rates of service utilization by region, residence and selected socio-demographic variables. Findings show marginal increases in accessibility to and utilisation of skilled antenatal, delivery and postnatal care services following the policy implementation (2003-2007). However, large gradients of inequities exist between geographic regions, urban and rural areas, and different socio-demographic, religious and ethnic groupings. More urban women (40%) than rural, 53% more women in the highest wealth quintile than women in the lowest, 38% more women in the best performing region (Central Region) than the worst (Upper East Region), and 48% more women with at least secondary education than those with no formal education, accessed and used all components of skilled maternal health services in the five years preceding the survey. Our findings raise questions about the potential equity and distributional benefits of Ghana's user-fee exemption policy, and the role of non-financial barriers or considerations. Exempting user-fees for maternal health services is a promising policy option for improving access to maternal health care, but might be insufficient on its own to secure equitable access to

  14. 49 CFR 360.5 - Updating user fees.

    Science.gov (United States)

    2010-10-01

    ... updating the cost components comprising the fee. Cost components shall be updated as follows: (1) Direct... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... by total office costs for the office directly associated with user fee activity. Actual updating of...

  15. Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.

    Science.gov (United States)

    Miller, Benjamin F; Ross, Kaile M; Davis, Melinda M; Melek, Stephen P; Kathol, Roger; Gordon, Patrick

    2017-01-01

    The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet. However, challenges to implementing the PCMH framework are compounded for real-world practitioners because payment reform rarely happens concurrently. Nowhere is this more evident than in attempts to integrate behavioral health clinicians into primary care. As behavioral health clinicians find opportunities to work in integrated settings, a comprehensive understanding of payment models is integral to the dialogue. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. A Longitudinal Analysis of Site of Death: The Effects of Continuous Enrollment in Medicare Advantage Versus Conventional Medicare.

    Science.gov (United States)

    Chen, Elizabeth Edmiston; Miller, Edward Alan

    2017-09-01

    This study assessed the odds of dying in hospital associated with enrollment in Medicare Advantage (M-A) versus conventional Medicare Fee-for-Service (M-FFS). Data were derived from the 2008 and 2010 waves of the Health and Retirement Study ( n = 1,030). The sample consisted of elderly Medicare beneficiaries who died in 2008-2010 (34% died in hospital, and 66% died at home, in long-term senior care, a hospice facility, or other setting). Logistic regression estimated the odds of dying in hospital for those continuously enrolled in M-A from 2008 until death compared to those continuously enrolled in M-FFS and those switching between the two plans. Results indicate that decedents continuously enrolled in M-A had 43% lower odds of dying in hospital compared to those continuously enrolled in M-FFS. Financial incentives in M-A contracts may reduce the odds of dying in hospital.

  17. 29 CFR 25.7 - Fees; cost; expenses; decisions.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Fees; cost; expenses; decisions. 25.7 Section 25.7 Labor... ORDER 10988 § 25.7 Fees; cost; expenses; decisions. (a) Arbitrator's fees, per diem and travel expenses... entirely by the agency. (b) The standard fee for the services of an arbitrator should be $100 per day...

  18. Should fee-for-service be for all guideline-advocated acute coronary syndrome (ACS) care? Observations from the Snapshot ACS study.

    Science.gov (United States)

    Briffa, Thomas G; Hammett, Christopher J; Cross, David B; Macisaac, Andrew I; Rankin, James M; Board, Neville; Carr, Bridie; Hyun, Karice K; French, John; Brieger, David B; Chew, Derek P

    2015-09-01

    The aim of the present study was to explore the association of health insurance status on the provision of guideline-advocated acute coronary syndrome (ACS) care in Australia. Consecutive hospitalisations of suspected ACS from 14 to 27 May 2012 enrolled in the Snapshot study of Australian and New Zealand patients were evaluated. Descriptive and logistic regression analysis was performed to evaluate the association of patient risk and insurance status with the receipt of care. In all, 3391 patients with suspected ACS from 247 hospitals (23 private) were enrolled in the present study. One-third of patients declared private insurance coverage; of these, 27.9% (304/1088) presented to private facilities. Compared with public patients, privately insured patients were more likely to undergo in-patient echocardiography and receive early angiography; furthermore, in those with a discharge diagnosis of ACS, there was a higher rate of revascularisation (P fee-for-service. In contrast, proportionately fewer privately insured ACS patients were discharged on selected guideline therapies and were referred to a secondary prevention program (P = 0.056), neither of which directly attracts a fee. Typically, as GRACE (the Global Registry of Acute Coronary Events) risk score rose, so did the level of ACS care; however, propensity-adjusted analyses showed lower in-hospital adverse events among the insured group (odds ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.004). Fee-for-service reimbursement may explain differences in the provision of selected guideline-advocated components of ACS care between privately insured and public patients.

  19. 32 CFR 204.5 - Fees.

    Science.gov (United States)

    2010-07-01

    ... demand exists for a good, resource, or service, its market price will be determined using commercial... substantial competitive demand, market price will be determined by taking into account the prevailing prices... advance, when feasible. The benefit of charging user fees must outweigh the cost of collecting the fees...

  20. DME Prosthetics Orthotics, and Supplies Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Durable Medical Equipment, Prosthetics-Orthotics, and Supplies Fee Schedule. The list contains the fee schedule amounts, floors, and ceilings for all procedure codes...

  1. 37 CFR 382.2 - Royalty fees for the digital performance of sound recordings and the making of ephemeral...

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fees for the digital... SATELLITE DIGITAL AUDIO RADIO SERVICES Preexisting Subscription Services § 382.2 Royalty fees for the... monthly royalty fee for the public performance of sound recordings pursuant to 17 U.S.C. 114(d)(2) and the...

  2. 78 FR 59817 - Revision to United States Marshals Service Fees for Services

    Science.gov (United States)

    2013-09-30

    .... 4(b). When a statute does not address issues of how to calculate fees or what costs to include in..., investment, productivity, innovation, or on the ability of United States-based enterprises to compete with...

  3. 76 FR 43960 - NARA Records Reproduction Fees

    Science.gov (United States)

    2011-07-22

    .... The current fees are based on the usual costs, such as salaries, equipment, travels, and supplies... valid reproduction of a file; this service is available for an additional fee. Cost means the total... created and maintained them. Sec. 1258.4 What costs make up the NARA fees? (a) 44 U.S.C. 2116(c) allows...

  4. 37 CFR 211.3 - Mask work fees.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Mask work fees. 211.3 Section... PROCEDURES MASK WORK PROTECTION § 211.3 Mask work fees. (a) Section 201.3 of this chapter prescribes the fees or charges established by the Register of Copyrights for services relating to mask works. (b) Section...

  5. 26 CFR 1.61-2 - Compensation for services, including fees, commissions, and similar items.

    Science.gov (United States)

    2010-04-01

    ... (including Christmas bonuses), termination or severance pay, rewards, jury fees, marriage fees and other...). For the special rules relating to the includibility in an employee's gross income of an amount equal...

  6. Medicaid Primary Care Physician Fees and the Use of Preventive Services among Medicaid Enrollees

    Science.gov (United States)

    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

  7. Effect of Filmless Imaging on Utilization of Radiologic Services with a Two-stage, Hospital-Wide Implementation of a Picture Archiving and Communication System: Initial Experience of a Fee-for-Service Model

    Directory of Open Access Journals (Sweden)

    Yu-Ting Kuo

    2003-02-01

    Full Text Available A medium-sized general hospital using a fee-for-service model implemented a hospital-wide picture archiving and communication system (PACS in two stages. This study evaluated the reporting time with filmless operation and the effect of filmless imaging on referring physicians' use of the radiologic service before and after completion of the second stage of PACS implementation. The relationship between the total number of hospital patients and the number of radiologic department patients was also evaluated. All sample images were retrieved from the PACS. All corresponding reports except for one for a computerized tomography study were available. The median reporting time for different studies performed during working hours was less than 2 hours. There was a significantly positive and linear relationship (p < 0.01 between the total number of hospital patients and the number of radiologic department patients after hospital-wide implementation of PACS. We conclude that the fee-for-service model had no negative impact on referring physicians' use of radiologic services in a filmless hospital.

  8. 76 FR 24035 - Generic Drug User Fee; Public Meeting; Request for Comments

    Science.gov (United States)

    2011-04-29

    ... legislation would be required for FDA to establish and collect user fees for generic drugs, and FDA is... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS...

  9. 76 FR 65639 - International Mail: Proposed Product Rate and Fee Changes

    Science.gov (United States)

    2011-10-24

    ... Customs Clearance and Delivery Fee International Reply Coupons International Business Reply Service The... * * * * * International Business Reply Service (382) [For each country that offers International Business Reply Service... POSTAL SERVICE 39 CFR Part 20 International Mail: Proposed Product Rate and Fee Changes AGENCY...

  10. Provider-Induced Demand in the Treatment of Carotid Artery Stenosis: Variation in Treatment Decisions Between Private Sector Fee-for-Service vs Salary-Based Military Physicians.

    Science.gov (United States)

    Nguyen, Louis L; Smith, Ann D; Scully, Rebecca E; Jiang, Wei; Learn, Peter A; Lipsitz, Stuart R; Weissman, Joel S; Helmchen, Lorens A; Koehlmoos, Tracey; Hoburg, Andrew; Kimsey, Linda G

    2017-06-01

    Although many factors influence the management of carotid artery stenosis, it is not well understood whether a preference toward procedural management exists when procedural volume and physician compensation are linked in the fee-for-service environment. To explore evidence for provider-induced demand in the management of carotid artery stenosis. The Department of Defense Military Health System Data Repository was queried for individuals diagnosed with carotid artery stenosis between October 1, 2006, and September 30, 2010. A hierarchical multivariable model evaluated the association of the treatment system (fee-for-service physicians in the private sector vs salary-based military physicians) with the odds of procedural intervention (carotid endarterectomy or carotid artery stenting) compared with medical management. Subanalysis was performed by symptom status at the time of presentation. The association of treatment system and of management strategy with clinical outcomes, including stroke and death, was also evaluated. Data analysis was conducted from August 15, 2015, to August 2, 2016. The odds of procedural intervention based on treatment system was the primary outcome used to indicate the presence and effect of provider-induced demand. Of 10 579 individuals with a diagnosis of carotid artery stenosis (4615 women and 5964 men; mean [SD] age, 65.6 [11.4] years), 1307 (12.4%) underwent at least 1 procedure. After adjusting for demographic and clinical factors, the odds of undergoing procedural management were significantly higher for patients in the fee-for-service system compared with those in the salary-based setting (odds ratio, 1.629; 95% CI, 1.285-2.063; P fee-for-service system were significantly more likely to undergo procedural management for carotid stenosis compared with those in the salary-based setting. These findings remained consistent for individuals with and without symptomatic disease.

  11. Physician Fee Schedule Search

    Data.gov (United States)

    U.S. Department of Health & Human Services — This website is designed to provide information on services covered by the Medicare Physician Fee Schedule (MPFS). It provides more than 10,000 physician services,...

  12. 50 CFR 25.53 - Establishment of single visit entrance fees.

    Science.gov (United States)

    2010-10-01

    ... fees. 25.53 Section 25.53 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM ADMINISTRATIVE PROVISIONS Fees and Charges § 25.53 Establishment of single visit entrance fees. Entrance fees established for single visit...

  13. NRC levies $62 100 fee for FY 1993 on all licensees

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The Nuclear Regulatory Commission has issued its final rule on fee collections for fiscal year 1993, partly in response to a court decision that challenged the agency's FY 1991 fee schedule. Because the NRC must recover all of its annual budget - in excess of $500 million - through fees on licensees and users of agency services, those licensees and users are very sensitive about who shoulders how much of the burden. The new rule voids the previous NRC policy of exempting nonprofit educational institutions from the fee schedule, and the allocation of generic costs for low-level waste management to groups of licensees, rather than to individual licensees. The new rule went into effect on August 19

  14. 20 CFR 402.165 - Fee schedule.

    Science.gov (United States)

    2010-04-01

    ... requester for the services rendered. (i) Fee for copies of printed materials. When extra copies of printed... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Fee schedule. 402.165 Section 402.165 Employees' Benefits SOCIAL SECURITY ADMINISTRATION AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC...

  15. Medicare program; replacement of reasonable charge methodology by fee schedules for parenteral and enteral nutrients, equipment, and supplies. Final rule.

    Science.gov (United States)

    2001-08-28

    This final rule implements fee schedules for payment of parenteral and enteral nutrition (PEN) items and services furnished under the prosthetic device benefit, defined in section 1861(s)(8) of the Social Security Act. The authority for establishing these fee schedules is provided by the Balanced Budget Act of 1997, which amended the Social Security Act at section 1842(s). Section 1842(s) of the Social Security Act specifies that statewide or other area wide fee schedules may be implemented for the following items and services still subject to the reasonable charge payment methodology: medical supplies; home dialysis supplies and equipment; therapeutic shoes; parenteral and enteral nutrients, equipment, and supplies; electromyogram devices; salivation devices; blood products; and transfusion medicine. This final rule describes changes made to the proposed fee schedule payment methodology for these items and services and provides that the fee schedules for PEN items and services are effective for all covered items and services furnished on or after January 1, 2002. Fee schedules will not be implemented for electromyogram devices and salivation devices at this time since these items are not covered by Medicare. In addition, fee schedules will not be implemented for medical supplies, home dialysis supplies and equipment, therapeutic shoes, blood products, and transfusion medicine at this time since the data required to establish these fee schedules are inadequate.

  16. 75 FR 71548 - Clarification of the Post Office Box Lock Replacement Fee

    Science.gov (United States)

    2010-11-24

    ... POSTAL SERVICE 39 CFR Part 111 Clarification of the Post Office Box Lock Replacement Fee AGENCY... of the lock replacement fee for Post Office TM boxes to reflect current practice. DATES: January 2... Standards for Domestic Mailing Services (75 FR 39477-39492). The applicability of the lock replacement fee...

  17. 39 CFR 266.8 - Schedule of fees.

    Science.gov (United States)

    2010-07-01

    ... micrographic record or publication or computer report, the fee is $.15 per page, except that the first 100... 39 Postal Service 1 2010-07-01 2010-07-01 false Schedule of fees. 266.8 Section 266.8 Postal... Schedule of fees. (a) Policy. The purpose of this section is to establish fair and equitable fees to permit...

  18. 32 CFR 286.30 - Collection of fees and fee rates for technical data.

    Science.gov (United States)

    2010-07-01

    ... REGULATION Fee Schedule § 286.30 Collection of fees and fee rates for technical data. (a) Fees for technical data. Technical data, other than technical data that discloses critical technology with military or... 32 National Defense 2 2010-07-01 2010-07-01 false Collection of fees and fee rates for technical...

  19. Discount rate in the spent fuel storage and disposal fee

    International Nuclear Information System (INIS)

    Forster, J.D.; Cohen, S.

    1980-04-01

    After introducing the financial analyses, discount rates, and interest rates involved, the study discusses existing government guidelines for establishing charges for any service provided by the government to be paid by users of those services. Three current government user charges are analyzed including specifically their interest rate policies and how these charges provide precedent for the spent fuel acceptance and disposal fee: uranium enrichment services, the sale of electric power, and the delivery of experiments to orbit by the NASA Space Shuttle. The current DOE policy regarding this storage and disposal fee is stated and discussed. Features of this policy include: the full government cost is borne by users of the services provided; the fee is established and due in full at the time of spent fuel delivery; and the fee is adjusted when spent fuel is transferred from the AFR to the repository. Four evaluation criteria for use in analyzing the applications of discount rates in the spent fuel acceptance fee calculation are discussed. Three outstanding issues are discussed

  20. DMEPOS Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — The list contains the fee schedule amounts, floors, and ceilings for all procedure codes and payment category, jurisdication, and short description assigned to each...

  1. 30 CFR 202.353 - Measurement standards for reporting and paying royalties and direct use fees.

    Science.gov (United States)

    2010-07-01

    ... royalties and direct use fees. 202.353 Section 202.353 Mineral Resources MINERALS MANAGEMENT SERVICE... standards for reporting and paying royalties and direct use fees. (a) For geothermal resources used to... a royalty or direct use fee is due on Form MMS-2014 in: (1) Millions of Btu to the nearest whole...

  2. Paying for banking services: what determines the fees?

    Czech Academy of Sciences Publication Activity Database

    Dvořák, P.; Hanousek, Jan

    -, č. 388 (2009), s. 1-25 ISSN 1211-3298 R&D Projects: GA MŠk LC542; GA ČR GA402/09/1595 Institutional research plan: CEZ:MSM0021620846 Keywords : bank fee s * Central and Eastern Europe * international comparison Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp388.pdf

  3. 75 FR 11375 - Revision of Fee Schedules; Fee Recovery for FY 2010

    Science.gov (United States)

    2010-03-10

    ... Part IV Nuclear Regulatory Commission 10 CFR Parts 170 and 171 Revision of Fee Schedules; Fee...] RIN 3150-AI70 Revision of Fee Schedules; Fee Recovery for FY 2010 AGENCY: Nuclear Regulatory... licensing, inspection, and annual fees charged to its applicants and licensees. The proposed amendments are...

  4. 75 FR 34219 - Revision of Fee Schedules; Fee Recovery for FY 2010

    Science.gov (United States)

    2010-06-16

    ... Part II Nuclear Regulatory Commission 10 CFR Parts 170 and 171 Revision of Fee Schedules; Fee...-2009-0333 RIN 3150-AI70 Revision of Fee Schedules; Fee Recovery for FY 2010 AGENCY: Nuclear Regulatory..., inspection, and annual fees charged to its applicants and licensees. The amendments are necessary to...

  5. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation.

    Science.gov (United States)

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2016-06-07

    This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  6. Practice expenses in the MFS (Medicare fee schedule): the service-class approach.

    Science.gov (United States)

    Latimer, E A; Kane, N M

    1995-01-01

    The practice expense component of the Medicare fee schedule (MFS), which is currently based on historical charges and rewards physician procedures at the expense of cognitive services, is due to be changed by January 1, 1998. The Physician Payment Review Commission (PPRC) and others have proposed microcosting direct costs and allocating all indirect costs on a common basis, such as physician time or work plus direct costs. Without altering the treatment of direct costs, the service-class approach disaggregates indirect costs into six practice function costs. The practice function costs are then allocated to classes of services using cost-accounting and statistical methods. This approach would make the practice expense component more resource-based than other proposed alternatives.

  7. 48 CFR 915.404-4-71-5 - Fee schedules.

    Science.gov (United States)

    2010-10-01

    ... METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 915.404-4-71-5 Fee schedules. (a... subcontracting, normal contractor services performed by the government or another contractor: (1) The target fee...) The target fee schedule provides for 45 percent of the contract work to be subcontracted for such...

  8. 48 CFR 215.404-74 - Fee requirements for cost-plus-award-fee contracts.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Fee requirements for cost... NEGOTIATION Contract Pricing 215.404-74 Fee requirements for cost-plus-award-fee contracts. In developing a fee objective for cost-plus-award-fee contracts, the contracting officer shall— (a) Follow the...

  9. Removing user fees for health services: A multi-epistemological perspective on access inequities in Senegal.

    Science.gov (United States)

    Mladovsky, Philipa; Ba, Maymouna

    2017-09-01

    Plan Sésame (PS) is a user fee exemption policy launched in 2006 to provide free access to health services to Senegalese citizens aged 60 and over. Analysis of a large household survey evaluating PS echoes findings of other studies showing that user fee removal can be highly inequitable. 34 semi-structured interviews and 19 focus group discussions with people aged 60 and over were conducted in four regions in Senegal (Dakar, Diourbel, Matam and Tambacounda) over a period of six months during 2012. They were analysed to identify underlying causes of exclusion from/inclusion in PS and triangulated with the household survey. The results point to three steps at which exclusion occurs: (i) not being informed about PS; (ii) not perceiving a need to use health services under PS; and (iii) inability to access health services under PS, despite having the information and perceived need. We identify lay explanations for exclusion at these different steps. Some lay explanations point to social exclusion, defined as unequal power relations. For example, poor access to PS was seen to be caused by corruption, patronage, poverty, lack of social support, internalised discrimination and adverse incorporation. Other lay explanations do not point to social exclusion, for example: poor implementation; inadequate funding; high population demand; incompetent bureaucracy; and PS as a favour or moral obligation to friends or family. Within a critical realist paradigm, we interpret these lay explanations as empirical evidence for the presence of the following hidden underlying causal mechanisms: lacking capabilities; mobilisation of institutional bias; and social closure. However, social constructionist perspectives lead us to critique this paradigm by drawing attention to contested health, wellbeing and corruption discourses. These differences in interpretation lead to subsequent differential policy recommendations. This demonstrates the need for the adoption of a "multi

  10. 32 CFR 518.21 - Collection of fees and fee rates for technical data.

    Science.gov (United States)

    2010-07-01

    ... § 518.21 Collection of fees and fee rates for technical data. (a) Fees for technical data. Technical data, other than technical data that discloses critical technology with military or space application... 32 National Defense 3 2010-07-01 2010-07-01 true Collection of fees and fee rates for technical...

  11. 18 CFR 3b.223 - Fees.

    Science.gov (United States)

    2010-04-01

    ... INFORMATION Rules for Disclosure of Records § 3b.223 Fees. (a) Fees will be charged for the direct cost of... practicable, self-service duplication of requested documents may also be made on duplicating machines by the... to determine if they fall within the disclosure requirements of this part; and (3) When the system...

  12. Making capitated Medicare work for women: policy and research challenges.

    Science.gov (United States)

    Bierman, A S; Clancy, C M

    2000-01-01

    Growth in capitated Medicare has special ramifications for older women who comprise the majority of Medicare beneficiaries. Older women are more likely than men to have chronic conditions that lead to illness and disability, and they often have fewer financial and social resources to cope with these problems. Gender differences in health status have a number of important implications for the financing and delivery of care for older women under both traditional fee-for-service Medicare and capitation. The utilization of effective preventive interventions, new therapeutic interventions for the management of common chronic disorders, and more cost-effective models of chronic disease management could potentially extend the active life expectancy of older women. However, there are financial and delivery system barriers to achieving these objectives. Traditional FFS Medicare has gaps in coverage of care for chronic illness and disability that disproportionately impact women. Managed care potentially offers flexibility to allocate resources creatively, to develop new models of care, and offer enhanced benefits with lower out-of-pocket costs. However, challenges to realizing this potential under Medicare managed care with unique implications for older women include: possible gender bias in capitation payments, risk selection, inadequacy of risk adjustment models, benefit and market instability, and disenrollment patterns.

  13. 45 CFR 5b.13 - Fees.

    Science.gov (United States)

    2010-10-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PRIVACY ACT REGULATIONS § 5b.13 Fees. (a) Policy. Where applicable, fees for copying records will be charged in accordance with the schedule set... whether the search is manual, mechanical, or electronic. Where a copy of the record must be made in order...

  14. Fee-for-service as a business model of growing importance: the academic biobank experience.

    Science.gov (United States)

    McDonald, Sandra A; Sommerkamp, Kara; Egan-Palmer, Maureen; Kharasch, Karen; Holtschlag, Victoria

    2012-10-01

    Biorepositories offer tremendous scientific value to a wide variety of customer groups (academic, commercial, industrial) in their ability to deliver a centralized, standardized service model, encompassing both biospecimen storage and related laboratory services. Generally, the scientific expertise and economies of scale that are offered in centralized, properly resourced research biobanks has yielded value that has been well-recognized by universities, pharmaceutical companies, and other sponsoring institutions. However, like many facets of the economy, biobanks have been under increasing cost pressure in recent years. This has been a particular problem in the academic arena, where direct support from grant sources (both governmental and philanthropic) typically now is more difficult to secure, or provides reduced financial support, relative to previous years. One way to address this challenge is to establish or enhance a well-defined fee-for-service model which is properly calibrated to cover operational costs while still offering competitive value to users. In this model, customers are never charged for the biospecimens themselves, but rather for the laboratory services associated with them. Good communication practices, proper assessment of value, implementation of best practices, and a sound business plan are all needed for this initiative to succeed. Here we summarize our experiences at Washington University School of Medicine in the expectation they will be useful to others.

  15. 76 FR 14747 - Revision of Fee Schedules; Fee Recovery for Fiscal Year 2011

    Science.gov (United States)

    2011-03-17

    ... 171 Revision of Fee Schedules; Fee Recovery for Fiscal Year 2011; Proposed Rule #0;#0;Federal Register... COMMISSION 10 CFR Parts 170 and 171 RIN 3150-AI93 [NRC-2011-0016] Revision of Fee Schedules; Fee Recovery for... fees charged to its applicants and licensees. The proposed amendments are necessary to implement the...

  16. Report from the Committee for Improving the Work Environment of Japanese Surgeons: survey on effects of the fee revision for medical services provided by surgeons.

    Science.gov (United States)

    Hanazaki, Kazuhiro; Tominaga, Ryuji; Nio, Masaki; Iwanaka, Tadashi; Okoshi, Kae; Kaneko, Koichi; Nagano, Hiroaki; Nishida, Takahiro; Nishida, Hiroshi; Hoshino, Ken; Maehara, Tadaaki; Masuda, Munetaka; Matsufuji, Hiroshi; Yanaga, Katsuhiko; Tabayashi, Koichi; Satomi, Susumu; Kokudo, Norihiro

    2013-11-01

    The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons. Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey. To examine the influence of 2010 revision of the fee for medical services performed by surgeons, we distributed a second questionnaire to directors of hospitals and administrators of clerks belonging to official institutes in JSS. Collective data were analyzed retrospectively. The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %). Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively. Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork. Of note, approximately 25 % of surgeons had over time of more than 100 h a week, coinciding to the number of hours that might lead to death from fatigue, described in the Japanese labor law. Although the total medical service fee in hospitals, especially in large-scale hospitals with more than 500 beds, increased markedly after 2010 revision of the fee for medical services performed by surgeons, few hospitals gave perquisites and/or incentives to surgeons. To prevent and avoid collapse of the surgical specialty in Japan, an improvement in the work environment of surgeons by initiation of the JSS would be required as soon as possible.

  17. 5 CFR 297.206 - Fees charged by the Office.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Fees charged by the Office. 297.206 Section 297.206 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PRIVACY PROCEDURES FOR PERSONNEL RECORDS Request for Access § 297.206 Fees charged by the Office. (a) No fees will be charged for search and review time...

  18. Contracting for engineering services: Experience with innovative fee arrangements

    International Nuclear Information System (INIS)

    Criner, D.E.; Schenk, J.L.

    1995-01-01

    The relationship between an engineering firm and a client can be favorably influenced by a clearly defined incentive plan. This paper addresses several approaches and the advantages and disadvantages of each. It also summarizes the lessons learned to date in using incentive fee arrangements

  19. 46 CFR 9.14 - Assessment and collection of fees.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Assessment and collection of fees. 9.14 Section 9.14 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC EXTRA COMPENSATION FOR OVERTIME SERVICES § 9.14 Assessment and collection of fees. Assessment and collection of fees...

  20. Education fees – New forms

    CERN Multimedia

    2015-01-01

    The application forms for the payment of education fees have been updated and are now available in the Admin e-guide (under the “Useful Documents” heading):   Payment of education fees (including language course fees) – AC12A (form to be used by staff members recruited before 1 January 2007, with the exception of former “local staff”).   Payment of education fees – AC12B (form to be used by staff members recruited on or after 1 January 2007, by fellows, scientific associates and guest professors and by former “local staff” whose contracts started before 1 January 2007). The Education Fees service will continue to accept the old forms until the end of the current academic year, i.e. until 31 August 2015. Members of the personnel are reminded that any false declaration or failure to declare information with a view to deceiving others or achieving a gain that would result in a financial loss for CERN or...

  1. 78 FR 14034 - Health Insurance Providers Fee

    Science.gov (United States)

    2013-03-04

    ... Health Insurance Providers Fee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... insurance for United States health risks. This fee is imposed by section 9010 of the Patient Protection and... insurance for United States health risks. DATES: Written or electronic comments must be received by June 3...

  2. 20 CFR 10.806 - How are the maximum fees defined?

    Science.gov (United States)

    2010-04-01

    ... AMENDED Information for Medical Providers Medical Fee Schedule § 10.806 How are the maximum fees defined? For professional medical services, the Director shall maintain a schedule of maximum allowable fees.../Current Procedural Terminology (HCPCS/CPT) code which represents the relative skill, effort, risk and time...

  3. 47 CFR 76.1511 - Fees.

    Science.gov (United States)

    2010-10-01

    ... TELEVISION SERVICE Open Video Systems § 76.1511 Fees. An open video system operator may be subject to the... local franchising authority or other governmental entity, in lieu of the franchise fees permitted under... open video system operator or its affiliates, including all revenues received from subscribers and all...

  4. 75 FR 41931 - Assessment and Collection of Regulatory Fees for Fiscal Year 2010

    Science.gov (United States)

    2010-07-19

    ... regulatory fees are mandated by Congress and are collected to recover the regulatory costs associated with... base our fee schedule on the available cost data first used in 1997.\\74\\ Since the inception of that... service categories (some of which are not able to pass the cost of the fee to the end user), and this...

  5. 21 CFR 70.19 - Fees for listing.

    Science.gov (United States)

    2010-04-01

    ... order, bank draft or certified check drawn to the order of the Food and Drug Administration, collectable... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Fees for listing. 70.19 Section 70.19 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL COLOR ADDITIVES...

  6. 77 FR 15529 - Revision of Fee Schedules; Fee Recovery for Fiscal Year 2012

    Science.gov (United States)

    2012-03-15

    ... and 171 Revision of Fee Schedules; Fee Recovery for Fiscal Year 2012; Proposed Rule #0;#0;Federal... REGULATORY COMMISSION 10 CFR Parts 170 and 171 [NRC-2011-0207] RIN 3150-AJ03 Revision of Fee Schedules; Fee..., inspection, and annual fees charged to its applicants and licensees. The proposed amendments are necessary to...

  7. 77 FR 48111 - Branded Prescription Drug Fee; Correction

    Science.gov (United States)

    2012-08-13

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [REG-112805-10] RIN 1545-BJ39 Branded Prescription Drug Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice..., August 6, 2012 (77 FR 46653) relating to the branded prescription drug fee imposed by the Affordable Care...

  8. 32 CFR 93.6 - Fees.

    Science.gov (United States)

    2010-07-01

    ... SERVICE OF PROCESS; RELEASE OF OFFICIAL INFORMATION IN LITIGATION; AND TESTIMONY BY NSA PERSONNEL AS WITNESSES § 93.6 Fees. Consistent with the guidelines in § 93.1(e), NSA may charge reasonable fees to... providing such information, and may include: (a) The costs of time expended by NSA employees to process and...

  9. 78 FR 17612 - Health Insurance Providers Fee; Correction

    Science.gov (United States)

    2013-03-22

    ... Health Insurance Providers Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... guidance on the annual fee imposed on covered entities engaged in the business of providing health insurance for United States health risks. FOR FURTHER INFORMATION CONTACT: Charles J. Langley, Jr. at (202...

  10. International experiences in stormwater fee.

    Science.gov (United States)

    Tasca, F A; Assunção, L B; Finotti, A R

    2017-04-01

    Stormwater management (SWM) includes a wide range of services aimed at environmental protection, enhancement of water resources and flood control. Local governments are responsible for managing all these aspects within their jurisdiction, but they often present limitations in generating revenues. Thus, many municipalities have been seeking a dedicated funding source for these programs and practices. This publication provides a brief overview of current legal issues associated with stormwater funding focusing on the most used method: fees. It is a successful mechanism to fund legal obligations of municipalities; however, it must have a significant value to motivate the reduction of runoff. Through literature, we found stormwater fees in Australia, Brazil, Canada, Ecuador, France, Germany, Poland, South Africa and the United States (USA). France had the highest average monthly fee, but this financing experience was suspended in 2014. Brazil has the lowest fee by m², comparable to the US fee. While in Brazil overall SWM represents low priority investments, the USA represents one of the most evolved countries in stormwater funding practices. It was noticed by reviewing the international experience that charging stormwater fees is a successful mechanism to fund the legal obligations and environmental protection.

  11. Medicare program; appeals of CMS or CMS contractor determinations when a provider or supplier fails to meet the requirements for Medicare billing privileges. Final rule.

    Science.gov (United States)

    2008-06-27

    This final rule implements a number of regulatory provisions that are applicable to all providers and suppliers, including durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. This final rule establishes appeals processes for all providers and suppliers whose enrollment, reenrollment or revalidation application for Medicare billing privileges is denied and whose Medicare billing privileges are revoked. It also establishes timeframes for deciding enrollment appeals by an Administrative Law Judge (ALJ) within the Department of Health and Human Services (DHHS) or the Departmental Appeals Board (DAB), or Board, within the DHHS; and processing timeframes for CMS' Medicare fee-for-service (FFS) contractors. In addition, this final rule allows Medicare FFS contractors to revoke Medicare billing privileges when a provider or supplier submits a claim or claims for services that could not have been furnished to a beneficiary. This final rule also specifies that a Medicare contractor may establish a Medicare enrollment bar for any provider or supplier whose billing privileges have been revoked. Lastly, the final rule requires that all providers and suppliers receive Medicare payments by electronic funds transfer (EFT) if the provider or supplier, is submitting an initial enrollment application to Medicare, changing their enrollment information, revalidating or re-enrolling in the Medicare program.

  12. 75 FR 33445 - U.S. Citizenship and Immigration Services Fee Schedule

    Science.gov (United States)

    2010-06-11

    ... comprehensive fee study and refined its cost accounting process, and determined that current fees do not recover... State. DNB--Dun and Bradstreet. EAD--Employment Authorization Document. FASAB--Federal Accounting... naturalization benefits and ensures the collection, safeguarding, and accounting of fees by USCIS. INA section...

  13. Fees and penalties for use of the environment – financial and legal aspects

    Directory of Open Access Journals (Sweden)

    Andrzej Borodo

    2016-09-01

    Full Text Available Fees and penalties for use of the environment, regulated by the Environmental Protection Act, are legal structures related with each other. These are the four basic fees (for the emission of gases or dust into the air, the discharge of sewage, for water drawing and for storage of waste, as well as increased fees and penalties. Fees and penalties for use of the environment are separate institutions in relation to other categories of public revenues (taxes, fees for services. These are the payments for use directly the components of the environment (e.g. air, water. They constitute public burden for the use of the environment, which the state legislature imposes on entities using the environment. Their aim is to limit the use of the natural environment and the accumulation of funds for financing the tasks in the area of environmental protection.

  14. Fee Versus Free in Libraries.

    Science.gov (United States)

    Garrett, Amy B.

    This study examines 104 articles on the fee versus free controversy in libraries, written primarily between the years of 1992 and 1997. The content analysis assesses the types of libraries that charges fees--academic, public, school, or special; who is charged--everyone, businesses and their personnel, law firms and lawyers; and what services the…

  15. 78 FR 47319 - Fee Schedule for Reference Biological Standards and Biological Preparations

    Science.gov (United States)

    2013-08-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Fee Schedule for Reference Biological Standards and Biological Preparations AGENCY: Centers for Disease Control and... for Disease Control and Prevention (CDC), located within the Department of Health and Human Services...

  16. 15 CFR Appendix A to Part 950 - Schedule of User Fees for Access to NOAA Environmental Data

    Science.gov (United States)

    2010-01-01

    ... NOAA Environmental Data A Appendix A to Part 950 Commerce and Foreign Trade Regulations Relating to..., App. A Appendix A to Part 950—Schedule of User Fees for Access to NOAA Environmental Data Name of product/data/publication/information/service Current fee New fee NOAA National Data Centers Standard User...

  17. 7 CFR 27.81 - Fees; certificates.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Fees; certificates. 27.81 Section 27.81 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... CLASSIFICATION UNDER COTTON FUTURES LEGISLATION Regulations Costs of Classification and Micronaire § 27.81 Fees...

  18. Tuition fees and funding – barriers for non-traditional students? First results from the international research project Opening Universities for Lifelong Learning (OPULL)

    DEFF Research Database (Denmark)

    Moissidis, Sonja; Schwarz, Jochen; Yndigegn, Carsten

    2011-01-01

    Project OPULL – Opening Universities for Lifelong Learning – is undertaking research into ways of opening up higher education to vocationally qualified and experienced target groups in four European countries. Open university models in Germany, Denmark, Finland and the United Kingdom are being...... investigated in three research phases between 2009 and 2012 with the aim of identifying critical success factors for building open universities for Europe. This paper presents the first phase, in which educational systems in the participant countries have been mapped and interviews with lifelong learning...... experts undertaken. The current situation and perspectives in each country together with critical issues on how fees and funding influence higher education access for non-traditional students in these countries are discussed and explored through the interview evidence. The initial findings of the first...

  19. User fee exemptions and excessive household spending for normal delivery in Burkina Faso: the need for careful implementation

    Directory of Open Access Journals (Sweden)

    Ameur Amal

    2012-11-01

    Full Text Available Abstract Background In 2006, the Parliament of Burkina Faso passed a policy to reduce the direct costs of obstetric services and neonatal care in the country’s health centres, aiming to lower the country’s high national maternal mortality and morbidity rates. Implementation was via a “partial exemption” covering 80% of the costs. In 2008 the German NGO HELP launched a pilot project in two health districts to eliminate the remaining 20% of user fees. Regardless of any exemptions, women giving birth in Burkina Faso’s health centres face additional expenses that often represent an additional barrier to accessing health services. We compared the total cost of giving birth in health centres offering partial exemption versus those with full exemption to assess the impact on additional out-of-pocket fees. Methods A case–control study was performed to compare medical expenses. Case subjects were women who gave birth in 12 health centres located in the Dori and Sebba districts, where HELP provided full fee exemption for obstetric services and neonatal care. Controls were from six health centres in the neighbouring Djibo district where a partial fee exemption was in place. A random sample of approximately 50 women per health centre was selected for a total of 870 women. Results There was an implementation gap regarding the full exemption for obstetric services and neonatal care. Only 1.1% of the sample from Sebba but 17.5% of the group from Dori had excessive spending on birth related costs, indicating that women who delivered in Sebba were much less exposed to excessive medical expenses than women from Dori. Additional out-of-pocket fees in the full exemption health districts took into account household ability to pay, with poorer women generally paying less. Conclusions We found that the elimination of fees for facility-based births benefits especially the poorest households. The existence of excessive spending related to direct costs of

  20. 14 CFR 187.15 - Payment of fees.

    Science.gov (United States)

    2010-01-01

    ... REGULATIONS FEES § 187.15 Payment of fees. (a) The fees of this part are payable to the Federal Aviation Administration by check, money order, wire transfers, draft, payable in U.S. currency and drawn on a U.S. bank, or by credit card payable in U.S. currency, prior to the provision of any service under this part. (b...

  1. AUDIT FEE DETERMINANTS IN THE HOSPITAL SECTOR

    OpenAIRE

    Vanderbeke Dave; Christiaens Johan; Verbruggen Sandra

    2014-01-01

    Although the number of non-profit audit fee studies recently has risen, evidence in the hospital sector is rather scarce. Apart from NHS studies, hospitals are a fairly new topic and several specific fee determinants are yet to be tested. For instance, hospitals can have a private or a public status and they have a distinct number of clinical services. These and other dependent variables known from earlier research are added to a fee model and investigated. As hypothesized the hospital status...

  2. Socioeconomic Differences in Use of Low-Value Cancer Screenings and Distributional Effects in Medicare.

    Science.gov (United States)

    Xu, Wendy Yi; Jung, Jeah Kyoungrae

    2017-10-01

    Consuming low-value health care not only highlights inefficient resource use but also brings an important concern regarding the economics of disparities. We identify the relation of socioeconomic characteristics to the use of low-value cancer screenings in Medicare fee-for-service (FFS) settings, and quantify the amount subsidized from nonusers and taxpayers to users of these screenings. 2007-2013 Medicare Current Beneficiary Survey, Medicare FFS claims, and the Area Health Resource Files. Our sample included enrollees in FFS Part B for the entire calendar year. We excluded beneficiaries with a claims-documented or self-reported history of targeted cancers, or those enrolled in Medicaid or Medicare Advantage plans. We identified use of low-value Pap smears, mammograms, and prostate-specific antigen tests based on established algorithms, and estimated a logistic model with year dummies separately for each test. Secondary data analyses. We found a statistically significant positive association between privileged socioeconomic characteristics and use of low-value screenings. Having higher income and supplemental private insurance strongly predicted more net subsidies from Medicare. FFS enrollees who are better off in terms of sociodemographic characteristics receive greater subsidies from taxpayers for using low-value cancer screenings. © Health Research and Educational Trust.

  3. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE uniform health maintenance organization (HMO) benefit--Prime enrollment fee exemption for survivors of active duty deceased sponsors and medically retired uniformed services members and their dependents. Final rule.

    Science.gov (United States)

    2014-09-30

    This final rule creates an exception to the usual rule that TRICARE Prime enrollment fees are uniform for all retirees and their dependents and responds to public comments received to the proposed rule published in the Federal Register on June 7, 2013. Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents are part of the retiree group under TRICARE rules. In acknowledgment and appreciation of the sacrifices of these two beneficiary categories, the Secretary of Defense has elected to exercise his authority under the United States Code to exempt Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents enrolled in TRICARE Prime from paying future increases to the TRICARE Prime annual enrollment fees. The Prime beneficiaries in these categories have made significant sacrifices for our country and are entitled to special recognition and benefits for their sacrifices. Therefore, the beneficiaries in these two TRICARE beneficiary categories who enrolled in TRICARE Prime prior to 10/1/2013, and those since that date, will have their annual enrollment fee frozen at the appropriate fiscal year rate: FY2011 rate $230 per single or $460 per family, FY2012 rate $260 or $520, FY2013 rate $269.38 or $538.56, or the FY2014 rate $273.84 or $547.68. The future beneficiaries added to these categories will have their fee frozen at the rate in effect at the time they are classified in either category and enroll in TRICARE Prime or, if not enrolling, at the rate in effect at the time of enrollment. The fee remains frozen as long as at least one family member remains enrolled in TRICARE Prime and there is not a break in enrollment. The fee charged for the dependent(s) of a Medically Retired Uniformed Services Member would not change if the dependent(s) was later re-classified a Survivor.

  4. Protocol: a realist review of user fee exemption policies for health services in Africa.

    Science.gov (United States)

    Robert, Emilie; Ridde, Valéry; Marchal, Bruno; Fournier, Pierre

    2012-01-01

    Background Four years prior to the Millenium Development Goals (MDGs) deadline, low- and middle-income countries and international stakeholders are looking for evidence-based policies to improve access to healthcare for the most vulnerable populations. User fee exemption policies are one of the potential solutions. However, the evidence is disparate, and systematic reviews have failed to provide valuable lessons. The authors propose to produce an innovative synthesis of the available evidence on user fee exemption policies in Africa to feed the policy-making process. Methods The authors will carry out a realist review to answer the following research question: what are the outcomes of user fee exemption policies implemented in Africa? why do they produce such outcomes? and what contextual elements come into play? This type of review aims to understand how contextual elements influence the production of outcomes through the activation of specific mechanisms, in the form of context-mechanism-outcome configurations. The review will be conducted in five steps: (1) identifying with key stakeholders the mechanisms underlying user fee exemption policies to develop the analytical framework, (2) searching for and selecting primary data, (3) assessing the quality of evidence using the Mixed-Method Appraisal Tool, (4) extracting the data using the analytical framework and (5) synthesising the data in the form of context-mechanism-outcomes configurations. The output will be a middle-range theory specifying how user fee exemption policies work, for what populations and under what circumstances. Ethics and dissemination The two main target audiences are researchers who are looking for examples to implement a realist review, and policy-makers and international stakeholders looking for lessons learnt on user fee exemption. For the latter, a knowledge-sharing strategy involving local scientific and policy networks will be implemented. The study has been approved by the ethics

  5. Physician fees and managed care plans.

    Science.gov (United States)

    Zwanziger, Jack

    2002-01-01

    One of the objectives of managed care organizations (MCOs) has been to reduce the rate of growth of health care expenditures, including that of physician fees. Yet, due to a lack of data, no one has been able to determine whether MCOs have been successful in encouraging the growth of price competition in the market for physician services in order to slow the growth in physician fees. This study uses a unique, national-level data set to determine what factors influenced the physician fees that MCOs negotiated during the 1990-92 period. The most influential characteristics were physician supply and managed care penetration, which suggest that the introduction of competition into the health care market was an effective force in reducing physician fees.

  6. 37 CFR 383.3 - Royalty fees for public performances of sound recordings and the making of ephemeral recordings.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fees for public... SUBSCRIPTION SERVICES § 383.3 Royalty fees for public performances of sound recordings and the making of... regulations for all years 2007 and earlier. Such fee shall be recoupable and credited against royalties due in...

  7. Cash Cow: User Fees in Alberta Public Libraries

    Directory of Open Access Journals (Sweden)

    Jason Hammond

    2007-03-01

    Full Text Available Alberta is the wealthiest province in Canada. It is also the only jurisdiction in NorthAmerica where the majority of local library boards charge patrons to use their publiclibraries.There are many reasons why these fees came into being in the 1980s and continue toexist today. Library trustees see them as an easy source of funds for their cashstrappedlibraries, some librarians feel that they help instill a sense of value in librarymaterials and services, library patrons realise the fees are often less than the cost of asingle paperback book and don’t mind paying them.But the main reason the fees still exist is because of the unique form of conservatismespoused by the popular Alberta premier Ralph Klein, who favoured big business, lowertaxes, and privatization of public services while leading the province from 1992 to 2006.Klein’s policies included a focus on user-pay models for all manner of services. Payingfor library cards is something that Alberta’s citizens have accepted for the most part. Butbecause of Alberta’s strong support for user-pay models, this isn’t just an issue for thelibrarians, patrons, and politicians of that province. The possibility also exists thatlibraries in other provinces could be opened up to a GATS challenge by for-profitcorporations outside of Canada because of Alberta’s current user fee policies.How this unique user fee arrangement developed, the current situation, and what thefuture may bring will be the subject of this paper.

  8. 37 CFR 382.13 - Terms for making payment of royalty fees and statements of account.

    Science.gov (United States)

    2010-07-01

    ... royalty fees and statements of account. 382.13 Section 382.13 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS RATES AND TERMS FOR STATUTORY LICENSES RATES AND TERMS FOR... Audio Radio Services § 382.13 Terms for making payment of royalty fees and statements of account. (a...

  9. 24 CFR 4001.122 - Fees and closing costs.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Fees and closing costs. 4001.122... Requirements and Underwriting Procedures § 4001.122 Fees and closing costs. (a) The holder or servicer of the... delinquency and default fees. (b) Allowable closing costs incurred in connection with the refinancing and...

  10. Health Services Utilization Among Fee-for-Service Medicare and Medicaid Patients Under Age 65 with Behavioral Health Illness at an Urban Safety Net Hospital.

    Science.gov (United States)

    Cancino, Ramon S; Jack, Brian W; Jarvis, John; Cummings, Alice Kate; Cooper, Ellie; Cremieux, Pierre-Yves; Burgess, James F

    2017-07-01

    In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011. We compared patients with and without behavioral health illness. The main outcome measures were hospital admission and ED use. Chi-square and Wilcoxon rank-sum tests were used for descriptive statistics on categorical and continuous variables, respectively. Greedy propensity score matching was used to control for confounding factors. Rate ratios (RR) and 95% confidence intervals (CI) were determined after matching and after adjusting for those variables that remained significantly different after matching. In 2011, 10% of all fee-for-service dual eligible patients aged less than 65 years in Massachusetts were seen at Boston Medical Center. Data before propensity score matching showed significant differences in age, sex, race/ethnicity, marital status, education, employment, physical comorbidities, and Charlson Comorbidity Index score between patients with and without behavioral health illness. Analysis after propensity score matching found significant differences in sex, Hispanic race, and other education and employment status. Compared with patients without behavioral health illness, patients with behavioral health illness had a higher RR for hospital admissions (RR = 2.07; 95% CI = 1.81-2.38; P fee-for-service plan had significantly higher rates of hospital admission and ED use compared with dual eligible patients without behavioral health illness at the largest urban safety net medical center in New England. Safety net hospitals care for a large proportion of dual

  11. 11 CFR 5.6 - Fees.

    Science.gov (United States)

    2010-01-01

    ... requester of the identity of the private contractor who will perform the duplication services. The fee for... Activity Financial Control and Compliance Manual MUR Index Guideline for Presentation in Good Order Office...

  12. 77 FR 18106 - Award Fee for Service and End-Item Contracts

    Science.gov (United States)

    2012-03-27

    ... payments exceed the final evaluation score, the Contractor will either credit the next payment voucher for... either credit the next payment voucher for the amount of such overpayment or refund the difference to the... fee payments, at a not-to-exceed amount of $100,000 for the contract, in reserve to protect the...

  13. 33 CFR 55.11 - How are child development center fees established?

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false How are child development center... HOMELAND SECURITY PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.11 How are child development center fees established? (a) Fees for the provision of services at child development centers shall be set by...

  14. Community oncology in an era of payment reform.

    Science.gov (United States)

    Cox, John V; Ward, Jeffery C; Hornberger, John C; Temel, Jennifer S; McAneny, Barbara L

    2014-01-01

    Patients and payers (government and private) are frustrated with the fee-for-service system (FFS) of payment for outpatient health services. FFS rewards volume and highly valued services, including expensive diagnostics and therapeutics, over lesser valued cognitive services. Proposed payment schemes would incent collaboration and coordination of care among providers and reward quality. In oncology, new payment schemes must address the high costs of all services, particularly drugs, while preserving the robust distribution of sites of service available to patients in the United States. Information technology and personalized cancer care are changing the practice of oncology. Twenty-first century oncology will require increasing cognitive work and shared decision making, both of which are not well regarded in the FFS model. A high proportion of health care dollars are consumed in the final months of life. Effective delivery of palliative and end-of-life care must be addressed by practice and by new models of payment. Value-based reimbursement schemes will require oncology practices to change how they are structured. Lessons drawn from the principles of primary care's Patient Centered Medical Home (PCMH) will help oncology practice to prepare for new schemes. PCMH principles place a premium on proactively addressing toxicities of therapies, coordinating care with other providers, and engaging patients in shared decision making, supporting the ideal of value defined in the triple aim-to measurably improve patient experience and quality of care at less cost. Payment reform will be disruptive to all. Oncology must be engaged in policy discussions and guide rational shifts in priorities defined by new payment models.

  15. 75 FR 39475 - International Mail: Proposed Changes in Prices and Fees

    Science.gov (United States)

    2010-07-09

    ... Fee International Reply Coupons International Business Reply Service Registered Mail TM Return Receipt....3a to change the price to $2.20.] * * * * * 382 International Business Reply Service * * * * * 382.4... POSTAL SERVICE 39 CFR Part 20 International Mail: Proposed Changes in Prices and Fees AGENCY...

  16. 36 CFR 223.280 - Waiver of fees and/or fair market value.

    Science.gov (United States)

    2010-07-01

    ... fees and/or fair market value. The Forest Service waives the collection of fees otherwise required... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Waiver of fees and/or fair market value. 223.280 Section 223.280 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF...

  17. Tuition Fees, as User Prices, and Private Incentives

    OpenAIRE

    Economides, George; Philippopoulos, Apostolis; Sakkas, Stelios

    2016-01-01

    This paper studies the aggregate and distributional implications of introducing tuition fees for public education services into a tax system with income and consumption taxes. The setup is a neoclassical growth model where agents differ in capital holdings. We show that the introduction of tuition fees (a) improves individual incentives to work and/or save and (b) can be both efficient and equitable. The focus is on the role of tuition fees as an extra price and how this affects private incen...

  18. Decomposing Fees paid to Audit Firms-Assessing Knowledge Spillovers and Independence

    DEFF Research Database (Denmark)

    Holm, Claus

    We extend prior studies (e.g., Whisenant et al., 2003; Krishnan and Yu, 2011; Chan et al., 2012) by explicitly utilizing a stringent decomposition of total fee paid for audit services and other services in a sample of listed non-financial Danish companies. When controlling for the joint determina......We extend prior studies (e.g., Whisenant et al., 2003; Krishnan and Yu, 2011; Chan et al., 2012) by explicitly utilizing a stringent decomposition of total fee paid for audit services and other services in a sample of listed non-financial Danish companies. When controlling for the joint...... determination of fees pertaining to the statutory audit and non-audit services, we find support for the existence of positive knowledge spillover from non-audit to audit and the possible independence problems related to this economic bonding. In terms of the non-audit components, the knowledge spillover...... argument holds for tax services provided and other services provided, but not for the provision of audit-related services. We also consider the implication of new regulation of the provision of non-audit services in EU countries. From the perspective of maintaining independence, there will be no apparent...

  19. 32 CFR 701.54 - Collection of fees and fee rates for technical data.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Collection of fees and fee rates for technical... fee rates for technical data. (a) Technical data, other than technical data that discloses critical... after the person requesting such technical data pays all reasonable costs attributed to search...

  20. The New Statutory Audit Framework in Europe: Implications for the Provision of Non-audit Services

    DEFF Research Database (Denmark)

    Holm, Claus

    2016-01-01

    Purpose: The individual EU Member States have options on how they implement the new statutory audit framework in Europe. They may introduce stricter rules or apply certain exemptions where deemed appropriate. Denmark exemplifies Member States with a traditionally high level of non-audit services...... provided by its auditors. The aim of this study is to contrast the minimum implementation rationale observed in the Danish implementation process with an ex ante examination of fee dependency. Design/methodology/approach: The audit reform introduces a cap on non-audit fees which implies a regulator......-determined condition of non-independence. The cap is applied as a treatment effect on the ex ante relationship between audit fees and non-audit fees. In a sample with 3,238 observations, Denmark is compared with Finland, Germany, Sweden and the UK in order to determine whether the new measure will have different...

  1. 37 CFR 382.12 - Royalty fees for the public performance of sound recordings and the making of ephemeral recordings.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fees for the public... Preexisting Satellite Digital Audio Radio Services § 382.12 Royalty fees for the public performance of sound recordings and the making of ephemeral recordings. (a) In general. The monthly royalty fee to be paid by a...

  2. The Liberalization of Notary Fees in Romania. Objectives and Restrictions

    Directory of Open Access Journals (Sweden)

    Florentina MOISESCU

    2013-03-01

    Full Text Available Minimum notary fees are the questionable regulatory feature of Romanian notary system. Classic latin notary system to which it belongs Romanian notary system is the most regulated and most restrictive of the four existing notary systems in the European Union. Notary fees are set by law. Notary is an unusual market activity when assessing service provision is not during but after the quality transpires. Minimum notary fees militate to ensure an adequate quality of notary services at an acceptable cost. In contrast, the liberalization of notary fees aims to increase competition among service providers to encourage professionals to act according to the principle of cost-effectiveness, increase quality or to offer innovative services practice the lowest prices. The purpose of writing is to assess the impact of price liberalization in Romania with reference to me deregulated Dutch notary system and similar systems similar to Romanian, the Belgian system and German system.

  3. Measuring coding intensity in the Medicare Advantage program.

    Science.gov (United States)

    Kronick, Richard; Welch, W Pete

    2014-01-01

    In 2004, Medicare implemented a system of paying Medicare Advantage (MA) plans that gave them greater incentive than fee-for-service (FFS) providers to report diagnoses. Risk scores for all Medicare beneficiaries 2004-2013 and Medicare Current Beneficiary Survey (MCBS) data, 2006-2011. Change in average risk score for all enrollees and for stayers (beneficiaries who were in either FFS or MA for two consecutive years). Prevalence rates by Hierarchical Condition Category (HCC). Each year the average MA risk score increased faster than the average FFS score. Using the risk adjustment model in place in 2004, the average MA score as a ratio of the average FFS score would have increased from 90% in 2004 to 109% in 2013. Using the model partially implemented in 2014, the ratio would have increased from 88% to 102%. The increase in relative MA scores appears to largely reflect changes in diagnostic coding, not real increases in the morbidity of MA enrollees. In survey-based data for 2006-2011, the MA-FFS ratio of risk scores remained roughly constant at 96%. Intensity of coding varies widely by contract, with some contracts coding very similarly to FFS and others coding much more intensely than the MA average. Underpinning this relative growth in scores is particularly rapid relative growth in a subset of HCCs. Medicare has taken significant steps to mitigate the effects of coding intensity in MA, including implementing a 3.4% coding intensity adjustment in 2010 and revising the risk adjustment model in 2013 and 2014. Given the continuous relative increase in the average MA risk score, further policy changes will likely be necessary.

  4. 50 CFR 260.81 - Readjustment and increase in hourly rates of fees.

    Science.gov (United States)

    2010-10-01

    ... of fees. 260.81 Section 260.81 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL... Certification of Establishments and Fishery Products for Human Consumption Fees and Charges § 260.81 Readjustment and increase in hourly rates of fees. (a) When Federal Pay Act increases occur, the hourly rates...

  5. The Business Information Services: Old-Line Online Moves to the Web.

    Science.gov (United States)

    O'Leary, Mick

    1997-01-01

    Although the availability of free information on the World Wide Web has placed traditional, fee-based proprietary online services on the defensive, most major online business services are now on the Web. Highlights several business information providers: Profound, NewsNet and ProQuest Direct, Dow Jones and Wall Street Journal Interactive Edition,…

  6. Specialty Payment Model Opportunities and Assessment: Oncology Simulation Report.

    Science.gov (United States)

    White, Chapin; Chan, Chris; Huckfeldt, Peter J; Kofner, Aaron; Mulcahy, Andrew W; Pollak, Julia; Popescu, Ioana; Timbie, Justin W; Hussey, Peter S

    2015-07-15

    This article describes the results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). CMS asked MITRE and RAND to conduct simulation analyses to preview some of the possible impacts of the payment model and to inform design decisions related to the model. The simulation analysis used an episode-level dataset based on Medicare fee-for-service (FFS) claims for historical oncology episodes provided to Medicare FFS beneficiaries in 2010. Under the proposed model, participating practices would continue to receive FFS payments, would also receive per-beneficiary per-month care management payments for episodes lasting up to six months, and would be eligible for performance-based payments based on per-episode spending for attributed episodes relative to a per-episode spending target. The simulation offers several insights into the proposed payment model for oncology: (1) The care management payments used in the simulation analysis-$960 total per six-month episode-represent only 4 percent of projected average total spending per episode (around $27,000 in 2016), but they are large relative to the FFS revenues of participating oncology practices, which are projected to be around $2,000 per oncology episode. By themselves, the care management payments would increase physician practices' Medicare revenues by roughly 50 percent on average. This represents a substantial new outlay for the Medicare program and a substantial new source of revenues for oncology practices. (2) For the Medicare program to break even, participating oncology practices would have to reduce utilization and intensity by roughly 4 percent. (3) The break-even point can be reduced if the care management payments are reduced or if the performance-based payments are reduced.

  7. Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

    Science.gov (United States)

    Ludwick, D. A.; Doucette, John

    2009-01-01

    Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT). Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation. PMID:19081787

  8. Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

    Directory of Open Access Journals (Sweden)

    D. A. Ludwick

    2009-01-01

    Full Text Available Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT. Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation.

  9. 7 CFR 1962.29 - Payment of fees and insurance premiums.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Payment of fees and insurance premiums. 1962.29... Security § 1962.29 Payment of fees and insurance premiums. (a) Fees. (1) Security instruments. Borrowers... the service cannot be obtained without cost. (b) Insurance premiums. County Supervisors are authorized...

  10. Professional Knowledge of No-Fee and For-Fee Preservice Students

    Science.gov (United States)

    Li, Guang Ping; Zhang, Dewei

    2013-01-01

    Improving the quality of training for no-fee preservice students is crucial in implementing the no-fee teacher education policy. This study used the Preservice Student Professional Growth Questionnaire to survey the level of professional knowledge of the first class (entering in 2007) of Northeast Normal University preservice students during the…

  11. 45 CFR 61.13 - Fees applicable to requests for information.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Fees applicable to requests for information. 61.13 Section 61.13 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND...

  12. 45 CFR 60.14 - Fees applicable to requests for information.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Fees applicable to requests for information. 60.14 Section 60.14 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS Disclosure of...

  13. 47 CFR 1.1157 - Payment of charges for regulatory fees.

    Science.gov (United States)

    2010-10-01

    ... wireless radio, mass media, common carrier, cable and international services shall be filed in full on an... 47 Telecommunication 1 2010-10-01 2010-10-01 false Payment of charges for regulatory fees. 1.1157 Section 1.1157 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule...

  14. Federal interim storage fee study for civilian spent nuclear fuel: a technical and economical analysis

    International Nuclear Information System (INIS)

    1983-07-01

    This report describes the study conducted by the Department of Energy (the Department) regarding payment charges for the federal interim storage (FIS) of spent fuel and presents the details of the study results. It describes the selection of a methodology for calculating a FIS fee schedule, sets forth the estimates of cost for construction and operation of FIS facilities, provides a range of estimates for the fee for FIS services, and identifies special contractual considerations associated with providing FIS services to authorized users. The fee is structured for a range of spent fuel capacities because of uncertainties regarding the schedule of availability and amount of spent fuel that may require and qualify for FIS. The results set forth in the report were used as a basis for development of the report entitled Payment Charges for Federal Interim Storage of Spent Nuclear Fuel from Civilian Nuclear Power Plants in the United States, dated July 1983

  15. 8 CFR 244.20 - Waiver of fees.

    Science.gov (United States)

    2010-01-01

    ... 103.7(b) which relate to applications to the district director or service center director for... expenditures, such as essential medical expenses, or expenses for clothing, laundry, and child care, to the... officer in support of a fee waiver request are subject to verification by the Service. (i) In requiring...

  16. 9 CFR 592.500 - Payment of fees and charges.

    Science.gov (United States)

    2010-01-01

    ... holiday inspection service shall be paid by the interested party making the application for such service... inclusive. If so required by the Inspection program personnel, such fees and charges shall be paid in...

  17. Education fees: Indexation of the amounts for accommodation, meals and school transport for the 2010-2011 academic year

    CERN Multimedia

    HR Department

    2010-01-01

    At its meeting on 21 September 2010, the Standing Concertation Committee approved the calculated indexation of the amounts for accommodation, meals and school transport for the 2010-2011 academic year. Accommodation fees for the 2010-2011 academic year will be paid in the form of a lump sum of 537 CHF per month (paid at the rate of 100%). The amount used for the calculation of meal payments will be 18 CHF per meal (paid at the rate of 75%). The ceiling for school transport fees has been set at 615 CHF for the 2010-2011 academic year. Education Fees Service Tel. 72862 / 71421

  18. Education fees: Indexation of the amounts for accommodation, meals and school transport for the 2011-2012 academic year

    CERN Multimedia

    HR Department

    2011-01-01

    At its meeting on 1 September 2011, the Standing Concertation Committee approved the calculated indexation of the amounts for accommodation, meals and school transport for the 2011-2012 academic year.  Accommodation fees for the 2011-2012 academic year will be paid in the form of a lump sum of 545 CHF per month (paid at the rate of 100%). The amount used for the calculation of meal payments will be 18.50 CHF per meal (paid at the rate of 75%). The ceiling for school transport fees has been set at 627 CHF for the 2011-2012 academic year. Education Fees Service Tel. 72862 / 71421

  19. Qualitative Study of correspondence between Patient Perception of Service Advertisement and Service Provided from Traditional Health Facilities

    Directory of Open Access Journals (Sweden)

    Lusi Kristiana

    2015-01-01

    Full Text Available background: Attractive adses of traditional health services often promises such as certainty of healing, treatment without side effect, experience personnel, exclusive recipes, and testimony of patients who recovered. Ads that this unsubstantiated allegedly played a role in the tendency of people turn to traditional medicine. The aim of the study is to describe the perception of patients about the correspondence between the advertisement and the services provided qualitatively. Methods: The study was conducted in Surabaya for 5 months in 2012. Informants were selected purposively. results: The result shows that most of the information about traditional health services obtained from either advertisement local and national television. Health complaints predominanly degenerative diseases, and most have been treated to modern medicine but because they do not heal, switch to traditional medicine. conclusion: Informants judge ad featuring attractive because advanced equipment, herbal remedies as well as testimonials of patients who have recovered. Much of the promise of the ads is not evident when patients seek treatment, so they seek other traditional treatments. Most of them are less satisfied, but there is a fraction that satisfied because being cured. Traditional health services responsiveness associated with the non-medical aspects assessed either by informants. recomendation:Competent authorities should enforce and socialize media literacy to encourage community.

  20. Patient-initiated Electronic Messages and Quality of Care for Patients With Diabetes and Hypertension in a Large Fee-for-Service Medical Group: Results From a Natural Experiment.

    Science.gov (United States)

    McClellan, Sean R; Panattoni, Laura; Chan, Albert S; Tai-Seale, Ming

    2016-03-01

    Few studies have examined the association between patient-initiated electronic messaging (e-messaging) and clinical outcomes in fee-for-service settings. To estimate the association between patient-initiated e-messages and quality of care among patients with diabetes and hypertension. Longitudinal observational study from 2009 to 2013. In March 2011, the medical group eliminated a $60/year patient user fee for e-messaging and established a provider payment of $3-5 per patient-initiated e-message. Quality of care for patients initiating e-messages was compared before and after March 2011, relative to nonmessaging patients. Propensity score weighting accounted for differences between e-messaging and nonmessaging patients in generalized estimating equations. Large multispecialty practice in California compensating providers' fee-for-service. Patients with diabetes (N=4232) or hypertension (N=15,463) who had activated their online portal but not e-messaged before e-messaging became free. Quality of care included HEDIS-based process measures for hemoglobin (Hb) A1c, blood pressure, low-density lipoprotein (LDL), nephropathy, and retinopathy tests, and outcome measures for HbA1c, blood pressure, and LDL. E-messaging was measured as counts of patient-initiated e-message threads sent to providers. Patients were categorized into quartiles by e-messaging frequency. The probability of annually completing indicated tests increased by 1%-7% for e-messaging patients, depending on the outcome and e-messaging frequency. E-messaging was associated with small improvements in HbA1c and LDL for some patients with diabetes. Patient-initiated e-messaging may increase the likelihood of completing recommended tests, but may not be sufficient to improve clinical outcomes for most patients with diabetes or hypertension without additional interventions.

  1. 76 FR 59897 - Branded Prescription Drug Fee; Correction

    Science.gov (United States)

    2011-09-28

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [TD 9544] RIN 1545-BK34 Branded... branded prescription drugs. This fee was enacted by section 9008 of the Patient Protection and Affordable...: This correction is effective on September 28, 2011 and applies to any fee on branded prescription drug...

  2. 7 CFR 51.45 - Fees and charges at shipping point areas.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Fees and charges at shipping point areas. 51.45 Section 51.45 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE..., AND STANDARDS) Regulations 1 Schedule of Fees and Charges at Shipping Point Areas § 51.45 Fees and...

  3. 32 CFR 299.6 - Fees.

    Science.gov (United States)

    2010-07-01

    ... PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICE (NSA/CSS) FREEDOM OF INFORMATION ACT PROGRAM... requested. There are no fees associated with a Privacy Act request, except as stated in NSA/CSS Regulation...

  4. 48 CFR 452.216-71 - Base Fee and Award Fee Proposal.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Base Fee and Award Fee... Base Fee and Award Fee Proposal. As prescribed in 416.470, insert the following provision: Base Fee and Award Proposal (FEB 1988) For the purpose of this solicitation, offerors shall propose a base fee of...

  5. Fees for Advertisements in Public Space Incurred by a Given Bank Brand in Poland

    Directory of Open Access Journals (Sweden)

    Płuciennik Monika

    2017-03-01

    Full Text Available This article aims to present significant changes in the rates of fees for advertisements on selected bank buildings located in public space, resulting from the implementation of the so-called "Act on Landscape Protection" (Act on amending certain acts in connection with the strengthening of landscape protection tools from 24 April 2015 (2015 Journal Of Laws, item 774. The Act on landscape protection aims to minimize the amount of signboards in city centers. It introduces significant changes regarding (a fees, (b the expanded definition of advertisements, and (c potential revisions and renewal of advertisements. The implementation of the Act causes significant inconveniences and challenges in the process advertising services. The objective of this research is to assess changes in the costs of advertising incurred by banks. More specifically, the research estimated (a fees incurred by a selected bank brand for signboards placed on all bank branches within the entire country. An altered definition of an advertisement placed in the right-of-way and in public space will cause an increase in the surface of signboards, and, therefore, an increase in fees. In addition, a new type of fee (i.e., advertising fee will increase the expenses incurred by the bank for the specified objects.

  6. 7 CFR 54.28 - Payment of fees and other charges.

    Science.gov (United States)

    2010-01-01

    ... furnished. Upon receipt of billing for fees and other charges for service the applicant shall remit by check... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... MEAT PRODUCTS (GRADING, CERTIFICATION, AND STANDARDS) Regulations Charges for Service § 54.28 Payment...

  7. Choosing and Paying for Legal Services: There Is a Way To Get and Pay for What You Need and Can Afford!

    Science.gov (United States)

    Geiger, Philip E.; Cantelme, David

    2002-01-01

    Discusses pros and cons of various methods of compensating an attorney or law firm for legal services: Hourly fee; retainer and hourly fee; long-term or annual contract; retainer, fees, and benefits; capped fees; and expenses and reimbursements. Includes brief questionnaire to determine legal services needed and wanted by a school district. (PKP)

  8. How to buy a medical home? Policy options and practical questions.

    Science.gov (United States)

    Berenson, Robert A; Rich, Eugene C

    2010-06-01

    In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for "new" PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations.

  9. Taxes, Tuition Fees and Education for Pleasure

    DEFF Research Database (Denmark)

    Malchow-Møller, Nikolaj; Nielsen, Søren Bo; Skaksen, Jan Rose

    2011-01-01

    are unconstrained, the optimal tax/fee system involves regressive income taxes and high tuition fees. A progressive labor income tax system may, on the other hand, be a second-best response to politically constrained, low tuition fees. Finally, the existence of individuals with different abilities will also move...... the optimal income tax system toward progressivity.......The fact that education provides both a productive and a consumptive (nonproductive) return has important and, in some cases, dramatic implications for optimal taxes and tuition fees. Using a simple model, we show that when the consumption share in education is endogenous and tuition fees...

  10. Alternatives for Revitalizing Student Services Programs.

    Science.gov (United States)

    Deegan, William L.

    1984-01-01

    Reviews alternatives for revitalizing the programs and management of community college student services. As program development models, considers Miami-Dade Community College's computer-based instructional management system; entrepreneurial fee-based services; and divestment of situational or special-interest services to student groups. In…

  11. 47 CFR 1.1158 - Form of payment for regulatory fees.

    Science.gov (United States)

    2010-10-01

    ... instrument and cover mass media, common carrier, international, and cable service fee payments. Each... Section 1.1158 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule.... dollars and drawn on a United States financial institution and made payable to the Federal Communications...

  12. Medicare program; revisions to payment policies under the physician fee schedule, clinical laboratory fee schedule & other revisions to Part B for CY 2014. Final rule with comment period.

    Science.gov (United States)

    2013-12-10

    This major final rule with comment period addresses changes to the physician fee schedule, clinical laboratory fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule with comment period also includes a discussion in the Supplementary Information regarding various programs. (See the Table of Contents for a listing of the specific issues addressed in the final rule with comment period.)

  13. Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits?

    Science.gov (United States)

    Jacobs, Paul D; Buntin, Melinda B

    2015-07-01

    To evaluate the sensitivity of Medicare beneficiaries to premiums and benefits when selecting healthcare plans after the introduction of Part D. We matched respondents in the 2008 Medicare Current Beneficiary Survey to the Medicare Advantage (MA) plans available to them using the Bid Pricing Tool and previously unavailable data on beneficiaries' plan choices. We estimated a 2-stage nested logit model of Medicare plan choice decision making, including the decision to choose traditional fee-for-service (FFS) Medicare or an MA plan, and for those choosing MA, which specific plan they chose. Beneficiaries living in areas with higher average monthly rebates available from MA plans were more likely to choose MA rather than FFS. When choosing MA plans, beneficiaries are roughly 2 to 3 times more responsive to dollars spent to reduce cost sharing than reductions in their premium. We calculated an elasticity of plan choice with respect to the monthly MA premium of -0.20. Beneficiaries with lower incomes are more sensitive to plan premiums and cost sharing than higher-income beneficiaries. MA plans appear to have a limited incentive to aggressively price their products, and seem to compete primarily over reduced beneficiary cost sharing. Given the limitations of the current plan choice environment, policies designed to encourage the selection of lower-cost plans may require increasing premium differences between plans and providing the tools to enable beneficiaries to easily assess those differences.

  14. 28 CFR 802.10 - Fee schedule.

    Science.gov (United States)

    2010-07-01

    ... Judicial Administration COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA... Guidelines. They reflect direct costs for search, review (in the case of commercial requesters), and... case of commercial requesters), and duplicating documents to respond to a FOIA request. (c) Fees shall...

  15. Ecological effects of alternative fuel-reduction treatments: highlights of the National Fire and Fire Surrogate study (FFS)

    Science.gov (United States)

    James D. McIver; Scott L. Stephens; James K. Agee; Jamie Barbour; Ralph E. J. Boerner; Carl B. Edminster; Karen L. Erickson; Kerry L. Farris; Christopher J. Fettig; Carl E. Fiedler; Sally Haase; Stephen C. Hart; Jon E. Keeley; Eric E. Knapp; John F. Lehmkuhl; Jason J. Moghaddas; William Otrosina; Kenneth W. Outcalt; Dylan W. Schwilk; Carl N. Skinner; Thomas A. Waldrop; C. Phillip Weatherspoon; Daniel A. Yaussy; Andrew Youngblood; Steve Zack

    2012-01-01

    The 12-site National Fire and Fire Surrogate study (FFS) was a multivariate experiment that evaluated ecological consequences of alternative fuel-reduction treatments in seasonally dry forests of the US. Each site was a replicated experiment with a common design that compared an un-manipulated control, prescribed fire, mechanical and mechanical + fire treatments....

  16. An evaluation system for financial compensation in traditional Chinese medicine services.

    Science.gov (United States)

    Dou, Lei; Yin, Ai-Tian; Hao, Mo; Lu, Jun

    2015-10-01

    To describe the major factors influencing financial compensation in traditional Chinese medicine (TCM) and prioritize what TCM services should be compensated for. Two structured questionnaires-a TCM service baseline questionnaire and a service cost questionnaire-were used to collect information from TCM public hospitals on TCM services provided in certain situations and service cost accounting. The cross-sectional study examined 110 TCM services provided in four county TCM public hospitals in Shandong province. From the questionnaire data, a screening index system was established via expert consultation and brainstorming. Comprehensive evaluation of TCM services was performed using the analytic hierarchy process method. Weighted coefficients were used to measure the importance of each criterion, after which comprehensive evaluation scores for each service were ranked to indicate what services should receive priority for financial compensation. Economy value, social value, and efficacy value were the three main criteria for screening for what TCM services should be compensated for. The economy value local weight had the highest value (0.588), of which the profit sub-criterion (0.278) was the most important for TCM financial compensation. Moxibustion was tied for the highest comprehensive evaluation scores, at 0.65 while Acupuncture and Massage Therapy were tied for the second and third highest, with 0.63 and 0.58, respectively. Government and policymakers should consider offer financial compensation to Moxibustion, Acupuncture, Massage Therapy, and TCM Orthopedics as priority services. In the meanwhile, it is essential to correct the unreasonable pricing, explore compensation methods, objects and payment, and revise and improve the accounting system for the costs of TCM services. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Craft qualities translated from traditional crafts to smart textile services

    NARCIS (Netherlands)

    Kuusk, K.; Wensveen, S.A.G.; Tomico Plasencia, O.

    2016-01-01

    In this article we suggest craft and craftsmanship as an inspiration to design more sustainable smart textile services. We look into the opportunities that interactive properties and services bring into the textile and garment life cycle. We use traditional crafts as a source of inspiration for the

  18. To retain or remove user fees?: reflections on the current debate in low- and middle-income countries.

    Science.gov (United States)

    James, Chris D; Hanson, Kara; McPake, Barbara; Balabanova, Dina; Gwatkin, Davidson; Hopwood, Ian; Kirunga, Christina; Knippenberg, Rudolph; Meessen, Bruno; Morris, Saul S; Preker, Alexander; Souteyrand, Yves; Tibouti, Abdelmajid; Villeneuve, Pascal; Xu, Ke

    2006-01-01

    Many low- and middle-income countries continue to search for better ways of financing their health systems. Common to many of these systems are problems of inadequate resource mobilisation, as well as inefficient and inequitable use of existing resources. The poor and other vulnerable groups who need healthcare the most are also the most affected by these shortcomings. In particular, these groups have a high reliance on user fees and other out-of-pocket expenditures on health which are both impoverishing and provide a financial barrier to care. It is within this context, and in light of recent policy initiatives on user fee removal, that a debate on the role of user fees in health financing systems has recently returned. This paper provides some reflections on the recent user fees debate, drawing from the evidence presented and subsequent discussions at a recent UNICEF consultation on user fees in the health sector, and relates the debate to the wider issue of access to adequate healthcare. It is argued that, from the wealth of evidence on user fees and other health system reforms, a broad consensus is emerging. First, user fees are an important barrier to accessing health services, especially for poor people. They also negatively impact on adherence to long-term expensive treatments. However, this is offset to some extent by potentially positive impacts on quality. Secondly, user fees are not the only barrier that the poor face. As well as other cost barriers, a number of quality, information and cultural barriers must also be overcome before the poor can access adequate health services. Thirdly, initial evidence on fee abolition in Uganda suggests that this policy has improved access to outpatient services for the poor. For this to be sustainable and effective in reaching the poor, fee removal needs to be part of a broader package of reforms that includes increased budgets to offset lost fee revenue (as was the case in Uganda). Fourthly, implementation matters

  19. Economic Impacts of the Generic Drug User Fee Act Fee Structure.

    Science.gov (United States)

    Dong, Ke; Boehm, Garth; Zheng, Qiang

    2017-06-01

    A Food and Drug Administration (FDA) Generic Drug User system, Generic Drug User Fee Amendment of 2012 (GDUFA), started October 1, 2012, and has been in place for over 3 years. There is controversy about the GDUFA fee structure but no analysis of GDUFA data that we could find. To look at the economic impact of the GDUFA fee structure. We compared the structure of GDUFA with that of other FDA Human Drug User fees. We then, using FDA-published information, analyzed where GDUFA facility and Drug Master File fees are coming from. We used the Orange Book to identify the sponsors of all approved Abbreviated New Drug Applications (ANDAs) and the S&P Capital IQ database to find the ultimate parent companies of sponsors of approved ANDAs. The key differences between the previous structure for Human Drug User fees and the GDUFA are as follows: GDUFA has no approved product fee and no first-time or small business fee exemptions and GDUFA charges facility fees from the time of filing and charges a foreign facility levy. Most GDUFA fees are paid by or on behalf of foreign entities. The top 10 companies hold nearly 50% of all approved ANDAs but pay about 14% of GDUFA facility fees. We conclude that the regressive nature of the GDUFA fee structure penalizes small, new, and foreign firms while benefiting the large established firms. A progressive fee structure in line with other human drug user fees is needed to ensure a healthy generic drug industry. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. 9 CFR 130.10 - User fees for pet birds.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

  1. 24 CFR 983.354 - Other fees and charges.

    Science.gov (United States)

    2010-04-01

    ... DEVELOPMENT PROJECT-BASED VOUCHER (PBV) PROGRAM Payment to Owner § 983.354 Other fees and charges. (a) Meals... require the tenant or family members to pay charges for meals or supportive services. Non-payment of such... services be included in the calculation of reasonable rent. Non-payment of such charges is grounds for...

  2. Developing Traditional Food Service: A Portrait of Women in Culinary Industry

    Science.gov (United States)

    Maukar, S. M. D.; Langitan, F. W.; Tangkere, T. F. S.; Dondokambey, A.

    2018-02-01

    The purpose of this research is to obtain data about development of traditional food service for small woman business in Minahasa Toulour, Indonesia. The type of research used is descriptive qualitative method. The result of this research is to show that the profile data of the development of the service quality of the catering service business and the traditional home industry of the small business women at the grassroots around Lake Tondano, Minahasa, is in desperate need of rocks and guidance, because although it has the strength and opportunities such as traditional food products, the taste is quite good and popular consumer, the main raw material is the main agricultural products Minahasa so the price is relatively affordable, the role of print media and electronics to support the socialization of traditional foods Regional, National, International so it can be exported abroad, but on the other hand is also faced with weaknesses both internally and externally such as the lack of traditional entrepreneurial knowledge of Minahasa’s traditional cuisine, suffering from a lack of capital, and the impact of lack of knowledge and lack of capital result in the following items being prepared, as limited and monotonous as well lack of innovation, inadequate food business equipment, lack of clear health insurance, information dissemination and limited development, although facilities exist but cannot be implemented due to lack of funds, poor sanitation is noticed.

  3. Recreation users fees on federal lands: a test of structural change between 1995 and 2003

    Science.gov (United States)

    J.M. Bowker; Gary Green; Dan MuCullom; Ken Cordell

    2008-01-01

    Federal lands provide many recreation facilities and services. On some of these lands, fees have been and are currently being charged for certain recreational services. This study examined the attitudes of users, between 1995 and 2003, towards recreation user fees on public lands. Data from the National Survey on Recreation and the Environment on recreational...

  4. 75 FR 45641 - Medical Device User Fee Rates for Fiscal Year 2011

    Science.gov (United States)

    2010-08-03

    ... fees.) If you prefer to send a check by a courier (such as Federal Express (FEDEX), DHL, United Parcel... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0363... under section 351 of the Public Health Service (PHS) Act (42 U.S.C. 262)) Premarket report (submitted...

  5. 24 CFR 982.510 - Other fees and charges.

    Science.gov (United States)

    2010-04-01

    ... DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Rent and Housing Assistance Payment § 982.510 Other fees and charges. (a) The cost of meals or supportive services may not be included... meals or supportive services. Non-payment of such charges is not grounds for termination of tenancy. (c...

  6. 78 FR 14879 - Revision of Fee Schedules; Fee Recovery for Fiscal Year 2013

    Science.gov (United States)

    2013-03-07

    ... schedule; 5) The NRC could assess a fee for renewing a license to operate a low-level radioactive waste... upon small licensees and performed a trend analysis to calculate the appropriate fee tier levels. From... appropriate, except for topical reports whose costs exceed $50,000. Costs which exceed $50,000 for any topical...

  7. The patient-centered medical home in oncology: from concept to reality.

    Science.gov (United States)

    Page, Ray D; Newcomer, Lee N; Sprandio, John D; McAneny, Barbara L

    2015-01-01

    In recent years, the cost of providing quality cancer care has been subject to an epic escalation causing concerns on the verge of a health care crisis. Innovative patient-management models in oncology based on patient-centered medical home (PCMH) principles, coupled with alternative payments to traditional fee for service (FFS), such as bundled and episodes payment are now showing evidence of effectiveness. These efforts have the potential to bend the cost curve while also improving quality of care and patient satisfaction. However, going forward with FFS alternatives, there are several performance-based payment options with an array of financial risks and rewards. Most novel payment options convey a greater financial risk and accountability on the provider. Therefore, the oncology medical home (OMH) can be a way to mitigate some financial risks by sharing savings with the payer through better global care of the patient, proactively preventing complications, emergency department (ED) visits, and hospitalizations. However, much of the medical home infrastructure that is required to reduced total costs of cancer care comes as an added expense to the provider. As best-of-practice quality standards are being elucidated and refined, we are now at a juncture where payers, providers, policymakers, and other stakeholders should work in concert to expand and implement the OMH framework into the variety of oncology practice environments to better equip them to assimilate into the new payment reform configurations of the future.

  8. 78 FR 46955 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

    Science.gov (United States)

    2013-08-02

    ... courier such as Federal Express or United Parcel Service, the courier may deliver the check and printed... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0007] Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014 AGENCY: Food and Drug...

  9. 78 FR 32067 - User Fees for 2013 Crop Cotton Classification Services to Growers

    Science.gov (United States)

    2013-05-29

    ...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0..., Testing, and Standards. Fees for Classification Under the Cotton Statistics and Estimates Act of 1927 This... www.regulations.gov . List of Subjects in 7 CFR Part 28 Administrative practice and procedure, Cotton...

  10. The Provision of Non-Audit Services, Audit Fees and Auditor Independence

    OpenAIRE

    Ayoib Che Ahmad; Nava Subramaniam

    2006-01-01

    Although internal auditing (IA) services have been traditionally performed in-house, organizations are increasingly outsourcing such services. Using a Transaction Cost Economics (TCE) perspective, this study examined the influence of several organizational-level variables on the decision to outsource or in-house their internal audit function. The study also identified the type of IA services that were likely to be out-sourced rather than in-housed, the extent to which incumbent external finan...

  11. 76 FR 79198 - Generic Drug User Fee; Public Meeting; Correction

    Science.gov (United States)

    2011-12-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Correction AGENCY: Food and Drug Administration, HHS. ACTION... meeting entitled ``Generic Drug User Fee.'' The document published with an inadvertent error in the Dates...

  12. Is there value in retrospective 90-day bundle payment models for shoulder arthroplasty procedures?

    Science.gov (United States)

    Odum, Susan M; Hamid, Nady; Van Doren, Bryce A; Spector, Leo R

    2018-05-01

    The Centers for Medicare & Medicaid Services Bundled Payments for Care Improvement (BPCI) initiative was implemented as part of the Affordable Care Act. We implemented a retrospective payment model 2 for a 90-day total shoulder arthroplasty (TSA) episode to assess the value of TSA BPCI at our private practice. Expenditures and postacute event rates of 132 fee-for-service (FFS) patients who underwent a TSA operation between 2009 and 2012 were compared with 333 BPCI patients who had a TSA operation in 2015. The 90-day postacute events included an inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), and home health (HH) admissions and readmissions. Expenditures were converted to 2016 dollars using the Consumer Price Index. Wilcoxon tests and multivariate generalized estimating equation were used to assess independent cost-drivers. The median FFS expenditure was $21,157 (interquartile range, $16,894-$30,748) compared with $17,894 (interquartile range, $15,796-$20,894) for BPCI (P model, we found BPCI had a 4% decrease in expenditures (P = .08). All postacute events were independently associated with higher expenditures. Our private practice implemented cost-containment practices, including clinical guidelines, patient navigators, and a BPCI management team. IRF and SNF utilization and the 90-day readmission rate significantly decreased. As a result, we were able to control the postacute spending, which resulted in decreased costs of performing TSA surgery. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. An evaluation of substance misuse treatment providers used by an employee assistance program.

    Science.gov (United States)

    Miller, N A

    1992-05-01

    Structural measures of access, continuity, and quality of substance misuse treatment services were compared in 30 fee-for-service (FFS) facilities and nine health maintenance organizations (HMOs). Probit models related effects of the provider system (FFS or HMO) and the system's structural characteristics to 243 employees' access to and outcomes from treatment. Access was decreased in Independent Practice Association (IPA)/network HMOs and in all facilities which did not employ an addictionologist or provide coordinated treatment services. When bivariate correlations were examined, both use of copayments and imposing limits to the levels of treatment covered were negatively related to access, while a facility's provision of ongoing professional development was positively associated with access. These correlations did not remain significant in the multivariate probits. Receiving treatment in a staff model HMO and facing limits to the levels of treatment covered were negatively associated with attaining sufficient progress, while receiving treatment in a facility which provided ongoing professional development was positively related to progress: these effects did not remain significant in multivariate analyses. Implications for employee assistance program (EAP) staff in their role as case managers and for EAP staff and employers in their shared role as purchasers of treatment are discussed.

  14. 77 FR 67062 - Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book...

    Science.gov (United States)

    2012-11-08

    ... DEPARTMENT OF THE TREASURY Fiscal Service Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book-Entry System AGENCY: Bureau of the Public Debt, Fiscal... fee schedule applicable to transfers of U.S. Treasury book-entry securities maintained on the National...

  15. 76 FR 68523 - Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book...

    Science.gov (United States)

    2011-11-04

    ... DEPARTMENT OF THE TREASURY Fiscal Service Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book-Entry System AGENCY: Bureau of the Public Debt, Fiscal... fee schedule applicable to transfers of U.S. Treasury book-entry securities maintained on the National...

  16. 76 FR 46628 - Regulations Governing Fees for Services Performed in Connection With Licensing and Related...

    Science.gov (United States)

    2011-08-03

    ... (1993). The Board concludes that the fee changes adopted here will not have a significant economic... merge their properties or franchises (or a part thereof) into one corporation for ownership, management...

  17. A cloud system for mobile medical services of traditional Chinese medicine.

    Science.gov (United States)

    Hu, Nian-Ze; Lee, Chia-Ying; Hou, Mark C; Chen, Ying-Ling

    2013-12-01

    Many medical centers in Taiwan have started to provide Traditional Chinese Medicine (TCM) services for hospitalized patients. Due to the complexity of TCM modality and the increasing need for providing TCM services for patients in different wards at distantly separate locations within the hospital, it is getting difficult to manage the situation in the traditional way. A computerized system with mobile ability can therefore provide a practical solution to the challenge presented. The study tries to develop a cloud system equipped with mobile devices to integrate electronic medical records, facilitate communication between medical workers, and improve the quality of TCM services for the hospitalized patients in a medical center. The system developed in the study includes mobile devices carrying Android operation system and a PC as a cloud server. All the devices use the same TCM management system developed by the study. A website of database is set up for information sharing. The cloud system allows users to access and update patients' medical information, which is of great help to medical workers for verifying patients' identification and giving proper treatments to patients. The information then can be wirelessly transmitted between medical personnel through the cloud system. Several quantitative and qualitative evaluation indexes are developed to measure the effectiveness of the cloud system on the quality of the TCM service. The cloud system is tested and verified based on a sample of hospitalized patients receiving the acupuncture treatment at the Lukang Branch of Changhua Christian Hospital (CCH) in Taiwan. The result shows a great improvement in operating efficiency of the TCM service in that a significant saving in labor time can be attributable to the cloud system. In addition, the cloud system makes it easy to confirm patients' identity through taking a picture of the patient upon receiving any medical treatment. The result also shows that the cloud system

  18. An in-house alternative to traditional SDI services at Argonne National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Noel, R.E.; Dominiak, R.R.

    1997-02-20

    Selective Dissemination of Information (SDIs) are based on automated, well-defined programs that regularly produce precise, relevant bibliographic information. Librarians have typically turned to information vendors such as Dialog or STN international to design and implement these searches for their users in business, academia, and the science community. Because Argonne National Laboratory (ANL) purchases the Institute for Scientific Information (ISI) Current Contents tapes (all subject areas excluding Humanities). ANL scientists enjoy the benefit of in-house developments with BASISplus software programming and no longer need to turn to outside companies for reliable SDI service. The database and its customized services are known as ACCESS (Argonne Current Contents Electronic Search Service). Through collaboration with librarians on Boolean logic and selection of terms, users can now design their own personal profiles to comb the new data, thereby avoiding service fees from outside providers. Based on the feedback from scientists, it seems that this new service can help transform the ANL distributed libraries into more efficient central functioning entities that better serve the users. One goal is to eliminate the routing of paper copies of many new journal issues to different library locations for users to browse; instead users may be expected to rely more on electronic dissemination of both table of contents and customized SDIs for new scientific and technical information.

  19. 76 FR 72619 - User Fee To Take the Registered Tax Return Preparer Competency Examination

    Science.gov (United States)

    2011-11-25

    ..., 2011)), provide that only attorneys, certified public accountants, enrolled agents, and registered tax... Fee To Take the Registered Tax Return Preparer Competency Examination AGENCY: Internal Revenue Service... regulations. The final regulations redesignate rules pertaining to fees for obtaining a preparer tax...

  20. 75 FR 67807 - Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book...

    Science.gov (United States)

    2010-11-03

    ... DEPARTMENT OF THE TREASURY Fiscal Service Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book-Entry System Authority: 31 CFR 357.45. AGENCY: Bureau of the...) is announcing a new fee schedule applicable to transfers of U.S. Treasury book-entry securities...

  1. 7 CFR 28.958 - Payment of fees.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... officers in charge of testing laboratories to all persons from whom payment of fees and costs under the... order of “Agricultural Marketing Service, USDA.” [35 FR 8532, June 3, 1970. Redesignated at 46 FR 30075...

  2. Aligning incentives in the management of inguinal hernia: the impact of the payment model.

    Science.gov (United States)

    Devarajan, Karthik; Rogers, Loni; Smith, Paul; Schwaitzberg, Steven D

    2012-09-01

    The Affordable Care Act has stimulated discussion to find feasible, alternate payment models. Adopting a global payment (GP) mechanism may dampen the high number of procedures incentivized by the fee-for-service (FFS) system. The evolving payment mechanism should reflect collaboration between surgeon and system goals. Our aim was to model and perform simulation of a GP system for hernia care and its impact on cost, revenue, and physician reimbursement in an integrated health care system. The results of the 2006 Watchful Waiting (WW) vs Repair of Inguinal Hernia in Minimally Symptomatic Men trial was used as a clinical model for the natural history and progression of inguinal hernia disease Simulations were built using 2009 financial and clinical data from the Cambridge Health Alliance to model costs and revenues in managing care for a 4-year cohort of inguinal hernia patients; FFS, FFS-WW, and the GP-WW were modeled. To build this GP model, surgeons were paid a constant $500 per patient whether herniorrhaphy was performed or not. Compared with the actual combined physician and hospital revenue under the current FFS model ($308,820), implementing the FFS-WW system for 4 years for 139 hernia patients decreased hospital and physician revenues by $93,846 and $19,308, respectively. This resulted in a total savings of $113,154 for the payors only. In contrast, when using WW methodology within a GP model, system savings of $69,174 were observed after 4 years, with preservation of physician and hospital income. Collaboration to achieve shared savings can be accomplished by pooling physician and hospital revenue in order to meet the goals of all parties. Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  3. 78 FR 59949 - Annual Factors for Determining Public Housing Agency Administrative Fees for the Section 8...

    Science.gov (United States)

    2013-09-30

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5724-N-02] Annual Factors for... Web site of the annual factors for determining the on-going administrative fee for housing agencies... Relay Service during business hours at 1-800-877-8337. SUPPLEMENTARY INFORMATION: The annual factors for...

  4. 78 FR 33436 - 2013 Final Fee Rate and Fingerprint Fees

    Science.gov (United States)

    2013-06-04

    ... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 2013 Final Fee Rate and Fingerprint Fees AGENCY: National Indian Gaming Commission, Interior. ACTION: Notice. SUMMARY: Notice is hereby... annual fee rates of 0.00% for tier 1 and 0.072% (.00072) for tier 2. These rates shall apply to all...

  5. 75 FR 6816 - Attorneys' Fees; Fee-Generating Cases; Use of Non-LSC Funds, Transfers of LSC Funds, Program...

    Science.gov (United States)

    2010-02-11

    ... also moving provisions on accounting for and use of attorneys' fees and acceptance of reimbursements... reimbursements of costs from a client. The regulation also sets forth rules for the accounting for and use of... recipient to provide services to additional clients and help close the justice gap.\\1\\ More fundamental, the...

  6. 10 CFR 9.85 - Fees.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Fees. 9.85 Section 9.85 Energy NUCLEAR REGULATORY COMMISSION PUBLIC RECORDS Privacy Act Regulations Fees § 9.85 Fees. Fees shall not be charged for search or... available for review, although fees may be charged for additional copies. Fees established under 31 U.S.C...

  7. 48 CFR 552.238-74 - Industrial Funding Fee and Sales Reporting.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Industrial Funding Fee and Sales Reporting. 552.238-74 Section 552.238-74 Federal Acquisition Regulations System GENERAL SERVICES... shall include the Industrial Funding Fee (IFF). The Contractor shall maintain a consistent accounting...

  8. Fee structures for low-level radioactive waste disposal

    International Nuclear Information System (INIS)

    Sutherland, A.A.; Baird, R.D.; Rogers, V.C.

    1988-01-01

    Some compacts and states require that the fee system at their new low-level waste (LLW) disposal facility be based on the volume and radioactive hazard of the wastes. The fee structure discussed in this paper includes many potential fee elements that could be used to recover the costs of disposal and at the same time influence the volume and nature of waste that arrives at the disposal facility. It includes a base fee which accounts for some of the underlying administrative costs of disposal, and a broad range of charges related to certain parameters of the waste, such as volume, radioactivity, etc. It also includes credits, such as credits for waste with short-lived radionuclides or superior waste forms. The fee structure presented should contain elements of interest to all states and compacts. While no single disposal facility is likely to incorporate all of the elements discussed here in its fee structure, the paper presents a fairly exhaustive list of factors worth considering

  9. ACE Inhibitor and ARB utilization and expenditures in the Medicaid fee-for-service program from 1991 to 2008.

    Science.gov (United States)

    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

  10. 76 FR 45826 - Medical Device User Fee Rates for Fiscal Year 2012

    Science.gov (United States)

    2011-08-01

    ... paper check: All paper checks must be in U.S. currency from a U.S. bank and made payable to the Food and... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0542] Medical Device User Fee Rates for Fiscal Year 2012 AGENCY: Food and Drug Administration, HHS. ACTION...

  11. Impact of office-based intravenous deep sedation providers upon traditional sedation practices employed in pediatric dentistry.

    Science.gov (United States)

    Tarver, Michael; Guelmann, Marcio; Primosch, Robert

    2012-01-01

    This survey intended to determine how the implementation of office-based IV deep sedation by a third party provider (OIVSED) impacted the traditional sedation practices employed in pediatric dentistry private practice settings. A digital survey was e-mailed to 924 members of the American Academy of Pediatric Dentistry practicing in California, Florida, and New York, chosen because these states had large samples of practicing pediatric dentists in geographically disparate locations. 151 pediatric dentists using OIVSED responded to the survey. Improved efficiency, safety and quality of care provided, and increased parental acceptance were reported advantages of this service. Although less costly than hospital-based general anesthesia, the average fee for this service was a deterrent to some parents considering this option. Sixty-four percent of respondents continued to provide traditional sedation modalities, mostly oral sedation, in their offices, as parenteral routes taught in their training programs were less often selected. OIVSED users reported both a reduction in the use of traditional sedation modalities in their offices and use of hospital-based GA services in exchange for perceived improvements in efficiency, safety and quality of care delivered. Patient costs, in the absence of available health insurance coverage, inhibited accessing this service by some parents.

  12. 76 FR 57681 - Modification of Interlibrary Loan Fee Schedule

    Science.gov (United States)

    2011-09-16

    ... through the National Technical Information Service (NTIS) or payment through the Online Computer Library... in order to support the current cost of providing the service and will enable customers to estimate... Service 7 CFR Part 505 RIN 0518-8AA04 Modification of Interlibrary Loan Fee Schedule AGENCY: Agricultural...

  13. Private Schools and Public Benefit: Fees, Fee Remissions, and Subsidies

    Science.gov (United States)

    Davies, Peter

    2011-01-01

    The level of fee remissions offered by private schools bears upon the scope for relying on private schools to provide public benefit. Analyses of education voucher systems have generally ignored the possibility that they will partially crowd out school-financed fee remissions. Moreover, variation in fee remissions between private schools may be…

  14. Experiences and Perceptions of Barriers to Health Services for Elderly in Rural Namibia

    Directory of Open Access Journals (Sweden)

    Gert Van Rooy

    2015-07-01

    Full Text Available We investigate barriers to accessing health facilities (e.g., transportation and cost of services and health service delivery barriers (e.g., timeliness of services scheduling of appointments, language that the literature suggest are operative. Semistructured interviews were utilized with respondents in three purposefully selected regional research sites in Namibia. All questions were translated into local languages. It is found that although many senior citizens appreciate the use of modern health care and are exempted from paying health care consultation fees, they still prefer to use traditional health medicine because of the long distance to health care facilities, which when they decide to travel translates into high transportation costs. Referrals to hospitals become very expensive. There is a need to consider the unique issues (extended family system affecting access to health care for elderly people in Namibia to achieve equitable access to health care services.

  15. 75 FR 22026 - User Fees for 2010 Crop Cotton Classification Services to Growers

    Science.gov (United States)

    2010-04-27

    ... size and cash-flow timing while meeting minimum reserve requirements set by the Agricultural Marketing... level. This proposed fee and the existing reserve are sufficient to cover the costs of providing... challenge to the provisions of this rule. Regulatory Flexibility Act Pursuant to requirements set forth in...

  16. 77 FR 46653 - Branded Prescription Drug Fee; Hearing

    Science.gov (United States)

    2012-08-06

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [REG-112805-10] RIN 1545-BJ39 Branded Prescription Drug Fee; Hearing AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... document provides notice of public hearing on proposed regulations relating to the branded prescription...

  17. Commute Equilibrium for Mixed Networks with Autonomous Vehicles and Traditional Vehicles

    Directory of Open Access Journals (Sweden)

    Yangbeibei Ji

    2017-01-01

    Full Text Available Recent development of autonomous vehicle (AV provides new travel opportunities for citizens, and traditional vehicles (TVs will still be used for a long time. Therefore, it is highly possible that both AVs and TVs will be used as travel modes in a city. In a transportation system with both AVs and TVs, the traffic pattern is worthy of studying. This paper investigates user equilibrium traffic pattern based on the traditional bottleneck model considering AVs and TVs. For both TVs and AVs, travel costs include queuing delay and schedule delay. However, they also have different components of travel costs; more specifically, for AVs, passengers have to pay a riding fare, and, for TVs, travelers encounter a walking time cost after parking their cars. For different combinations of travel demands and riding fare of AVs, analytical solutions of three different user equilibrium traffic patterns are obtained. Finally, numerical examples are provided to demonstrate the usefulness of the analytical models. Sensitivity analyses are examined to show the impacts of AV’s time-dependent fee and trip-based fixed fee on the traffic pattern and travel costs.

  18. Differences in risk behaviours and HIV/STI prevalence between low-fee and medium-fee female sex workers in three provinces in China.

    Science.gov (United States)

    Han, Lifeng; Zhou, Chu; Li, Zhijun; Poon, Adrienne N; Rou, Keming; Fuller, Serena; Li, Yan; Shen, Limei; Kang, Dianmin; Huang, Lu; Liao, Meizhen; Fu, Xiaobing; Shepard, Colin; Wu, Zunyou; Bulterys, Marc

    2016-06-01

    To better understand risk behaviours and factors associated with low-fee female sex workers (FSW) and support HIV/sexually transmitted infections (STI) epidemic control among this key population in China. A cross-sectional study using convenience sampling to recruit 1487 eligible low-fee and medium-fee FSW was conducted in 2012 in three provinces. The participants were interviewed using a structured questionnaire and tested for HIV-1, herpes simplex virus (HSV)-2 and syphilis antibody. Log-binomial modelling was used to estimate prevalence ratios (PR) and examine factors associated with low-fee sex work. Prevalence of HIV-1, syphilis and HSV-2 antibody positive were 0.5%, 4.8% and 27.8%, respectively. Low-fee FSW were more likely to have HSV-2 infection (adjusted prevalence ratio (APR)=1.3, 95% CI 1.1 to 1.7), but not more likely to have HIV-1 and syphilis infection compared with medium-fee FSW. Compared with medium-fee FSW, low-fee FSW were more likely to be ≥35 years of age (APR=2.1, 95% CI 1.3 to 3.6), engage in sex work ≥6 days/per week (APR=1.7, 95% CI 1.2 to 2.6), have ≥3 clients per day (APR=2.2, 95% CI 1.5 to 3.3), have clients decide condom use (APR=1.6, 95% CI 1.1 to 2.3), fail to persuade clients to use condoms (APR=1.6, 95% CI 1.1 to 2.6), express willingness to have unprotected sex in return for receipt of a higher fee (APR=1.8, 95% CI 1.2 to 2.8), have had genital symptoms in the past year (APR=1.4, 95% CI 1.1 to 1.8) and have migrated from another city. Low-fee FSW in China have unique risks for acquiring HIV/STI, in part due to greater economic pressures. Tailored interventions targeting low-fee FSW and incorporating their prevailing perception of HIV/STI risks and condom use negotiation challenges that they face are urgently needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. 7 CFR 205.642 - Fees and other charges for certification.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees and other charges for certification. 205.642...) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Administrative Fees § 205.642 Fees and other charges for certification. Fees charged by a certifying agent must be reasonable, and a certifying...

  20. The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi.

    Science.gov (United States)

    Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic

    2016-11-01

    The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  1. 7 CFR 56.47 - Fees for appeal grading or review of a grader's decision.

    Science.gov (United States)

    2010-01-01

    ...) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS... Fees for appeal grading or review of a grader's decision. The cost of an appeal grading or review of a...

  2. 76 FR 16321 - User Fees for 2011 Crop Cotton Classification Services to Growers

    Science.gov (United States)

    2011-03-23

    ... manage uncertainties related to crop size and cash-flow timing while meeting minimum reserve requirements... level. This proposed fee and the existing reserve are sufficient to cover the costs of providing.... Regulatory Flexibility Act Pursuant to requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S...

  3. Sustainability of portable water services in the Philippines

    Science.gov (United States)

    Bohm, Robert A.; Essenburg, Timothy J.; Fox, William F.

    1993-07-01

    Financial sustainability of rural water systems in the Philippines is evaluated based on a comparison of willingness to pay for improved water and the costs of service delivery. Willingness to pay estimates indicate that user fees are unlikely to be sufficient to cover the full cost of service and subsidies are necessary, at least for a major portion of capital costs, or the water systems will become unsustainable because of insufficient resources. Sustainability is more probable when care is exercised in selecting villages for improved water services. Economies of scale lead to lower unit costs in larger villages. Willingness to pay is greater for household connections than for public faucets. Willingness to pay increases with income and wealth, family size, education, and dissatisfaction with traditional water sources.

  4. 47 CFR 1.1159 - Filing locations and receipts for regulatory fees.

    Science.gov (United States)

    2010-10-01

    ... fees. 1.1159 Section 1.1159 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND... for regulatory fees. (a) Regulatory fee payments must be directed to the location and address set forth in §§ 1.1152 through 1.1156 for the specific category of fee involved. Any regulatory fee required...

  5. 76 FR 60801 - Assessment of Fees for Dairy Import Licenses for the 2012 Tariff-Rate Import Quota Year

    Science.gov (United States)

    2011-09-30

    ... for the 2012 calendar year. Notice: The total cost to USDA of administering the licensing system for... administering the licensing system, and $125,280 represents other miscellaneous costs, including travel, postage... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Assessment of Fees for Dairy Import...

  6. The Public Debate about the Recreation Fee Demonstration Program on the U.S. Nation Forests1

    Science.gov (United States)

    David N. Bengston; David P. Fan

    2000-01-01

    The Recreation Fee Demonstration Program (RFDP) is a pilot program authorized by Congress in 1996. The RFDP allows the U.S. Department of Agriculture Forest Service, and the United States Department of the Interior Park Service, Bureau of Land Management, and Fish and Wildlife Service to experiment with new or increased fees at up to 100 recreation sites per agency....

  7. 48 CFR 2452.216-70 - Estimated cost, base fee and award fee.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Estimated cost, base fee... Provisions and Clauses 2452.216-70 Estimated cost, base fee and award fee. As prescribed in 2416.406(e)(1), insert the following clause in all cost-plus-award-fee contracts: Estimated Cost, Base Fee and Award Fee...

  8. 45 CFR 1609.4 - Accounting for and use of attorneys' fees.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Accounting for and use of attorneys' fees. 1609.4... CORPORATION FEE-GENERATING CASES § 1609.4 Accounting for and use of attorneys' fees. (a) Attorneys' fees... to support the representation. (b) Attorneys' fees received shall be recorded during the accounting...

  9. Getting value from health spending: going beyond payment reform.

    Science.gov (United States)

    Ho, Sam; Sandy, Lewis G

    2014-05-01

    It is widely held that fee-for-service (FFS) payment systems reward volume and intensity of services, contributing to overall cost inflation, while doing little to reward quality, efficiency, or care coordination. Recently, The National Commission on Physician Payment Reform (sponsored by SGIM) has recommended that payers "should largely eliminate stand-alone fee-for-service payment to medical practices because of its inherent inefficiencies and problematic financial incentives." As the current and former Chief Medical Officers of a large national insurer, we agree that payment reform is a critical component of health care modernization. But calls to transform payment simultaneously go too far, and don't go far enough. Based on our experience, we believe there are several critical ingredients that are either missing or under-emphasized in most payment reform proposals, including: health care is local so no one size fits all; upgrading performance measures; monitoring/overcoming unintended consequences; using a full toolbox to achieve transformation; and ensuring that the necessary components for successful delivery reform are in place. Thinking holistically and remembering that healthcare is a complex adaptive system are crucial to achieving better results for patients and the health system.

  10. Payment Reform Pilot In Beijing Hospitals Reduced Expenditures And Out-Of-Pocket Payments Per Admission.

    Science.gov (United States)

    Jian, Weiyan; Lu, Ming; Chan, Kit Yee; Poon, Adrienne N; Han, Wei; Hu, Mu; Yip, Winnie

    2015-10-01

    In 2009 China announced plans to reform provider payment methods at public hospitals by moving from fee-for-service (FFS) to prospective and aggregated payment methods that included the use of diagnosis-related groups (DRGs) to control health expenditures. In October 2011 health policy makers selected six Beijing hospitals to pioneer the first DRG payment system in China. We used hospital discharge data from the six pilot hospitals and eight other hospitals, which continued to use FFS and served as controls, from the period 2010-12 to evaluate the pilot's impact on cost containment through a difference-in-differences methods design. Our study found that DRG payment led to reductions of 6.2 percent and 10.5 percent, respectively, in health expenditures and out-of-pocket payments by patients per hospital admission. We did not find evidence of any increase in hospital readmission rates or cost shifting from cases eligible for DRG payment to ineligible cases. However, hospitals continued to use FFS payments for patients who were older and had more complications than other patients, which reduced the effectiveness of payment reform. Continuous evidence-based monitoring and evaluation linked with adequate management systems are necessary to enable China and other low- and middle-income countries to broadly implement DRGs and refine payment systems. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Does co-creation impact public service delivery? The importance of state and governance traditions

    NARCIS (Netherlands)

    Voorberg, Willem; Bekkers, Victor; Flemig, Sophie; Timeus, Krista; Tõnurist, Piret; Tummers, L.G.

    2017-01-01

    Co-creation in public service delivery requires partnerships between citizens and civil servants. The authors argue that whether or not these partnerships will be successful depends on state and governance traditions (for example a tradition of authority sharing or consultation). These traditions

  12. The Effect of Two Auditors and Non-audit Services on Audit Fees: Evidence from a Small Capital Market

    DEFF Research Database (Denmark)

    Thinggaard, Frank; Kiertzner, Lars

    2004-01-01

    of both audit fees and other fees paid to the auditor on a consolidated group level. Until 1.1. 2005 special Danish legal provisions require listed companies to be audited by two independent auditors. We have especially focused on the influence of this joint auditor effect on the pricing of audit fees....... Our results indicate that the requirement to have two independent auditors reduces total audit fees, most likely because of competitive pressure, but only in the segment of larger companies. We have applied the core audit fee determinants model which has evolved in international research with generic...... proxy variables for client size, complexity, risk profile and auditor size contributing to the level of audit fees. Our findings indicate similarities with respect to the determining factors, but again a distinction has to be made between segments of large and small companies. In the small Danish...

  13. When public service drama travels

    DEFF Research Database (Denmark)

    Jensen, Pia Majbritt; Nielsen, Jakob Isak; Waade, Anne Marit

    2016-01-01

    the last 15 years, our empirical data also show significant new patterns in production culture and international market orientation within DR. Interestingly, however, our study demonstrates the distinctive contribution that precisely DR’s public service remit has made to the quality of its drama......This article provides a detailed analysis of how the Danish public service broadcaster DR employs external funding for its drama productions. This investigation is carried out in order to discuss the schisms involved when a public service broadcaster – whose traditional obligations arguably pertain...... to the national sphere – becomes a player in the international market for television content and, as a consequence, becomes partly reliant on international funding. Our article examines five different forms of external funding (i.e. funding from sources other than DR’s licence fee income): (1) co...

  14. Physician Fee Schedule National Payment Amount File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The significant size of the Physician Fee Schedule Payment Amount File-National requires that database programs (e.g., Access, dBase, FoxPro, etc.) be used to read...

  15. 9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for FADDL veterinary..., DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.14 User fees for FADDL veterinary diagnostics. (a... 167.00 Rabbit antiserum, any agent 1 mL 179.00 185.00 190.00 196.00 (b) Veterinary diagnostics tests...

  16. 49 CFR 7.42 - Payment of fees.

    Science.gov (United States)

    2010-10-01

    ... taking into account all services that must be provided free of, or at a reduced, charge, is less than US... States, e.g. DOT/FAA. (b) Charges may be assessed by DOT for time spent searching for requested records... disclosure. In addition, if records are requested for commercial use, DOT may assess a fee for time spent...

  17. Economic evaluation of small modular nuclear reactors and the complications of regulatory fee structures

    International Nuclear Information System (INIS)

    Vegel, Benjamin; Quinn, Jason C.

    2017-01-01

    Carbon emission concerns and volatility in fossil fuel resources have renewed world-wide interest in nuclear energy as a solution to growing energy demands. Several large nuclear reactors are currently under construction in the United States, representing the first new construction in over 30 years. Small Modular Reactors (SMRs) have been in design for many years and offer potential technical and economic advantages compared with traditionally larger reactors. Current SMR capital and operational expenses have a wide range of uncertainty. This work evaluates the potential for SMRs in the US, develops a robust techno-economic assessment of SMRs, and leverages the model to evaluate US regulatory fees structures. Modeling includes capital expenses of a factory facility and capital and operational expenses with multiple scenarios explored through a component-level capital cost model. Policy regarding the licensing and regulation of SMRs is under development with proposed annual US regulatory fees evaluated through the developed techno-economic model. Results show regulatory fees are a potential barrier to the economic viability of SMRs with an alternate fee structure proposed and evaluated. The proposed fee structure is based on the re-distribution of fees for all nuclear reactors under a single structure based on reactor thermal power rating. - Highlights: • Potential demand for new small modular nuclear power in the US is established. • Capital costs are broken down on component level and include factory production. • US regulatory fees structures are evaluated, results show potential barrier. • An additional fee structure is proposed and compared with current US fee structures.

  18. 75 FR 32483 - Prescription Drug User Fee Act; Meetings on Reauthorization; Request for Notification of...

    Science.gov (United States)

    2010-06-08

    .../Legislation/FederalFoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheFDCAct/FoodandDrugAdministration... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0128] Prescription Drug User Fee Act; Meetings on Reauthorization; Request for Notification of Stakeholder Intention...

  19. Modifications of the design of the final transformer in the FFS to accommodate lower gradients in the final quadrupole triplet

    International Nuclear Information System (INIS)

    Murray, J.J.

    1983-01-01

    The final transformer of the FFS includes the soft bend magnet and two symmetric quadrupole triplets. It ends at the IP. It is a telescopic transformer (meaning that its transfer matrix is diagonal) with a magnification of -1/5 in both planes. In the current design, L*, the distance between the downstream end of Q1 and the IP, is equal to 7.25 feet (2.21 m) and space is provided upstream of Q6 to accommodate a 27 foot long soft bend magnet. Satisfaction of the foregoing conditions leads to field gradients of about 19.8 kg/cm in Q1 and Q3 and 18.1 kg/cm in Q2. It now appears that it would be very difficult to attain such gradients. For practical superconducting quad designs, meaning iron-free, 5 cm bore, two-layer windings and 4.2 0 K, experts have estimated that gradients of at least 14 kg/cm would be reasonable. This raises the question, can the final transformer in the FFS be modified to accommodate gradients of 14 kg/cm or less and if so at what price in performance

  20. 48 CFR 836.606-73 - Application of 6 percent architect-engineer fee limitation.

    Science.gov (United States)

    2010-10-01

    ... architect-engineer fee limitation. 836.606-73 Section 836.606-73 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Architect-Engineer Services 836.606-73 Application of 6 percent architect-engineer fee limitation...

  1. 41 CFR 105-50.303 - Cost basis in lieu of fees.

    Science.gov (United States)

    2010-07-01

    ... § 105-50.303 Cost basis in lieu of fees. Where the cost of services is to be recovered on other than a... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Cost basis in lieu of fees. 105-50.303 Section 105-50.303 Public Contracts and Property Management Federal Property...

  2. 75 FR 34319 - User Fees for 2010 Crop Cotton Classification Services to Growers

    Science.gov (United States)

    2010-06-17

    ... uncertainties related to crop size and cash-flow timing while meeting minimum reserve requirements set by the... cotton crop at that same level. This fee and the existing reserve are sufficient to cover the costs of... Pursuant to requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612), AMS has...

  3. 76 FR 25533 - User Fees for 2011 Crop Cotton Classification Services to Growers

    Science.gov (United States)

    2011-05-05

    ... uncertainties related to crop size and cash-flow timing while meeting minimum reserve requirements set by the... cotton crop at that same level. This fee and the existing reserve are sufficient to cover the costs of... Flexibility Act Pursuant to requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612...

  4. Hidden costs: the direct and indirect impact of user fees on access to malaria treatment and primary care in Mali.

    Science.gov (United States)

    Johnson, Ari; Goss, Adeline; Beckerman, Jessica; Castro, Arachu

    2012-11-01

    About 20 years after initial calls for the introduction of user fees in health systems in sub-Saharan Africa, a growing coalition is advocating for their removal. Several African countries have abolished user fees for health care for some or all of their citizens. However, fee-for-service health care delivery remains a primary health care funding model in many countries in sub-Saharan Africa. Although the impact of user fees on utilization of health services and household finances has been studied extensively, further research is needed to characterize the multi-faceted health and social problems associated with charging user fees. This ethnographic study aims to identify consequences of user fees on gender inequality, food insecurity, and household decision-making for a group of women living in poverty. Ethnographic life history interviews were conducted with 24 women in Yirimadjo, Mali in 2007. Purposive sampling selected participants across a broad socio-economic spectrum. Semi-structured interviews addressed participants' past medical history, socio-economic status, social and family history, and access to health care. Interview transcripts were coded using the guiding analytical framework of structural violence. Interviews revealed that user fees for health care not only decreased utilization of health services, but also resulted in delayed presentation for care, incomplete or inadequate care, compromised food security and household financial security, and reduced agency for women in health care decision making. The effects of user fees were amplified by conditions of poverty, as well as gender and health inequality; user fees in turn reinforced the inequalities created by those very conditions. The qualitative data reveal multi-faceted health and socioeconomic effects of user fees, and illustrate that user fees for health care may impact quality of care, health outcomes, food insecurity, and gender inequality, in addition to impacting health care utilization

  5. US approaches to physician payment: the deconstruction of primary care.

    Science.gov (United States)

    Berenson, Robert A; Rich, Eugene C

    2010-06-01

    The purpose of this paper is to address why the three dominant alternatives to compensating physicians (fee-for-service, capitation, and salary) fall short of what is needed to support enhanced primary care in the patient-centered medical home, and the relevance of such payment reforms as pay-for-performance and episodes/bundling. The review illustrates why prevalent physician payment mechanisms in the US have failed to adequately support primary care and why innovative approaches to primary care payment play such a prominent role in the PCMH discussion. FFS payment for office visits has never effectively rewarded all the activities that comprise prototypical primary care and may contribute to the "hamster on a treadmill" problems in current medical practice. Capitation payments are associated with risk adjustment challenges and, perhaps, public perceptions of conflict with patients' best interests. Most payers don't employ and therefore cannot generally place physicians on salary; while in theory such salary payments might neutralize incentives, operationally, "time is money;" extra effort devoted to meeting the needs of a more complex patient will likely reduce the services available to others. Fee-for-service, the predominant physician payment scheme, has contributed to both the continuing decline in the primary care workforce and the capability to serve patients well. Yet, the conceptual alternative payment approaches, modified fee-for-service (including fee bundles), capitation, and salary, each have their own problems. Accordingly, new payment models will likely be required to support restoration of primary care to its proper role in the US health care system, and to promote and sustain the development of patient-centered medical homes.

  6. 77 FR 51751 - Assessment of Fees for Dairy Import Licenses for the 2013 Tariff-Rate Import Quota Year

    Science.gov (United States)

    2012-08-27

    ... Agriculture's costs of administering the licensing system under this regulation. The regulation at 7 CFR 6.33... system, and $125,280.00 represents other miscellaneous costs, including travel, postage, publications... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Assessment of Fees for Dairy Import...

  7. Funding models for outreach ophthalmology services.

    Science.gov (United States)

    Turner, Angus W; Mulholland, Will; Taylor, Hugh R

    2011-01-01

    This paper aims to describe funding models used and compare the effects of funding models for remuneration on clinical activity and cost-effectiveness in outreach eye services in Australia. Cross-sectional case study based in remote outreach ophthalmology services in Australia. Key stake-holders from eye services in nine outreach regions participated in the study. Semistructured interviews were conducted to perform a qualitative assessment of outreach eye services' funding mechanisms. Records of clinical activity were used to statistically compare funding models. Workforce availability (supply of ophthalmologists), costs of services, clinical activity (surgery and clinic consultation rates) and waiting times. The supply of ophthalmologists (full-time equivalence) to all remote regions was below the national average (up to 19 times lower). Cataract surgery rates were also below national averages (up to 10 times lower). Fee-for-service funding significantly increased clinical activity. There were also trends to shorter waiting times and lower costs per attendance. For outreach ophthalmology services, the funding model used for clinician reimbursement may influence the efficiency and costs of the services. Fee-for-service funding models, safety-net funding options or differential funding/incentives need further exploration to ensure isolated disadvantaged areas prone to poor patient attendance are not neglected. In order for outreach eye health services to be sustainable, remuneration rates need to be comparable to those for urban practice. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  8. 42 CFR 415.130 - Conditions for payment: Physician pathology services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conditions for payment: Physician pathology... Physician Services to Beneficiaries in Providers § 415.130 Conditions for payment: Physician pathology... of physician pathology services to fee-for-service Medicare beneficiaries who were hospital...

  9. Assessing regional variations in the effect of the removal of user fees ...

    African Journals Online (AJOL)

    The aim of this research was to analyse the effect of user fee removal in rural ... Conclusion: Although user fees matter, to a degree, service quality is a relatively more important contributor to the promotion ... been required to purchase supplies – bleach, to sterilise ... decision-making at the individual and household level,.

  10. Exploring College Outcomes for Low-Income AP® Exam Takers with Fee Reductions. Research Report 2016-2

    Science.gov (United States)

    Godfrey, Kelly E.; Wyatt, Jeffrey N.; Beard, Jonathan J.

    2016-01-01

    The focus of this study is to explore college outcomes for students who come from traditionally lower-income backgrounds, reporting a household income of $30,000 or less, and who were awarded a fee reduction to take one or more Advanced Placement® (AP®) Exams, compared to students with a similar background and ability who did not participate in an…

  11. No Win, No Fee: Some Economics of Contingent Legal Fees.

    OpenAIRE

    Gravelle, Hugh; Waterson, Michael

    1993-01-01

    This paper analyzes the effects on the litigation process of alternative contracts between plaintiffs and their lawyers. Three contracts are compared: normal (hourly fee), contingent mark up fees, and contingent share contracts. The focus is on the first two, a recent change in English law governing legal fees providing the motivation. The influences of the contract type on the acceptance of settlement offers, the settlement probability, the accident probability, the demand for trials, and th...

  12. Permissible state permit/fee systems for radioactive materials transportation

    International Nuclear Information System (INIS)

    Friel, L.

    1987-01-01

    Many state permit/fee systems for radioactive materials transportation have been ruled inconsistent with federal law invalidated by the courts. As the date for repository operation, and its associated transportation, draws near, more states can be expected to adopt permit/fee systems. Examination of the U.S. Department of Transportation's advisory rulings and federal court cases on previous permit/fee systems gives general guidance on the type of permit/fee systems most likely to withstand challenges. Such a system would: have a simplified permit application with minimal information requirements; address a federally-defined class of hazardous or radioactive materials; allow access to all shipments conducted in compliance with federal law; charge a fee reasonably related to the costs imposed on the state by the transportation; and minimize the potential for re-directing shipments to other jurisdictions

  13. 25 CFR 152.4 - Application for patent in fee.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Application for patent in fee. 152.4 Section 152.4 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER ISSUANCE OF PATENTS IN FEE, CERTIFICATES OF COMPETENCY, REMOVAL OF RESTRICTIONS, AND SALE OF CERTAIN INDIAN LANDS Issuing Patents in Fee...

  14. 77 FR 11127 - Medicaid Program; Announcement of Medicaid Recovery Audit Contractors (RACs) Contingency Fee Update

    Science.gov (United States)

    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...

  15. Banking Fees in Australia

    OpenAIRE

    Reserve Bank of Australia

    2010-01-01

    The Reserve Bank has conducted a survey on bank fees each year since 1997. In 2009 growth in fee income increased slightly from recent years though it was again slower than growth in banks’ balance sheets. Growth in fee income was higher for businesses than for households. Banks reacted to the financial crisis by competing more aggressively for deposit funding which resulted in total fee income from deposit accounts falling, and repricing loan products which contributed to an increase in fe...

  16. 10 CFR 9.41 - Requests for waiver or reduction of fees.

    Science.gov (United States)

    2010-01-01

    ... publication fee; and (8) Describe any commercial or private interest the requester or any other party has in... 10 Energy 1 2010-01-01 2010-01-01 false Requests for waiver or reduction of fees. 9.41 Section 9... Requests for waiver or reduction of fees. (a)(1) The NRC will collect fees for searching for, reviewing...

  17. 10 CFR 1703.106 - Requests for waiver or reduction of fees.

    Science.gov (United States)

    2010-01-01

    ... provided free of charge or provided for an access or publication fee; and (8) Describe any commercial or... 10 Energy 4 2010-01-01 2010-01-01 false Requests for waiver or reduction of fees. 1703.106 Section... Requests for waiver or reduction of fees. (a) The Board shall collect fees for record requests made under...

  18. A new accounting system for financial balance based on personnel cost after the introduction of a DPC/DRG system.

    Science.gov (United States)

    Nakagawa, Yoshiaki; Takemura, Tadamasa; Yoshihara, Hiroyuki; Nakagawa, Yoshinobu

    2011-04-01

    A hospital director must estimate the revenues and expenses not only in a hospital but also in each clinical division to determine the proper management strategy. A new prospective payment system based on the Diagnosis Procedure Combination (DPC/PPS) introduced in 2003 has made the attribution of revenues and expenses for each clinical department very complicated because of the intricate involvement between the overall or blanket component and a fee-for service (FFS). Few reports have so far presented a programmatic method for the calculation of medical costs and financial balance. A simple method has been devised, based on personnel cost, for calculating medical costs and financial balance. Using this method, one individual was able to complete the calculations for a hospital which contains 535 beds and 16 clinics, without using the central hospital computer system.

  19. 46 CFR 10.219 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Fees. 10.219 Section 10.219 Shipping COAST GUARD... Requirements for All Merchant Mariner Credentials § 10.219 Fees. (a) Use table 10.219(a) of this section to calculate the mandatory fees for MMCs and associated endorsements. Table 10.219(a) Fees If you apply for And...

  20. 78 FR 54656 - Fee for Using a Priority Review Voucher in Fiscal Year 2014

    Science.gov (United States)

    2013-09-05

    .... currency by check, bank draft, or U.S. postal money order payable to the order of the Food and Drug... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0007] Fee for Using a Priority Review Voucher in Fiscal Year 2014 AGENCY: Food and Drug Administration, HHS...

  1. Banking Fees in Australia

    OpenAIRE

    Sarah Rudd; Chris Stewart

    2012-01-01

    The Reserve Bank has conducted a survey on bank fees each year since 1997. The results of the latest survey show that banks’ aggregate fee income rose slightly in the banks’ 2011 financial years, but that growth in fee income was less than that in banks’ total assets. Fee income from households declined while fee income from businesses grew, largely as a result of increases in fees on business loans and bank bills.

  2. 76 FR 51310 - Branded Prescription Drug Fee

    Science.gov (United States)

    2011-08-18

    ... Branded Prescription Drug Fee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed... issue of the Federal Register, the IRS is issuing temporary regulations relating to the branded... business of manufacturing or importing certain branded prescription drugs. The text of the temporary...

  3. Supplementary physicians' fees: a sustainable system?

    Science.gov (United States)

    Calcoen, Piet; van de Ven, Wynand P M M

    2018-01-25

    In Belgium and France, physicians can charge a supplementary fee on top of the tariff set by the mandatory basic health insurance scheme. In both countries, the supplementary fee system is under pressure because of financial sustainability concerns and a lack of added value for the patient. Expenditure on supplementary fees is increasing much faster than total health expenditure. So far, measures taken to curb this trend have not been successful. For certain categories of physicians, supplementary fees represent one-third of total income. For patients, however, the added value of supplementary fees is not that clear. Supplementary fees can buy comfort and access to physicians who refuse to treat patients who are not willing to pay supplementary fees. Perceived quality of care plays an important role in patients' willingness to pay supplementary fees. Today, there is no evidence that physicians who charge supplementary fees provide better quality of care than physicians who do not. However, linking supplementary fees to objectively proven quality of care and limiting access to top quality care to patients able and willing to pay supplementary fees might not be socially acceptable in many countries. Our conclusion is that supplementary physicians' fees are not sustainable.

  4. 76 FR 79195 - Animal Drug User Fee Act; Reopening of the Comment Period

    Science.gov (United States)

    2011-12-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0656] Animal Drug User Fee Act; Reopening of the Comment Period AGENCY: Food and Drug Administration, HHS... notice, FDA requested comments on the Animal Drug User Fee Act (ADUFA) program to date and solicited...

  5. 12 CFR 211.45 - Accounting for fees on international loans.

    Science.gov (United States)

    2010-01-01

    ... accordance with generally accepted accounting principles. [Reg. K, 68 FR 1159, Jan. 9, 2003] Interpretations ... 12 Banks and Banking 2 2010-01-01 2010-01-01 false Accounting for fees on international loans. 211... Accounting for fees on international loans. (a) Restrictions on fees for restructured international loans. No...

  6. Factors that determine the fees for audit NGOs financial statements in Kosovo

    Directory of Open Access Journals (Sweden)

    Bahtijar Berisha

    2016-03-01

    Full Text Available The purpose of this paper is to identify, analyze and evaluate the potential factors that influence the determinants of the fee/price of the NGOs financial statements audit in Kosovo based and tested, generally, traditional determinants and known in economic literature on this issue. In our study, we have chosen the NGO sector in Kosovo to investigate the factors that determine the fee/price of their financial statements, because the non-governmental organizations are among the first organizations that have gone through the audit process after war disintegration of former Yugoslavia, and to our knowledge no similar research was undertaken. The study is generally based on data collected through a questionnaire, sector financial audit of NGOs in Kosovo’s reality, focusing on the group of respondents who are professional in this field as statutory auditors, certified auditors and certified accountants. By the results of this analysis related to the importance variables of the model, it was found that the size, complexity, audit risk, NGO audit market, competition, international character and the number of donors who fund NGOs and the number of projects they develop, have a significant impact on the fee/price of the financial audit of NGOs Kosovo.

  7. Assessment of crack-like flaws - Comparison of procedures in BS 7910, API 579-1/ASME FFS-1, RSE-M AND FITNET

    International Nuclear Information System (INIS)

    Chaudouet, A.

    2007-01-01

    Among all Fitness For Service Codes enabling to assess flaws in metallic structures and to evaluate their remaining life, new editions of the most important ones at the international level have been issued recently. The latest edition of BS 7910 in United Kingdom has been released in October 2005. In the USA, API and ASME have edited a new standard in 2007, API579-1/ASME FFS-1, dedicated to pressure equipment. In France, the rules concerning the of Light Water Reactors, RSE-M, have been updated in 2005. Finally, in Europe, the FITNET network is writing a document based on BS 7910 but extended with the most recent results in this domain. Rules given in these documents to assess crack-like flaws with respect to fracture and fatigue propagation are presented. They are compared in order to point out the most interesting aspects of each ones and to identify those which could be generalized. An example assessed with the above mentioned 'Codes' enlightens the differences in the results with respect to the 'Code' used. (author) [fr

  8. Paying for payments: free payments and optimal interchange fees

    OpenAIRE

    Korsgaard, Søren

    2014-01-01

    Do consumers and merchants use the most efficient payment instruments? I examine how inter- change fees, which are fees paid from merchants' banks to consumers' banks when card transactions take place, influence the choice between cash and payment cards. I show that when consumers do not pay transaction fees to banks - a common feature in bank contracts - card use is declining in interchange fees, and surcharging does not neutralize interchange fees. According to my model, banks set interchan...

  9. 50 CFR 29.5 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Fees. 29.5 Section 29.5 Wildlife and... WILDLIFE REFUGE SYSTEM LAND USE MANAGEMENT General Rules § 29.5 Fees. Fees and charges for the grant of... prescribed by law or regulation, shall be set at a rate commensurate with fees and charges for similar...

  10. Discounting of quantity surveying fees in South Africa

    African Journals Online (AJOL)

    by clients have forced Quantity Surveying firms into competition with ... Furthermore, 43% of consulting engineering firms were discounting their fees at a rate of .... Quantity. Surveying services are also offered in the fields of dispute resolution,.

  11. 76 FR 45811 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2012

    Science.gov (United States)

    2011-08-01

    ... additional fees. If you prefer to send a check by a courier such as Federal Express (FEDEX) or United Parcel Service (UPS), the courier may deliver the check and printed copy of the cover sheet to: U.S. Bank, Attn... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0548...

  12. The present-day scope of practice and services of the traditional healer in South Africa

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2016-12-01

    Full Text Available Background The scope of practice of the traditional healer in South Africa is not guided or circumscribed by any statutory mandate at present. The traditional healer’s practice and services are currently based on and driven by the supernatural and the afterlife, lacking not only a scientific foundation, but also legal constraint. Aims This study aimed to determine and describe the present-day scope of practice and services of the South African traditional healer. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the scope of practice and services of the South African traditional healer. The findings are offered in narrative form. Results There is no established curriculum and practice culture to serve as an evaluation and descriptive criteria for the present-day traditional healer’s scope of practice. Conclusion The South African traditional healer’s practice and rights are unwritten and legally unregulated, especially when viewed against in comparison with the current practice customs, traditions and rights of the South African statutorily regulated healthcare practitioners.

  13. 40 CFR 1027.120 - Can I qualify for reduced fees?

    Science.gov (United States)

    2010-07-01

    ... United States. (2) The full fee for an application for certification for a model year exceeds 1.0% of the... sales area and model year as the requested certificate for the converted vehicle or engine. (3) For... information available at the time of the fee payment. (6) You may submit a reduced fee as described in this...

  14. 78 FR 72089 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    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...

  15. 76 FR 65741 - Customs Brokers User Fee Payment for 2012

    Science.gov (United States)

    2011-10-24

    ... DEPARTMENT OF HOMELAND SECURITY Customs and Border Protection Customs Brokers User Fee Payment for.... SUMMARY: This document provides notice to customs brokers that the annual fee of $138 that is assessed for... 2012 in accordance with the Tax Reform Act of 1986. DATES: Payment of the 2012 Customs Broker User Fee...

  16. Two-Stage Dynamic Pricing and Advertising Strategies for Online Video Services

    Directory of Open Access Journals (Sweden)

    Zhi Li

    2017-01-01

    Full Text Available As the demands for online video services increase intensively, the selection of business models has drawn the great attention of online providers. Among them, pay-per-view mode and advertising mode are two important resource modes, where the reasonable fee charge and suitable volume of ads need to be determined. This paper establishes an analytical framework studying the optimal dynamic pricing and advertising strategies for online providers; it shows how the strategies are influenced by the videos available time and the viewers’ emotional factor. We create the two-stage strategy of revenue models involving a single fee mode and a mixed fee-free mode and find out the optimal fee charge and advertising level of online video services. According to the results, the optimal video price and ads volume dynamically vary over time. The viewer’s aversion level to advertising has direct effects on both the volume of ads and the number of viewers who have selected low-quality content. The optimal volume of ads decreases with the increase of ads-aversion coefficient, while increasing as the quality of videos increases. The results also indicate that, in the long run, a pure fee mode or free mode is the optimal strategy for online providers.

  17. Free versus subsidised healthcare: options for fee exemptions, access to care for vulnerable groups and effects on the health system in Burkina Faso.

    Science.gov (United States)

    Yaogo, Maurice

    2017-07-12

    The many forms of healthcare fee exemptions implemented in Burkina Faso since the 2000s have varied between total exemption (free) and cost subsidisation. This article examines both options, their contextual variations and the ways in which they affect access to healthcare for vulnerable people as well as the operation of the health system. This research is part of an interdisciplinary regional program on the elimination of user fees for health services in West Africa (Burkina Faso, Mali and Niger). A conceptual framework and a chronological review of policy interventions are used as references to summarise the results of the three qualitative studies presented. Historical reference points are used to describe the emergence of healthcare fee exemption policies in Burkina Faso and the events that influenced their adoption. The joint analysis of opinions on options for fee exemption focuses on the different types of repercussions on access to healthcare and the operation of the health system. In conjunction with the twists and turns of the gradual development of a national health policy and in response to international recommendations, healthcare fee exemptions have evolved since colonisation. The limitations of the changes introduced with cost recovery and the barriers to healthcare access for the poorest people led to the adoption of the current sectorial fee exemptions. The results provide information on the reasons for the changes that have occurred over time. The nuanced perspectives of different categories of people surveyed about fee exemption options show that, beyond the perceived effects on healthcare access and the health system, the issue is one of more equitable governance. In principle, the fee exemption measures are intended to provide improved healthcare access for vulnerable groups. In practice, the negative effects on the operation of the health system advocate for reforms to harmonise the changes to multifaceted fee exemptions and the actual needs

  18. 45 CFR 1602.13 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Fees. 1602.13 Section 1602.13 Public Welfare... INFORMATION UNDER THE FREEDOM OF INFORMATION ACT § 1602.13 Fees. (a) No fees will be charged for information routinely provided in the normal course of doing business. (b)(1) Fees shall be limited to reasonable...

  19. 78 FR 27239 - General Services Administration Acquisition Regulation; Submission for OMB Review; Industrial...

    Science.gov (United States)

    2013-05-09

    ... Services Administration Acquisition Regulation; Submission for OMB Review; Industrial Funding Fee and Sales... Budget (OMB) a request to review and approve a reinstatement of a previously approved information collection requirement regarding industrial funding fee and sales reporting. A notice was published in the...

  20. 26 CFR 301.7610-1 - Fees and costs for witnesses.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Fees and costs for witnesses. 301.7610-1... Examination and Inspection § 301.7610-1 Fees and costs for witnesses. (a) Introduction. Section 7610 provides..., these fees are considered to be directly incurred by the summoned third party. (2) Reproduction cost...

  1. 43 CFR 35.25 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Fees. 35.25 Section 35.25 Public Lands... STATEMENTS § 35.25 Fees. The party requesting a subpoena shall pay the cost of the fees and mileage of any... Court. A check for witness fees and mileage shall accompany the subpoena when served, except that when a...

  2. 50 CFR 501.9 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Fees. 501.9 Section 501.9 Wildlife and Fisheries MARINE MAMMAL COMMISSION IMPLEMENTATION OF THE PRIVACY ACT OF 1974 § 501.9 Fees. A fee of $0.10... request of an individual. No fee shall be charged for copies made at the initiative of the Commission...

  3. 6 CFR 5.29 - Fees.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Fees. 5.29 Section 5.29 Domestic Security... § 5.29 Fees. (a) Components shall charge fees for duplication of records under the Privacy Act in the same way in which they charge duplication fees under § 5.11. (b) The Department shall not process a...

  4. 45 CFR 1305.9 - Policy on fees.

    Science.gov (United States)

    2010-10-01

    ... PROGRAM ELIGIBILITY, RECRUITMENT, SELECTION, ENROLLMENT AND ATTENDANCE IN HEAD START § 1305.9 Policy on... 45 Public Welfare 4 2010-10-01 2010-10-01 false Policy on fees. 1305.9 Section 1305.9 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES...

  5. 77 FR 54360 - CPI Adjustment of Patent Fees for Fiscal Year 2013

    Science.gov (United States)

    2012-09-05

    ...,365 SE $20 Fifth Month. 1.17(l) Petition to Revive $620 $630 $10 Unavoidably SE $310 SE $315 SE $5 Abandoned Application. 1.17(m) Petition to Revive $1,860 $1,890 $30 Unintentionally SE $930 SE $945 SE $15... appeal fee, appeal brief fee, request for an oral hearing fee, petition to revive fee, issue fee, or...

  6. 77 FR 74201 - Customs Brokers User Fee Payment for 2013

    Science.gov (United States)

    2012-12-13

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Customs Brokers User Fee...: General notice. SUMMARY: This document provides notice to customs brokers that the annual fee of $138 that... of the 2013 Customs Broker User Fee is due February 15, 2013. FOR FURTHER INFORMATION CONTACT: Craig...

  7. 75 FR 76472 - Biologics Price Competition and Innovation Act of 2009; Meetings on User Fee Program for...

    Science.gov (United States)

    2010-12-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0602] Biologics Price Competition and Innovation Act of 2009; Meetings on User Fee Program for Biosimilar and Interchangeable Biological Product Applications; Request for Notification of Stakeholder Intention To Participate...

  8. Fee Pricing for Bank Services: Who Benefits?

    Science.gov (United States)

    Nigro, Peter D.

    1984-01-01

    Discusses how banks brave enough to go against conventional wisdom, which says that customers should pay for everything, could end up with greater profits and more customer satisfaction by exchanging free minimum services for minimum reasonable balances. (RM)

  9. 45 CFR 1701.4 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Fees. 1701.4 Section 1701.4 Public Welfare... DISCLOSURE OF INFORMATION § 1701.4 Fees. (a) A fee may be charged for direct costs of document search and... locating records. (b) A fee may be waived in whole or in part where it is determined that it is in the...

  10. 77 FR 28331 - CPI Adjustment of Patent Fees for Fiscal Year 2013

    Science.gov (United States)

    2012-05-14

    ... $2,770 $80. within Fifth Month. SE $1,345 SE $1,385 SE $40. 1.17(l) Petition to Revive $620 $640 $20. Unavoidably Abandoned SE $310 SE $320 SE $10. Application. 1.17(m) Petition to Revive $1,860 $1,910 $50... fee, notice of appeal fee, appeal brief fee, request for an oral hearing fee, petition to revive fee...

  11. 77 FR 45624 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2013

    Science.gov (United States)

    2012-08-01

    .... currency by check, bank draft, or U.S. postal money order payable to the order of the Food and Drug... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0806] Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2013 AGENCY: Food and Drug...

  12. 41 CFR 302-12.109 - What must we consider in deciding whether to use the fixed-fee or cost-reimbursable contracting...

    Science.gov (United States)

    2010-07-01

    ... deciding whether to use the fixed-fee or cost-reimbursable contracting method? 302-12.109 Section 302-12... Services Company § 302-12.109 What must we consider in deciding whether to use the fixed-fee or cost...-fee or cost-reimbursable contracting method: (a) Risk of alternative methods. Under a fixed fee...

  13. Comorbidity, age, race and stage at diagnosis in colorectal cancer: a retrospective, parallel analysis of two health systems

    Directory of Open Access Journals (Sweden)

    Rowe Krista L

    2008-11-01

    Full Text Available Abstract Background Stage at diagnosis plays a significant role in colorectal cancer (CRC survival. Understanding which factors contribute to a more advanced stage at diagnosis is vital to improving overall survival. Comorbidity, race, and age are known to impact receipt of cancer therapy and survival, but the relationship of these factors to stage at diagnosis of CRC is less clear. The objective of this study is to investigate how comorbidity, race and age influence stage of CRC diagnosis. Methods Two distinct healthcare populations in the United States (US were retrospectively studied. Using the Cancer Care Outcomes Research and Surveillance Consortium database, we identified CRC patients treated at 15 Veterans Administration (VA hospitals from 2003–2007. We assessed metastatic CRC patients treated from 2003–2006 at 10 non-VA, fee-for-service (FFS practices. Stage at diagnosis was dichotomized (non-metastatic, metastatic. Race was dichotomized (white, non-white. Charlson comorbidity index and age at diagnosis were calculated. Associations between stage, comorbidity, race, and age were determined by logistic regression. Results 342 VA and 340 FFS patients were included. Populations differed by the proportion of patients with metastatic CRC at diagnosis (VA 27% and FFS 77% reflecting differences in eligibility criteria for inclusion. VA patients were mean (standard deviation; SD age 67 (11, Charlson index 2.0 (1.0, and were 63% white. FFS patients were mean age 61 (13, Charlson index 1.6 (1.0, and were 73% white. In the VA cohort, higher comorbidity was associated with earlier stage at diagnosis after adjusting for age and race (odds ratio (OR 0.76, 95% confidence interval (CI 0.58–1.00; p = 0.045; no such significant relationship was identified in the FFS cohort (OR 1.09, 95% CI 0.82–1.44; p = 0.57. In both cohorts, no association was found between stage at diagnosis and either age or race. Conclusion Higher comorbidity may lead to

  14. 76 FR 7879 - Fee Rate

    Science.gov (United States)

    2011-02-11

    ... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted preliminary annual fee rates of 0.00% for tier 1 and 0.074% (.00074) for tier 2 for... part 518, the preliminary fee rate on class II revenues for calendar year 2011 shall be one-half of the...

  15. 75 FR 5342 - Fee Rate

    Science.gov (United States)

    2010-02-02

    ... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted preliminary annual fee rates of 0.00% for tier 1 and 0.060% (.00060) for tier 2 for... part 518, the preliminary fee rate on class II revenues for calendar year 2010 shall be one-half of the...

  16. 77 FR 5267 - Fee Rate

    Science.gov (United States)

    2012-02-02

    ... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted preliminary annual fee rates of 0.00% for tier 1 and 0.074% (.00074) for tier 2 for... part 518, the preliminary fee rate on class II revenues for calendar year 2012 shall be one-half of the...

  17. 75 FR 44807 - Fee Rate

    Science.gov (United States)

    2010-07-29

    ... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted final annual fee rates of 0.00% for tier 1 and 0.060% (.00060) for tier 2 for calendar... 518, the preliminary fee rate on class II revenues for calendar year 2010 shall be one-half of the...

  18. 49 CFR 1002.3 - Updating user fees.

    Science.gov (United States)

    2010-10-01

    ... updating fees. Each fee shall be updated by updating the cost components comprising the fee. Cost... direct labor costs are direct labor costs determined by the cost study set forth in Revision of Fees For... by total office costs for the Offices directly associated with user fee activity. Actual updating of...

  19. 50 CFR 253.16 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Fees. 253.16 Section 253.16 Wildlife and... Fees. (a) Application fee. The Division will not accept an application without the application fee. Fifty percent of the application fee is fully earned at application acceptance, and is not refundable...

  20. 76 FR 38207 - Fee Rate

    Science.gov (United States)

    2011-06-29

    ... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted final annual fee rates of 0.00% for tier 1 and 0.074% (.00074) for tier 2 for calendar... 518, the final fee rate on class II revenues for calendar year 2011 shall be one-half of the annual...

  1. 77 FR 41202 - Fee Rate

    Science.gov (United States)

    2012-07-12

    ... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted final annual fee rates of 0.00% for tier 1 and 0.074% (.00074) for tier 2 for calendar... 518, the final fee rate on class II revenues for calendar year 2012 shall be one-half of the annual...

  2. 75 FR 6321 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2010-02-09

    ..., sex printed erroneously) if submitted within one year of passport issuance. (g) Passport Book Security...) Passport card replacement NO FEE. for data correction (name, date of birth, place of birth, sex printed... depositions, including depositions by video teleconference (per daily appointment). (b) Attending or taking...

  3. 76 FR 59898 - Branded Prescription Drug Fee; Correction

    Science.gov (United States)

    2011-09-28

    ... Branded Prescription Drug Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... Register on Thursday, August 18, 2011. The proposed regulation provides guidance relating to the branded... as follows: 1. On Page 51311, column 2, under the part heading PART 51--BRANDED PRESCRIPTION DRUGS...

  4. Variation of fee-for-service specialist direct care work effort with patient overall illness burden.

    Science.gov (United States)

    Goodman, Robert

    2011-08-01

    To explore whether a common industry measure of overall patient illness burden, used to assess the total costs of members in a health plan, would be suitable to describe variation in a summary metric of utilization that assesses specialist physician direct patient care services not grouped into clinical episodes, but with exclusion criteria applied to reduce any bias in the data. Data sources/study setting Calendar year 2006 administrative data on 153,557 commercial members enrolled in a non-profit single-state statewide Health Maintenance Organization (HMO) and treated by 4356 specialists in 11 specialties. The health plan's global referral process and specialist fee-for-service reimbursement likely makes these results applicable to the non-managed care setting, as once a global referral was authorized there was no required intervention by the HMO or referring primary care provider for the majority of any subsequent specialist direct clinical care. Study design Specialty-specific correlations and ordinary least-squares regression models to assess variations in specialist direct patient care work effort with patient overall illness burden, after the application of exclusion criteria to reduce potential bias in the data. Principle findings Statistically significant positive correlations exist between specialist direct patient care work effort and patient overall illness burden for all studied specialties. Regression models revealed a generally monotonic increasing relationship between illness burden categories and aggregate specialist direct patient care work effort. Almost all regression model differences from the reference category across specialties are statistically significant (P ≤ 0.012). Assessment of additional results demonstrates the relationship has more substantive significance in some specialties and less in others. The most substantive relationships in this study were found in the specialties of orthopaedic surgery, general surgery and interventional

  5. 37 CFR 256.2 - Royalty fee for compulsory license for secondary transmission by cable systems.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fee for compulsory... ADJUSTMENT OF ROYALTY FEE FOR CABLE COMPULSORY LICENSE § 256.2 Royalty fee for compulsory license for... receipts be reduced to less than $10,400. The royalty fee payable under this paragraph shall be 0.5 of 1...

  6. 28 CFR 802.22 - Fees.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Fees. 802.22 Section 802.22 Judicial... Privacy Act § 802.22 Fees. The Agency shall charge fees under the Privacy Act for duplication of records... Information Act (See § 802.10(i)(1)). ...

  7. 76 FR 62073 - Guidance for Industry on Implementation of the Fee Provisions of the FDA Food Safety...

    Science.gov (United States)

    2011-10-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0721] Guidance for Industry on Implementation of the Fee Provisions of the FDA Food Safety Modernization Act; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug...

  8. Competition and dental services.

    Science.gov (United States)

    Grytten, J; Sørensen, R

    2000-07-01

    Dental services for adults are different from all other Norwegian health services in that they are provided by private producers (dentists) who have full freedom to establish a practice. They have had this freedom since the end of World War II. A further liberalization of the market for dental services occurred in November 1995, when the so-called normal tariff was repealed. The system changed from a fixed fee system to a deregulated fee system. In principle, the market for dental services for adults operates as a free competitive market, in which dentists must compete for a market share. The aim of this study was to study the short-term effects of competition. A comprehensive set of data on fees, practice characteristics, treatment profiles and factors that dentists take into account when determining fees was analysed. The main finding was that competition has a weak effect. No support was found for the theory that the level of fees is the result of monopolistic competition or monopoly. The results also provided some evidence against the inducement hypothesis. At this stage, it is interesting to notice that dentists do not seem to exploit the power they have to control the market. One explanation, which is consistent with the more recent literature, is that physicians' behaviour to a large extent is influenced by professional norms and caring concerns about their patients. Financial incentives are important, but these incentives are constrained by norms other than self-interest. The interpretation of the results should also take into account that the deregulation has operated for a short time and that dentists and patients may not yet have adjusted to changes in the characteristics of the market. Copyright 2000 John Wiley & Sons, Ltd.

  9. Problem of determination of the elementary hardon-nucleon interaction amplitude from Glauber-theory analysis of elastic hardon-nucleus scattering and self-consistent FFS nuclear densities

    International Nuclear Information System (INIS)

    Saperstein, E.E.

    1992-01-01

    The influence of the detailed behavior of the nuclear densities on the Glauber-theory description of hadron-nucleus scattering is discussed in connection with the problem of determination of elementary hadron-nucleon amplitudes from such analysis. Arguments are given in favor of using the self-consistent FFS nuclear densities for this purpose. 20 refs., 6 figs

  10. Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis.

    Science.gov (United States)

    Leone, Tiziana; Cetorelli, Valeria; Neal, Sarah; Matthews, Zoë

    2016-01-28

    Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. Women's experience of user fees in 5 African countries. Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities' births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries' choice. We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria). User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana. Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Potentials of fee-based library services in Nigeria: with a case report ...

    African Journals Online (AJOL)

    Libraries have traditionally been custodians of information which are provided free of charge to users. Recent decline in funds to libraries and the change in the concept of information from a free resource to a marketable resource in the information age have necessitated the re-evaluation of free services in the libraries.

  12. 75 FR 14111 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2010-03-24

    ... using business rules that allowed the model to project unit costs for future years. The calculation of...SS), the activity-based costing model that the Department used to determine the fees for consular... , the Department chose to develop and use an activity-based costing (ABC) model to determine the true...

  13. 75 FR 36522 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2010-06-28

    ... purchasing a passport book with the intention of using it to cross the Canadian or Mexican borders for travel...) the Western Hemisphere Travel Initiative (WHTI) surcharge, which is embedded in the passport book and... cost recovery, there are limited circumstances, such as the passport book and card application fees for...

  14. 47 CFR 1.1507 - Rulemaking on maximum rates for attorney fees.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Rulemaking on maximum rates for attorney fees... § 1.1507 Rulemaking on maximum rates for attorney fees. (a) If warranted by an increase in the cost of... types of proceedings), the Commission may adopt regulations providing that attorney fees may be awarded...

  15. Payment methods for outpatient care facilities

    Science.gov (United States)

    Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Liying

    2017-01-01

    included 18 studies in this comparison, however we did not include five studies in the effects analysis due to high risk of bias. From the 13 studies, we found that the extra P4P incentives probably slightly improved the health professionals' use of some tests and treatments (adjusted RR median = 1.095, range 1.01 to 1.17; moderate-certainty evidence), and probably led to little or no difference in adherence to quality assurance criteria (adjusted percentage change median = -1.345%, range -8.49% to 5.8%; moderate-certainty evidence). We also found that P4P incentives may have led to little or no difference in patients' utilisation of health services (adjusted RR median = 1.01, range 0.96 to 1.15; low-certainty evidence) and may have led to little or no difference in the control of blood pressure or cholesterol (adjusted RR = 1.01, range 0.98 to 1.04; low-certainty evidence). 2) Capitation combined with P4P compared to fee-for-service (FFS) One study found that compared with FFS, a capitated budget combined with payment based on providers' performance on antibiotic prescriptions and patient satisfaction probably slightly reduced antibiotic prescriptions in primary health facilities (adjusted RR 0.84, 95% confidence interval 0.74 to 0.96; moderate-certainty evidence). 3) Capitation compared to FFS Two studies compared capitation to FFS in mental health centres in the United States. Based on these studies, the effects of capitation compared to FFS on the utilisation and costs of services were uncertain (very low-certainty evidence). Authors' conclusions Our review found that if policymakers intend to apply P4P incentives to pay health facilities providing outpatient services, this intervention will probably lead to a slight improvement in health professionals' use of tests or treatments, particularly for chronic diseases. However, it may lead to little or no improvement in patients' utilisation of health services or health outcomes. When considering using P4P to improve the

  16. 12 CFR 760.8 - Determination fees.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Determination fees. 760.8 Section 760.8 Banks... HAVING SPECIAL FLOOD HAZARDS § 760.8 Determination fees. (a) General. Notwithstanding any Federal or... flood hazard area. A determination fee may also include, but is not limited to, a fee for life-of-loan...

  17. 12 CFR 339.8 - Determination fees.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Determination fees. 339.8 Section 339.8 Banks... IN AREAS HAVING SPECIAL FLOOD HAZARDS § 339.8 Determination fees. (a) General. Notwithstanding any... hazard area. A determination fee may also include, but is not limited to, a fee for life-of-loan...

  18. 4 CFR 83.17 - Fees.

    Science.gov (United States)

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Fees. 83.17 Section 83.17 Accounts GOVERNMENT ACCOUNTABILITY OFFICE RECORDS PRIVACY PROCEDURES FOR PERSONNEL RECORDS § 83.17 Fees. (a) Generally, GAO's policy... discretion may charge a fee when the cost for copying the record (at a rate of 20 cents per page) would be in...

  19. 77 FR 47573 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-08-09

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 40 and 46 [REG-136008-11] RIN 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... on issuers of certain health insurance policies and plan sponsors of certain self-insured health...

  20. 77 FR 50757 - Charging Standard Administrative Fees for Nonprogram-Related Information

    Science.gov (United States)

    2012-08-22

    ... are announcing the standardized administrative fees we will charge to recover our full cost of... will ensure fees are consistent and that we collect the full cost of supplying our information when a... standard fees that are calculated to reflect the full cost of providing information for nonprogram-related...

  1. Global health actors no longer in favor of user fees: a documentary study.

    Science.gov (United States)

    Robert, Emilie; Ridde, Valéry

    2013-07-26

    Since the advent of health user fees in low- and middle-income countries in the 1980s, the discourse of global health actors (GHAs) has changed to the disadvantage of this type of healthcare financing mechanism. The aim of the study was to identify and analyze the stance of GHAs in the debate on user fees. We conducted documentary research using public documents published by and officially attributed to GHAs from 2005 to 2011. We categorized GHAs into four groups: intergovernmental organizations, international non-governmental organizations, government agencies, and working groups and networks. We then classified the GHAs according to their stance relative to the abolition of user fees, and conducted a thematic analysis of their discourse to understand the arguments used by each GHA to justify its stance. We identified 56 GHAs, for which we analyzed 140 documents. Among them, 55% were in favor of the abolition of user fees or in favor of free care at the point of delivery. None of the GHAs stated that they were in favor of user fees; however, 30% did not take a stand. Only the World Bank declares that it is both in favor of user fees and in favor of free care at point of service. GHAs generally circumscribe their stance to specific populations (pregnant women, children under 5 years, etc.) or to specific health services (primary, basic, essential). Three types of arguments are used by GHAs to justify their stance: economic, moral and ethical, and pragmatic. The principle of "user pays" seems to have fizzled. Production and dissemination of evidence, as well as certain advocacy networks, may have contributed to this change in discourse. However, GHAs should go a step further and translate their words into action, so that free healthcare at the point of delivery becomes a reality in low- and middle-income countries. They should provide technical and financial support to those countries that have chosen to implement user fee exemption policies, sometimes influenced

  2. 12 CFR 572.8 - Determination fees.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Determination fees. 572.8 Section 572.8 Banks... FLOOD HAZARDS § 572.8 Determination fees. (a) General. Notwithstanding any Federal or State law other... flood hazard area. A determination fee may also include, but is not limited to, a fee for life-of-loan...

  3. 27 CFR 70.302 - Fees and costs for witnesses.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Fees and costs for... Collection of Excise and Special (Occupational) Tax Miscellaneous Provisions § 70.302 Fees and costs for... costs. Directly incurred costs are costs incurred solely, immediately, and necessarily as a consequence...

  4. Michigan's Physician Group Incentive Program offers a regional model for incremental 'fee for value' payment reform.

    Science.gov (United States)

    Share, David A; Mason, Margaret H

    2012-09-01

    Blue Cross Blue Shield of Michigan partnered with providers across the state to create an innovative, "fee for value" physician incentive program that would deliver high-quality, efficient care. The Physician Group Incentive Program rewards physician organizations-formal groups of physicians and practices that can accept incentive payments on behalf of their members-based on the number of quality and utilization measures they adopt, such as generic drug dispensing rates, and on their performance on these measures across their patient populations. Physicians also receive payments for implementing a range of patient-centered medical home capabilities, such as patient registries, and they receive higher fees for office visits for incorporating these capabilities into routine practice while also improving performance. Taken together, the incentive dollars, fee increases, and care management payments amount to a potential increase in reimbursement of 40 percent or more from Blue Cross Blue Shield of Michigan for practices designated as high-performing patient-centered medical homes. At the same time, we estimate that implementing the patient-centered medical home capabilities was associated with $155 million in lower medical costs in program year 2011 for Blue Cross Blue Shield of Michigan members. We intend to devote a higher percentage of reimbursement over time to communities of caregivers that offer high-value, system-based care, and a lower percentage of reimbursement to individual physicians on a service-specific basis.

  5. 37 CFR 382.3 - Terms for making payment of royalty fees.

    Science.gov (United States)

    2010-07-01

    ... royalty fees. 382.3 Section 382.3 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF... royalty fees. (a) Payment to the Collective. All royalty payments shall be made to the Collective... month for that month, commencing with the month succeeding the month in which the royalty fees are set...

  6. 5 CFR 2610.107 - Allowable fees and expenses.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Allowable fees and expenses. 2610.107 Section 2610.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES... factors as may bear on the value of the services provided. (d) The reasonable cost of any study, analysis...

  7. Preliminary fee methodology for recovering GTCC-LLW management costs

    International Nuclear Information System (INIS)

    Clark, L.L.

    1990-06-01

    The US Department of Energy (DOE) is currently planning a fee to recover costs of managing Greater-Than-Class-C Low-Level Waste (GTCC-LLW). A cash flow basis will be used for fee calculations to ensure recovery of all applicable program costs. Positive cash flows are revenues received from waste generators. Negative cash flows are program expenses for storage, transportation, treatment, and disposal of the wastes and for program development, evaluation, and administration. Program balances are the net result of positive and negative cash flows each year. The methodology calculates fees that will recovery all program expenses taking into account cost inflation. 3 refs., 1 tab

  8. 37 CFR 260.3 - Terms for making payment of royalty fees.

    Science.gov (United States)

    2010-07-01

    ... royalty fees. 260.3 Section 260.3 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF... Terms for making payment of royalty fees. (a) All royalty payments shall be made to a designated agent(s... the month succeeding the month in which the royalty fees are set. (c) The agent designated to receive...

  9. 47 CFR 1.1162 - General exemptions from regulatory fees.

    Science.gov (United States)

    2010-10-01

    ... Commission authorization in any other mass media radio service (except the international broadcast (HF... 47 Telecommunication 1 2010-10-01 2010-10-01 false General exemptions from regulatory fees. 1.1162 Section 1.1162 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule...

  10. 45 CFR 1705.10 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Fees. 1705.10 Section 1705.10 Public Welfare... PRIVACY REGULATIONS § 1705.10 Fees. (a) The Commission will not charge an individual for the costs of... necessary part of the process of disclosing the record to the individual) the Commission will charge a fee...

  11. 12 CFR 347.304 - Accounting for fees on international loans.

    Science.gov (United States)

    2010-01-01

    ... accepted accounting principles. ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Accounting for fees on international loans. 347... OF GENERAL POLICY INTERNATIONAL BANKING International Lending § 347.304 Accounting for fees on...

  12. 19 CFR 24.12 - Customs fees; charges for storage.

    Science.gov (United States)

    2010-04-01

    ... OF THE TREASURY CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24.12 Customs fees; charges for storage... charge and collect a fee of $10.00 for each hour or fraction thereof for time spent by each clerical... working days following the day on which the permit to release or transfer was issued. As to an examination...

  13. 43 CFR 45.47 - What are the requirements for subpoenas and witness fees?

    Science.gov (United States)

    2010-10-01

    ... and witness fees? 45.47 Section 45.47 Public Lands: Interior Office of the Secretary of the Interior... § 45.47 What are the requirements for subpoenas and witness fees? (a) Request for subpoena. (1) Except...) Witness fees. (1) A party who subpoenas a witness who is not a party must pay him or her the same fees and...

  14. Break-even analysis of Medicaid vs fee for service in orthodontic practice: North Carolina as a case study.

    Science.gov (United States)

    Murdock, John E; Phillips, Ceib; Beane, Richard; Quinonez, Rocio

    2010-03-01

    Access to orthodontic services for children enrolled in Medicaid is limited nationwide. Orthodontists cite low fee reimbursement as a significant barrier to Medicaid participation. The purpose of this study was to examine, under a specific set of practice assumptions, the simulated effect on profitability of treating patients covered by Medicaid in orthodontic practices in North Carolina by using a break-even analysis for the 2005 fiscal year. Questionnaires were mailed to 154 orthodontists in active practice in North Carolina. The response rate was 58%. Seventy respondents met the eligibility criteria. Respondents were categorized into 4 groups based on the number of 2005 Medicaid case starts (I, 0; II, 1-5; III, 6-12; IV, 13 or more). By using the aggregated responses for treatment fees, treatment times, and overhead percentages for each group, average per-patient costs were calculated for each group and used in a break-even analysis. Group I accounted for 60% of respondents; group II, 20%; group III, 9%; and group IV, 11%. Assuming that the break-even point had not been reached, the group I practice would have an average estimated loss of $164 per patient whereas groups II, III, and IV would realize average profits from $98 to $256. The break-even point increased slightly in groups I, II, and III after the total number of patients in the patient pool was increased by 5%, assuming that additional patients were enrolled in Medicaid: group I, 203 to 210; group II, 220 to 226; group III, 158 to 160. The break-even point for group IV was 234 patients. Assuming that the break-even point had been reached, all groups were estimated to realize average per-patient profits of $1483 to $1897. Break-even analysis is a basic economic concept applicable to orthodontic practices. Under the specific conditions of this study, the inclusion of 5% of patients enrolled in Medicaid in the active patient pool had minimal effect on the financial break-even point and, assuming that the

  15. Protected area entrance fees in Tanzania: The search for competitiveness and value for money

    Directory of Open Access Journals (Sweden)

    Anna Spenceley

    2017-03-01

    Full Text Available User fees charged by Tanzania’s Game Reserves (GR and Wildlife Management Areas (WMAs have not changed since 2008. Although previous research has been done on visitors’ willingness-to-pay to enter national parks in Tanzania, none has been conducted on GRs and WMAs. This article assesses the entrance fees in GRs and WMAs, by comparing them with equivalent fees charged in Tanzania (at national parks and the Ngorongoro Crater and also with regional protected areas in Botswana, Kenya, Namibia, South Africa and Zimbabwe. Based on 28 semi-structured interviews with key stakeholder institutions working on tourism and conservation and more than 50 online survey responses from Tanzanian tourism operators, the research reviews local opinion and issues relating to adjusting current entrance fees. The article considers that while one objective for generating revenue from entrance fees is for conservation management, it is difficult to establish appropriate fees where there are gaps in knowledge about existing levels of visitation, tourism revenue and associated management costs. Conservation implications: This article has implications for protected area management practices, as it provides information on processes by which managers can review and revise entrance fee values.

  16. 7 CFR 4290.692 - Examination fees.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Examination fees. 4290.692 Section 4290.692... Recordkeeping, Reporting, and Examination Requirements for RBICs Examinations of Rbics by the Secretary for Regulatory Compliance § 4290.692 Examination fees. (a) General. The Secretary will assess fees for...

  17. 7 CFR 27.87 - Fees; classification and Micronaire determination information.

    Science.gov (United States)

    2010-01-01

    ... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY... Regulations Costs of Classification and Micronaire § 27.87 Fees; classification and Micronaire determination... costs prescribed in this subpart, the cost of tolls incurred in such transmission. ...

  18. 36 CFR 1258.12 - NARA reproduction fee schedule.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false NARA reproduction fee... ADMINISTRATION PUBLIC AVAILABILITY AND USE FEES § 1258.12 NARA reproduction fee schedule. (a) Certification: $15...) Unlisted processes: For reproductions not covered by this fee schedule, see also § 1258.4. Fees for other...

  19. The impact of global financial crisis on audit and non-audit fees

    OpenAIRE

    Alexeyeva, Irina; Svanström, Tobias

    2015-01-01

    This is the accepted and refereed manuscript to the article Purpose - The paper aims to investigate audit and non-audit fees during the global financial crisis (GFC) in an environment that is relatively sparsely regulated with regard to the provision of non-audit services. Design/methodology/approach - Audit and non-audit fees were studied during pre-GFC (2006-2007), GFC (2008-2009) and post-GFC (2010-2011) periods. Findings - During the GFC Swedish companies benefited from an increa...

  20. 49 CFR 1572.501 - Fee collection.

    Science.gov (United States)

    2010-10-01

    ... this section, except the FBI fee, may be adjusted annually on or after October 1, 2007, by publication... 49 Transportation 9 2010-10-01 2010-10-01 false Fee collection. 1572.501 Section 1572.501... ASSESSMENTS Fees for Security Threat Assessments for Transportation Worker Identification Credential (TWIC...

  1. 42 CFR 415.184 - Psychiatric services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Psychiatric services. 415.184 Section 415.184 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Psychiatric services. To qualify for physician fee schedule payment for psychiatric services furnished under...

  2. 75 FR 17281 - Changes in Hourly Fee Rates for Science and Technology Laboratory Services-Fiscal Years 2010-2012

    Science.gov (United States)

    2010-04-06

    ... mathematical formula used to calculate the apportioned rate for each fee charge category for fiscal year 2010... procedures which must be exhausted prior to any judicial challenge to this rule or the application of its... 20250-0270. (7) Statistics Branch Office. The Statistics Branch office of Science and Technology...

  3. 78 FR 63434 - International Mailing Services: Proposed Price Changes-Exigent

    Science.gov (United States)

    2013-10-24

    ...%) Registered Mail TM (4.2%) Return Receipt (4.2%) International Business Reply TM Cards and Envelopes (2.8... Duplicate copy of PS Form 3606 1.30 * * * * * International Business Reply Service (382) [For each country that offers International Business Reply service, revise the fees to read as follows:] Fee: Envelopes...

  4. 17 CFR 202.3a - Instructions for filing fees.

    Science.gov (United States)

    2010-04-01

    ... Commission's Web site at http://www.sec.gov for the proper format. (2) Instructions for payment of fees by... facilitate tracing the funds if any problems occur. If a wire transfer of filing fees does not contain the... paragraph (e). A company must update its account and other addresses using the EDGAR Web site. This method...

  5. 45 CFR 2105.5 - Fees.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Fees. 2105.5 Section 2105.5 Public Welfare.... 552, THE FREEDOM OF INFORMATION ACT § 2105.5 Fees. (a) Fees shall be charged according to the schedule... been notified that it cannot be determined in advance whether any records will be made available, fees...

  6. Medical ethics: enhanced or undermined by modes of payment?

    Science.gov (United States)

    Zweifel, Peter; Janus, Katharina

    2017-01-01

    In the medical literature [1, 2, 7], the view prevails that any change away from fee-for-service (FFS) jeopardizes medical ethics, defined as motivational preference in this article. The objective of this contribution is to test this hypothesis by first developing two theoretical models of behavior, building on the pioneering works of Ellis and McGuire [4] and Pauly and Redisch [11]. Medical ethics is reflected by a parameter α, which indicates how much importance the physician attributes to patient well-being relative to his or her own income. Accordingly, a weakening of ethical orientation amounts to a fall in the value of α. While traditional economic theory takes preferences as predetermined, more recent contributions view them as endogenous (see, e.g., Frey and Oberholzer-Gee [5]). The model variant based on Ellis and McGuire [4] depicts the behavior of a physician in private practice, while the one based on Pauly and Redisch [11] applies to providers who share resources such as in hospital or group practice. Two changes in the mode of payment are analyzed, one from FFS to prospective payment (PP), the other to pay-for-performance (P4P). One set of predictions relates physician effort to a change in the mode of payment; another, physician effort to a change in α, the parameter reflecting ethics. Using these two relationships, a change in ethics can observationally be related to a change in the mode of payment. The predictions derived from the models are pitted against several case studies from diverse countries. A shift from FFS to PP is predicted to give rise to a negative observed relationship between the medical ethics of physicians in private practice under a wide variety of circumstances, more so than a shift to P4P, which can even be seen as enhancing medical ethics, provided physician effort has a sufficiently high marginal effectiveness in terms of patient well-being. This prediction is confirmed to a considerable degree by circumstantial evidence

  7. 78 FR 59824 - Fees

    Science.gov (United States)

    2013-09-30

    .... NARA-2013-045] RIN 3095-AB81 Fees AGENCY: National Archives and Records Administration (NARA). ACTION... records fees regulation to remove the payment policy section, which sets out methods of payment. This is... practical or helpful to keep a general statement of methods of payment in the regulation on fees. The...

  8. Use of Western Medicine and Traditional Korean Medicine for Joint Disorders: A Retrospective Comparative Analysis Based on Korean Nationwide Insurance Data

    Science.gov (United States)

    2017-01-01

    This study aimed to compare the usage of Western medicine and traditional Korean medicine for treating joint disorders in Korea. Data of claims from all medical institutions with billing statements filed to HIRA from 2011 to 2014 for the four most frequent joint disorders were used for the analysis. Data from a total of 1,100,018 patients who received medical services from 2011 to 2014 were analyzed. Descriptive statistics are presented as type of care and hospital type. All statistical analyses were performed using IBM SPSS for Windows version 21. Of the 1,100,018 patients with joint disorders, 456,642 (41.5%) were males and 643,376 (58.5%) were females. Per diem costs of hospitalization in Western medicine clinics and traditional Korean medicine clinics were approximately 160,000 KRW and 50,000 KRW, respectively. Among costs associated with Western medicine, physiotherapy cost had the largest proportion (28.78%). Among costs associated with traditional Korean medicine, procedural costs and treatment accounted for more than 70%, followed by doctors' fees (21.54%). There were distinct differences in patterns of medical care use and cost of joint disorders at the national level in Korea. This study is expected to contribute to management decisions for musculoskeletal disease involving joint disorders. PMID:29456569

  9. Traditional vs. Innovative Uses of Computers among Mathematics Pre-Service Teachers in Serbia

    Science.gov (United States)

    Teo, Timothy; Milutinovic, Verica; Zhou, Mingming; Bankovic, Dragic

    2017-01-01

    This study examined pre-service teachers' intentions to use computers in traditional and innovative teaching practices in primary mathematics classrooms. It extended the technology acceptance model (TAM) by adding as external variables pre-service teachers' experience with computers and their technological pedagogical content knowledge (TPCK).…

  10. Developing a Model of Tuition Fee Calculation for Universities of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Seyed Amir Mohsen Ziaee

    2018-01-01

    Full Text Available Background: The aim of our study was to introduce and evaluate a practicable model for tuition fee calculation of each medical field in universities of medical sciences in Iran.Methods: Fifty experts in 11 panels were interviewed to identify variables that affect tuition fee calculation. This led to key points including total budgets, expenses of the universities, different fields’ attractiveness, universities’ attractiveness, and education quality. Tuition fees were calculated for different levels of education, such as post-diploma, Bachelor, Master, and Doctor of Philosophy (Ph.D degrees, Medical specialty, and Fellowship. After tuition fee calculation, the model was tested during 2013-2015. Since then, a questionnaire including 20 questions was prepared. All Universities’ financial and educational managers were asked to respond to the questions regarding the model’s reliability and effectiveness.Results: According to the results, fields’ attractiveness, universities’ attractiveness, zone distinction and education quality were selected as effective variables for tuition fee calculation. In this model, tuition fees per student were calculated for the year 2013, and, therefore, the inflation rate of the same year was used. Testing of the model showed that there is a 92% of satisfaction. This model is used by medical science universities in Iran.Conclusion: Education quality, zone coefficient, fields’ attractiveness, universities’ attractiveness, inflation rate, and portion of each level of education were the most important variables affecting tuition fee calculation.Keywords: TUITION FEES, FIELD’S ATTRACTIVENESS, UNIVERSITIES’ ATTRACTIVENESS, ZONE DISTINCTION, EDUCATION QUALITY

  11. 76 FR 45818 - Burden of Food and Drug Administration Food Safety Modernization Act Fee Amounts on Small...

    Science.gov (United States)

    2011-08-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0529] Burden of Food and Drug Administration Food Safety Modernization Act Fee Amounts on Small Business... burden of fee amounts on small business, as set forth in the FDA Food Safety Modernization Act (FSMA...

  12. Medicare program; payment policies under the physician fee schedule, five-year review of work relative value units, clinical laboratory fee schedule: signature on requisition, and other revisions to part B for CY 2012. Final rule with comment period.

    Science.gov (United States)

    2011-11-28

    This final rule with comment period addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses, implements or discusses certain statutory provisions including provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. In addition, this final rule with comment period discusses payments for Part B drugs; Clinical Laboratory Fee Schedule: Signature on Requisition; Physician Quality Reporting System; the Electronic Prescribing (eRx) Incentive Program; the Physician Resource-Use Feedback Program and the value modifier; productivity adjustment for ambulatory surgical center payment system and the ambulance, clinical laboratory, and durable medical equipment prosthetics orthotics and supplies (DMEPOS) fee schedules; and other Part B related issues.

  13. SOR 90-190, 22 March 1990, AECB Cost Recovery Fees Regulations

    International Nuclear Information System (INIS)

    1990-01-01

    These Regulations entered into force on 1 April 1990. They were made pursuant to the Atomic Energy Control Regulations and prescribe the legal obligations to pay fees imposed on applicants for and holders of licences from the Atomic Energy Control Board - AECB. The purpose of the Regulations is to shift the cost of government service from the general taxpayer to the users and to those who specifically benefit from the services. (NEA) [fr

  14. 77 FR 72788 - Copyright Office Fees

    Science.gov (United States)

    2012-12-06

    ... proposed fees failed to recover half of the actual operating costs of the cable and satellite program, and... Study for Setting Cable and Satellite SOA Filing Fees The original cost study for the Office's...-personnel costs to address concerns that an aberrant year may have an undue impact on the proposed fees. The...

  15. 48 CFR 1816.405-271 - Base fee.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Base fee. 1816.405-271... CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 1816.405-271 Base fee. (a) A base fee shall not be used on CPAF contracts for which the periodic award fee evaluations are final...

  16. Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

    Science.gov (United States)

    Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M

    2018-01-01

    In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

  17. A Comparative Analysis for Wilderness User Fee Policy.

    Science.gov (United States)

    Leuschner, William A.; And Others

    1987-01-01

    Two similar wilderness areas, one of which charges user fees, were sampled in order to compare user characteristics, trip characteristics, and travel cost demand functions. The purpose was to examine the effect fees had on user behavior and choices of area. Results are presented. (MT)

  18. Danish Patients are positive towards fees for non-attendance in public hospitals

    DEFF Research Database (Denmark)

    Lou, Stina; Frumer, Michal; Olesen, Steen

    2016-01-01

    Introduction: Patients’ non-attendance is a significant problem in modern healthcare. Non-attendance delays treatment, reduces efficiency and increases healthcare costs. For several years, the introduction of financial incentives such as a non-attendance fee has been discussed in Denmark. Set...... in the context of a tax-financed, free-for-all healthcare system, the political hesitance to introduce fees relates to concerns that additional fees may be badly received by tax-paying citizens and may undermine the polit­ical priority of patient equity. The aim of this qualitative sub-study was to investigate...... patients’ attitudes towards a fee for non-attendance. Methods: Six semi-structured focus group interviews were conducted with a total of 44 patients who had been informed about being charged a fee for non-attendance. Data were transcribed verbatim and analysed using a qualitative content analysis. Results...

  19. 48 CFR 915.404-4-72 - Special considerations for cost-plus-award-fee contracts.

    Science.gov (United States)

    2010-10-01

    ... cost-plus-award-fee contracts. 915.404-4-72 Section 915.404-4-72 Federal Acquisition Regulations System....404-4-72 Special considerations for cost-plus-award-fee contracts. (a) When a contract is to be awarded on a cost-plus-award-fee basis several special considerations are appropriate. Fee objectives for...

  20. 50 CFR 260.70 - Schedule of fees.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Schedule of fees. 260.70 Section 260.70... Products for Human Consumption Fees and Charges § 260.70 Schedule of fees. (a) Unless otherwise provided in a written agreement between the applicant and the Secretary, the fees to be charged and collected...