Sample records for fr03au10p medicare program
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-14
....773, Medicare--Hospital Insurance; and Program No. 93.774, Medicare-- Supplementary Medical Insurance... errors in the proposed rule entitled ``Medicare Program; Proposed Changes to the Hospital Inpatient...-9644 of May 5, 2011 (76 FR 25788), there were a number of technical and typographical errors that are...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-29
...This proposed rule would revise the Incentive Reward Program provisions in Sec. 420.405 and certain provider enrollment requirements in part 424, subpart P. The most significant of these revisions include: changing the Incentive Reward Program potential reward amount for information on individuals and entities who are or have engaged in acts or omissions which resulted in the imposition of a sanction from 10 percent of the overpayments recovered in the case or $1,000, whichever is less, to 15 percent of the final amount collected applied to the first $66,000,000 for the sanctionable conduct; expanding the instances in which a felony conviction can serve as a basis for denial or revocation of a provider or supplier's enrollment; if certain criteria are met, enabling us to deny enrollment if the enrolling provider, supplier, or owner thereof had an ownership relationship with a previously enrolled provider or supplier that had a Medicare debt; enabling us to revoke Medicare billing privileges if we determine that the provider or supplier has a pattern or practice of submitting claims for services that fail to meet Medicare requirements; and limiting the ability of ambulance suppliers to ``backbill'' for services performed prior to enrollment. We believe this proposed rule would--increase the incentive for individuals to report information on individuals and entities that have or are engaged in sanctionable conduct; improve our ability to detect new fraud schemes; and help us ensure that fraudulent entities and individuals do not enroll in or maintain their enrollment in the Medicare program.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-22
... Advantage and the Medicare Prescription Drug Benefit Programs; Correction AGENCY: Centers for Medicare... Medicare Advantage and the Medicare Prescription Drug Benefit Programs final rule and does not make... Register titled ``Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-10
... Medicare Advantage and the Medicare Prescription Drug Benefit Programs; Corrections AGENCY: Centers for... Advantage and the Medicare Prescription Drug Benefit Programs'' which appeared in the April 15, 2010 Federal... and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-16
... Insurance; and Program No. 93.774, Medicare-- Supplementary Medical Insurance Program) Dated: November 9...: Correction notice. SUMMARY: This document corrects a technical error that appeared in the notice published in... of July 22, 2010 (75 FR 42836), there was a technical error that we are identifying and correcting in...
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76 FR 44010 - Medicare Program; Hospice Wage Index for Fiscal Year 2012; Correction
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-22
.... 93.774, Medicare-- Supplementary Medical Insurance Program) Dated: July 15, 2011. Dawn L. Smalls... corrects technical errors that appeared in the notice of CMS ruling published in the Federal Register on... FR 26731), there were technical errors that are identified and corrected in the Correction of Errors...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-11
... to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2013 and Other Proposed Changes; Considering Changes to the Conditions of Participation for Long Term Care... to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2013...
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76 FR 76541 - Medicare Program; Availability of Medicare Data for Performance Measurement
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-07
... Centers for Medicare & Medicaid Services 42 CFR Part 401 Medicare Program; Availability of Medicare Data...; Availability of Medicare Data for Performance Measurement AGENCY: Centers for Medicare & Medicaid Services (CMS... regarding the release and use of standardized extracts of Medicare claims data for qualified entities to...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-22
...This proposed rule would implement medical loss ratio (MLR) requirements for the Medicare Advantage Program and the Medicare Prescription Drug Benefit Program under the Patient Protection and Affordable Care Act.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-22
... and the Medicare Prescription Drug Benefit Programs for Contract Year 2012 and Other Proposed Changes... for Contract Year 2012 and Other Proposed Changes'' which was filed for public inspection on November 10, 2010. FOR FURTHER INFORMATION CONTACT: Sabrina Ahmed, (410) 786-7499. SUPPLEMENTARY INFORMATION...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-15
...] Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions Program... interested parties of an opportunity to apply to participate in the Medicare Community-based Care Transitions Program, which was authorized by section 3026 of the Affordable Care Act. DATES: Proposals will be...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-22
...] Medicare Program; Solicitation for Proposals for the Medicare Graduate Nurse Education Demonstration... informs interested parties of an opportunity to apply to participate in the Medicare Graduate Nurse... advanced practice registered nurses (APRNs) in order to meet the health care needs of the growing Medicare...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-20
...] Medicare Program; Request for Nominations for Members for the Medicare Evidence Development & Coverage... notice announces the request for nominations for membership on the Medicare Evidence Development... Centers for Medicare & Medicaid Services (CMS) concerning the adequacy of scientific evidence available to...
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Medicare and Medicaid programs; revaluation of assets; correction--HCFA. Correcting amendments.
1993-04-05
This document contains corrections to final regulations (BPD-311-F) that were published September 23, 1992 (F.R. Doc. 92-22582) (57 FR 43906). The regulations describe new limitations on the valuations of assets acquired as the result of changes in ownership occurring on or after July 18, 1984. These changes affect hospitals and skilled nursing facilities under the Medicare program, and hospitals, nursing facilities, and intermediate care facilities for the mentally retarded under the Medicaid program.
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76 FR 67801 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-02
... Community Care Network NP Nurse Practitioner NPI National Provider Identifier NQF National Quality Forum OIG...: Accountable Care Organizations; Final Rule #0;#0;Federal Register / Vol. 76 , No. 212 / Wednesday, November 2... Savings Program: Accountable Care Organizations AGENCY: Centers for Medicare & Medicaid Services (CMS...
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75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-03
...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... registration information will be posted on the CMS Care Transitions Web site at http://www.cms.gov/DemoProjects...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-16
...] Medicare Program; Request for Nominations for Members for the Medicare Evidence Development & Coverage... notice announces the request for nominations for consideration for membership on the Medicare Evidence... serve on the MEDCAC. Nominees are selected based upon their individual qualifications and not as...
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75 FR 39641 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-12
... Medicare and Medicaid Services 42 CFR Part 488 [CMS-2435-P] Medicare and Medicaid Programs; Civil Money... regarding the imposition and collection of civil money penalties by CMS when nursing homes are not in... address facility noncompliance are civil money penalties. Authorized by sections 1819(h) and 1919(h) of...
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78 FR 75304 - Medicare Program; Medicare Secondary Payer and Certain Civil Money Penalties
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-11
... [CMS-6061-ANPRM] RIN 0938-AR88 Medicare Program; Medicare Secondary Payer and Certain Civil Money... practices for which civil money penalties (CMPs) may or may not be imposed for failure to comply with...-3951. I. Background A. Imposition of Civil Money Penalties (CMPs) In 1981, the Congress added section...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-07
... Savings Program and the Innovation Center AGENCY: Centers for Medicare & Medicaid Services (CMS) and...) of the Social Security Act (of the Act), as added by the Affordable Care Act (ACA) authorizes the... payment and service delivery models by the Center for Medicare and Medicaid Innovation. This notice with...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-09
... 0938-AP81 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2011. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-01
... 0938-AQ16 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2012. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-30
... 0938-AR58 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2014. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...
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76 FR 26731 - Medicare Program; Hospice Wage Index for Fiscal Year 2012
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-09
... care under Part A. See Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA), Public Law 97-248, Sec. 122, 96 Stat. 356, 364 (1982). The hospice benefit was designed to provide patients who are terminally... also 48 FR 56,008, 56,008 (Dec. 16, 1983) (describing hospice benefit). The Medicare hospice benefit...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-21
... percent reserve has been the normal target used to calculate the Part B premium. In view of the strong... 0938-AR16 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-04
...] Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel--May 21, 2012 AGENCY... announces that a public meeting of the Medicare Economic Index Technical Advisory Panel (``the Panel'') will... Economic Index (MEI). This first meeting will focus on MEI inputs and input weights. This meeting is open...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-11
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-8050-N] Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel--May 21, 2012 Correction In notice document 2012-10702 appearing on pages 26553-26554 in the issue of Friday, May 4, 2012 make...
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Marek, Karen Dorman; Adams, Scott J.; Stetzer, Frank; Popejoy, Lori; Rantz, Marilyn
2011-01-01
The purpose of this evaluation was to study the relationship of nurse care coordination (NCC) to the costs of Medicare and Medicaid in a community-based care program called Missouri Care Options (MCO). A retrospective cohort design was used comparing 57 MCO clients with NCC to 80 MCO clients without NCC. Total cost was measured using Medicare and Medicaid claims databases. Fixed effects analysis was used to estimate the relationship of the NCC intervention to costs. Controlling for high resource use on admission, monthly Medicare costs were lower ($686) in the 12 months of NCC intervention (p =.04) while Medicaid costs were higher ($203; p=.03) for the NCC group when compared to the costs of MCO group. PMID:20499393
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-30
...] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount... rule with comment period entitled: ``Medicare, Medicaid, and Children's Health Insurance Programs... entitled ``Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-02
...] 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... application fees as part of the Medicare, Medicaid, and Children's Health Insurance Program (CHIP) provider...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-28
... national coverage determinations (NCDs) affecting specific medical and health care services under Medicare... notification, such as a particular clinical trial or research study that qualifies for Medicare coverage.... 93.773, Medicare--Hospital Insurance, Program No. 93.774, Medicare-- Supplementary Medical Insurance...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-08
... economics of health care, medical ethics and other related professions such as epidemiology and... basis. The MEDCAC--(1) Hears public testimony; (2) reviews medical literature, technology assessments... Federal Domestic Assistance Program No. 93.774, Medicare--Supplementary Medical Insurance Program). Dated...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-02
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6051-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount... period entitled ``Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening...
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Safran, Dana Gelb; Wilson, Ira B; Rogers, William H; Montgomery, Jana E; Chang, Hong
2002-04-08
Since 1972, Medicare beneficiaries have had the option of enrolling in a Medicare-qualified health maintenance organization (HMO). Little information exists to inform beneficiaries' choices between the traditional fee-for-service (FFS) Medicare program and an HMO. To compare the primary care received by seniors in Medicare HMOs with that of seniors in the traditional FFS Medicare program, and among HMOs, and to examine performance differences associated with HMO model-type and profit status. Data were derived from a cross-sectional observational survey of Medicare beneficiaries 65 years or older in the 13 states with mature, substantial Medicare HMO markets. Only beneficiaries continuously enrolled for 12 months or more in traditional FFS Medicare or a qualified Medicare HMO were eligible. Data were obtained using a 5-stage protocol involving mail and telephone (64% response rate). Analyses included respondents who identified a primary physician and had all required data elements (N = 8828). We compared FFS and HMO performance on 11 summary scales measuring 7 defining characteristics of primary care: (1) access, (2) continuity, (3) integration, (4) comprehensiveness, (5) "whole-person" orientation, (6) clinical interaction, and (7) sustained clinician-patient partnership. For 9 of 11 indicators, performance favored traditional FFS Medicare over HMOs (P<.001). Financial access favored HMOs (P<.001). Preventive counseling did not differ by system. Network-model HMOs performed more favorably than staff/group-model HMOs on 9 of 11 indicators (P<.001). Few differences were associated with HMO profit status. The findings are consistent with previous comparisons of indemnity insurance and network-model and staff/group-model HMOs in elderly and nonelderly populations. The stability of results across time, geography, and populations suggests that the relative strengths and weaknesses of each system are enduring attributes of their care. Medicare enrollees seem to face the
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-02
.... 93.773, Medicare--Hospital Insurance; and Program No. 93.774, Medicare-- Supplementary Medical... technical errors that appeared in the supplementary proposed rule entitled ``Medicare Program; Supplemental... Doc. 2010-12567 filed May 21, 2010, there are technical and typographical errors that are identified...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-08
... Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title...
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75 FR 46948 - Medicare Program; Listening Session Regarding Confidential Feedback Reports and the...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-04
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1578-N] Medicare Program; Listening Session Regarding Confidential Feedback Reports and the Implementation of a Value-Based Payment Modifier for Physicians, September 24, 2010 AGENCY: Centers for Medicare & Medicaid...
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75 FR 30043 - Medicare Program; Meeting of the Advisory Panel on Medicare Education
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-28
... [Medicare Advantage] in order to promote an active, informed selection among such options.'' The Panel is... Program; Yanira Cruz, PhD, President and Chief Executive Officer, National Hispanic Council on Aging... Health; Sandy Markwood, Chief Executive Officer, National Association of Area Agencies on Aging; David W...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-23
... 0938-AQ99 Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application..., and Children's Health Insurance Programs; Additional Screening Requirements, Application Fees... application fees as part of the Medicare, Medicaid and Children's Health Insurance Program (CHIP) provider...
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Paying for the Medicare program.
Munnell, A H
1985-01-01
Although the hospital insurance (HI) trust fund acted as a source of strength for the old-age, survivors, and disability insurance program during its recent financial crises, projections by HCFA and CBO reveal that the Medicare program will experience financing problems of its own within the next decade. No one would argue that Medicare's financing problems should be solved simply by raising more money. However, the prospect of insolvency in the HI trust fund and the increasing strain on general revenues from the Supplementary Medical Insurance trust fund require policymakers to survey the options for increasing Medicare revenues while cost-control devices are being developed. Indeed, even if cost-control efforts are completely successful, additional revenues may be needed in the future to finance new initiatives in the Medicare program. Therefore, this paper will look briefly at current efforts to regain control of soaring hospital and physician costs and then examine some of the more feasible options for increasing Medicare revenues.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-04
...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... strategies concerning Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). This meeting is... Health Insurance Program (CHIP). Enhancing the Federal government's effectiveness in informing Medicare...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-31
...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... Medicare, Medicaid and the Children's Health Insurance Program (CHIP). This meeting is open to the public... Health Insurance Program (CHIP). Enhancing the federal government's effectiveness in informing Medicare...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-22
...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). This meeting is open to the public... Health Insurance Program (CHIP). Enhancing the federal governments effectiveness in informing Medicare...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-15
...This final rule makes revisions to the Medicare Advantage (MA) program (Part C) and Prescription Drug Benefit Program (Part D) to implement provisions specified in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) (ACA) and make other changes to the regulations based on our experience in the administration of the Part C and Part D programs. These latter revisions clarify various program participation requirements; make changes to strengthen beneficiary protections; strengthen our ability to identify strong applicants for Part C and Part D program participation and remove consistently poor performers; and make other clarifications and technical changes.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-23
...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). This meeting is open to the public... eligible for, Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Enhancing the Federal...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-22
...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). This meeting is open to the public... eligible for, Medicare, Medicaid and the Children's Health Insurance Program (CHIP). Enhancing the Federal...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-24
...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and... the Medicare, Medicaid, and Children's Health Insurance (CHIP) programs. This meeting is open to the... outreach programs for individuals enrolled in, or eligible for, Medicare, Medicaid, and the Children's...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-23
... skilled nursing facilities, in the Medicare program, and nursing facilities, in the Medicaid program, that... skilled nursing facilities (SNFs) for Medicare and nursing facilities (NFs) for Medicaid. The Federal... services provided by a nursing home are important, Congressional intent about what constitutes ``quality of...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3285-FN] Medicare and Medicaid Programs; Continued Approval of American Osteopathic Association/Healthcare... Medicare & Medicaid Services, HHS. ACTION: Final notice. SUMMARY: This final notice announces our decision...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1566-CN... 22, 2010 (75 FR 3743), there were a number of technical errors that are identified and corrected in... telephone at the number listed in the FOR FURTHER INFORMATION CONTACT section of this notice by the date...
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78 FR 21610 - Expansion Funds for the Support of the Senior Medicare Patrol (SMP) Program
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-11
... the Support of the Senior Medicare Patrol (SMP) Program ACTION: Notice of intent to provide expansion... funds for the support of the Senior Medicare Patrol (SMP) Program. This additional funding opportunity... program capacity to recruit, train, and support the SMP volunteer network. In addition, this funding...
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75 FR 78247 - Medicare Program; Town Hall Meeting on Physician Quality Reporting System
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-15
...] Medicare Program; Town Hall Meeting on Physician Quality Reporting System AGENCY: Centers for Medicare... to discuss the Physician Quality Reporting System (previously known as the Physician Quality... stakeholders on the individual quality measures and measures groups being considered for possible inclusion in...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-25
... Assurance for Medicare Advantage Health Maintenance Organizations and Local Preferred Provider Organizations... notice announces the decision to renew the Medicare Advantage Deeming Authority of the National Committee... Medicare program, eligible beneficiaries may receive covered services through a Medicare Advantage (MA...
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42 CFR 421.304 - Medicare integrity program contractor functions.
Code of Federal Regulations, 2010 CFR
2010-10-01
... services for which Medicare payment may be made either directly or indirectly. (b) Auditing, settling and.... 421.304 Section 421.304 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE CONTRACTING Medicare Integrity Program...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-27
...This final rule finalizes several provisions of the Affordable Care Act implemented in the May 5, 2010 interim final rule with comment period. It requires all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted under the Medicare and Medicaid programs. In addition, it requires physicians and other professionals who are permitted to order and certify covered items and services for Medicare beneficiaries to be enrolled in Medicare. Finally, it mandates document retention and provision requirements on providers and supplier that order and certify items and services for Medicare beneficiaries.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-23
...-service (FFS) program, we require that Medicare contractors review State licensing board data on a monthly... professional review actions and malpractice from the National Practitioner Data Bank (NPDB), accreditation... verify data submitted on, and as part of, the Medicare provider/supplier enrollment application, our...
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Todoroki, Takahito
2017-09-25
Here, we present the first results from the STAR MTD of mid-rapidity charmonium measurements via the di-muon decay channel in p+p, p+Au, and Au+Au collisions at √S NN = 200 GeV at RHIC. The inclusive J/Ψ production cross section in p+p collisions can be described by the Non-Relativistic QCD (NRQCD) formalism coupled with the color glass condensate e ective theory (CGC) at low transverse momentum (p T) and next-to-leading order NRQCD at high p T. The nuclear modification factor in p+Au collisions for inclusive J/Ψ is below unity at low p T and consistent with unity at high p T,more » which can be described by calculations including both nuclear PDF and nuclear absorption e ects. The double ratio of inclusive J/Ψ and Ψ(2S) production rates for 0 < p T < 10 GeV/c at mid-rapidity between p+p and p+Au collisions is measured to be 1.37 0.42 0.19. The nuclear modification factor in Au+Au collisions for inclusive J/Ψ shows significant J/Ψ suppression at high p T in central collisions and can be qualitatively described by transport models including dissociation and regeneration contributions.« less
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Todoroki, Takahito
Here, we present the first results from the STAR MTD of mid-rapidity charmonium measurements via the di-muon decay channel in p+p, p+Au, and Au+Au collisions at √S NN = 200 GeV at RHIC. The inclusive J/Ψ production cross section in p+p collisions can be described by the Non-Relativistic QCD (NRQCD) formalism coupled with the color glass condensate e ective theory (CGC) at low transverse momentum (p T) and next-to-leading order NRQCD at high p T. The nuclear modification factor in p+Au collisions for inclusive J/Ψ is below unity at low p T and consistent with unity at high p T,more » which can be described by calculations including both nuclear PDF and nuclear absorption e ects. The double ratio of inclusive J/Ψ and Ψ(2S) production rates for 0 < p T < 10 GeV/c at mid-rapidity between p+p and p+Au collisions is measured to be 1.37 0.42 0.19. The nuclear modification factor in Au+Au collisions for inclusive J/Ψ shows significant J/Ψ suppression at high p T in central collisions and can be qualitatively described by transport models including dissociation and regeneration contributions.« less
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2017-11-15
This major final rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies such as changes to the Medicare Shared Savings Program, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. In addition, this final rule includes policies necessary to begin offering the expanded Medicare Diabetes Prevention Program model.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-18
...This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this proposed rule, we describe the proposed changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS. These proposed changes would be applicable to services furnished on or after January 1, 2012. In addition, this proposed rule would update the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this proposed rule, we set forth the proposed relative payment weights and payment amounts for services furnished in ASCs, specific HCPCS codes to which these proposed changes would apply, and other proposed ratesetting information for the CY 2012 ASC payment system. These proposed changes would be applicable to services furnished on or after January 1, 2012. We are proposing to revise the requirements for the Hospital Outpatient Quality Reporting (IQR) Program, add new requirements for ASC Quality Reporting System, and make additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program. We also are proposing to allow eligible hospitals and CAHs participating in the Medicare Electronic Health Record (EHR) Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot. In addition, we are proposing to make changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-31
...] Medicare, Medicaid, and Children's Health Insurance Programs; Renewal of the Advisory Panel on Outreach and... Medicaid and the Children's Health Insurance Program (CHIP), and also expanded the availability of other... are eligible for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) about options...
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2006-04-21
This final rule requires that all providers and suppliers (other than physicians or practitioners who have elected to "opt-out" of the Medicare program) complete an enrollment form and submit specific information to us. This final rule also requires that all providers and suppliers periodically update and certify the accuracy of their enrollment information to receive and maintain billing privileges in the Medicare program. In addition, this final rule implements provisions in the statute that require us to ensure that all Medicare providers and suppliers are qualified to provide the appropriate health care services. These statutory provisions include requirements meant to protect beneficiaries and the Medicare Trust Funds by preventing unqualified, fraudulent, or excluded providers and suppliers from providing items or services to Medicare beneficiaries or billing the Medicare program or its beneficiaries.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-10
... Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment... [CMS-1599-P] RIN 0938-AR53 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute... capital-related costs of acute care hospitals to implement changes arising from our continuing experience...
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2016-11-15
This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-22
... * * * on the coverage options provided under [Medicare Advantage] in order to promote an active, informed..., National Hispanic Council on Aging; Stephen L. Fera, Vice President, Social Mission Programs, Independence Blue Cross; Clayton Fong, President and Chief Executive Officer, National Asian Pacific Center on Aging...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-24
... beneficiaries * * * on the coverage options provided under [Medicare Advantage] in order to promote an active... Area Agencies on Aging; David W. Roberts, M.P.A.,Vice President, Government Relations, Healthcare...
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77 FR 53967 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-04
...This final rule specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to qualify for Medicare and/or Medicaid electronic health record (EHR) incentive payments. In addition, it specifies payment adjustments under Medicare for covered professional services and hospital services provided by EPs, eligible hospitals, and CAHs failing to demonstrate meaningful use of certified EHR technology (CEHRT) and other program participation requirements. This final rule revises certain Stage 1 criteria, as finalized in the July 28, 2010 final rule, as well as criteria that apply regardless of Stage.
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Recent HBT results in Au+Au and p+p collisions from PHENIX
NASA Astrophysics Data System (ADS)
PHENIX Collaboration; Glenn, Andrew; PHENIX Collaboration
2009-11-01
We present Hanbury-Brown Twiss measurements from the PHENIX experiment at RHIC for final results for charged kaon pairs from s=200 GeV Au+Au collisions and preliminary results for charged pion pairs from s=200 GeVp+p collisions. We find that for kaon pairs from Au+Au, each traditional 3D Gaussian radius shows approximately the same linear increase as a function of Npart1/3. An imaging analysis reveals a significant non-Gaussian tail for r≳10 fm. The presence of a tail for kaon pairs demonstrates that similar non-Gaussian tails observed in earlier pion measurements cannot be fully explained by decays of long-lived resonances. The preliminary analysis of pions from s=200 GeV p+p minimum biased collisions show correlations which are well suited to traditional 3D HBT radii extraction via the Bowler-Sinyukov method, and we present R, R, and R as a function of mean transverse pair mass.
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ERIC Educational Resources Information Center
Chan, Leighton; Hart, L. Gary; Ricketts III, Thomas C.; Beaver, Shelli K.
2004-01-01
Medicare's Incentive Payment (MIP) program provides a 10% bonus payment to providers who treat Medicare patients in rural and urban areas where there is a shortage of generalist physicians. Purpose: To examine the experience of Alaska, Idaho, North Carolina, South Carolina, and Washington with the MIP program. We determined the program's…
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Sivakumar, Haran; Hanoch, Yaniv; Barnes, Andrew J; Federman, Alex D
2016-01-01
Poor Medicare knowledge is associated with worse health outcomes, especially in low-income patients. We examined the association of health literacy and cognition with actual and perceived Medicare knowledge in a sample of inner-city older adults. We conducted a cross-sectional analysis of data on 336 adults ages 65 years and older with Medicare coverage recruited from senior centers and low-income housing facilities in Manhattan, New York. Actual Medicare knowledge was determined by a summary score of 9 true/false questions about the Medicare program and perceived Medicare knowledge with a single item. Validated measures were used to assess health literacy and general cognition. Among respondents, 63.1% had high actual Medicare knowledge, and 36.0% believed that they knew what they needed to know about Medicare. Actual and perceived Medicare knowledge were poorly correlated (r = -.01, p > .05). In multivariable models, low health literacy was significantly associated with actual Medicare knowledge (β = -8.30, SE = 2.71, p < .01) but not perceived Medicare knowledge (β = 0.37, SE = 0.22, p = .09). Individuals with low health literacy were more likely to perceive their Medicare knowledge as adequate when actual Medicare knowledge was low (adjusted odds ratio = 3.30, 95% confidence interval [1.20, 9.05], p < .05). These results show that older adults with low health literacy are more likely to have poor understanding of the Medicare program and yet more likely to believe that their understanding of the program is adequate. This combination of factors may place them at increased risk for poor access to information about the Medicare program and diminish their ability to make fully informed choices.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-27
... [CMS-1510-CN2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home Health Agencies and Hospices AGENCY... ``Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-02
..., Medicare--Hospital Insurance; and Program No. 93.774, Medicare-- Supplementary Medical Insurance Program.... SUMMARY: This document corrects a typographical error that appeared in the notice published in the Federal... typographical error that is identified and corrected in the Correction of Errors section below. II. Summary of...
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Reforming Access: Trends in Medicaid Enrollment for New Medicare Beneficiaries, 2008-2011.
Keohane, Laura M; Rahman, Momotazur; Mor, Vincent
2016-04-01
To evaluate whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. Medicare enrollment records for years 2007-2011. We used a multinomial logistic model with state fixed effects to examine the annual change in limited and full Medicaid enrollment among new Medicare beneficiaries for 2 years before and after the reforms (2008-2011). We identified new Medicare beneficiaries in the years 2008-2011 and their participation in Medicaid based on Medicare enrollment records. The percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability (p < .001). There was no significant difference in the size of enrollment increases between states with and without concurrent limited Medicaid eligibility expansions. Our findings suggest that streamlining financial assistance programs may improve Medicare beneficiaries' access to benefits. © Health Research and Educational Trust.
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76 FR 67991 - Medicare Program; Final Waivers in Connection With the Shared Savings Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-02
... governance, management, and leadership of the ACO, as well as program integrity, transparency, compliance... ACOs to promote accountability for individual Medicare beneficiaries and population health management...-kickback statute safe harbors include, among others, those for employment, personal services and management...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-23
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3258-PN] Medicare and Medicaid Programs; Application From Det Norske Veritas Healthcare (DNVHC) for Continued... application from Det Norske Veritas Healthcare (DNVHC) for continued recognition as a national accrediting...
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Medicare program; Medicare depreciation, useful life guidelines--HCFA. Final rule.
1983-08-18
These final rules amend Medicare regulations to clarify which useful life guidelines may be used by providers of health care services to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize the Departmental useful life guidelines or, if none have been published by the Department, either the American Hospital Association (AHA) useful life guidelines of 1973 of IRS guidelines. We are eliminating the reference to IRS guidelines because these are now outdated for Medicare purposes since they have been rendered obsolete either by the IRS or by statutory change. We are also deleting the specific reference to the 1973 AHA guidelines since these guidelines are updated by the AHA periodically. In addition, we are clarifying that certain tax legislation on accelerated depreciation, passed by Congress, does not apply to the Medicare program.
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Lavenn, Christophe; Albrieux, Florian; Tuel, Alain; Demessence, Aude
2014-03-15
Research interest in ultra small gold thiolate clusters has been rising in recent years for the challenges they offer to bring together properties of nanoscience and well-defined materials from molecular chemistry. Here, a new atomically well-defined Au10 gold nanocluster surrounded by ten 4-aminothiophenolate ligands is reported. Its synthesis followed the similar conditions reported for the elaboration of Au144(SR)60, but because the reactivity of thiophenol ligands is different from alkanethiol derivates, smaller Au10 clusters were formed. Different techniques, such as ESI-MS, elemental analysis, XRD, TGA, XPS and UV-vis-NIR experiments, have been carried out to determine the Au10(SPh-pNH2)10 formula. Photoemission experiment has been done and reveals that the Au10 clusters are weakly luminescent as opposed to the amino-based ultra-small gold clusters. This observation points out that the emission of gold thiolate clusters is highly dependent on both the structure of the gold core and the type of the ligands at the surface. In addition, ultra-small amino-functionalized clusters offer the opportunity for extended work on self-assembling networks or deposition on substrates for nanotechnologies or catalytic applications. Copyright © 2013 Elsevier Inc. All rights reserved.
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Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Exclusion from participation in Medicare, Medicaid..., ASSESSMENTS AND EXCLUSIONS § 1003.105 Exclusion from participation in Medicare, Medicaid and all Federal... the Medicare and Medicaid programs, he or she will, at the same time he or she notifies the respondent...
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Ramirez, Adriana G; Tracci, Margaret C; Stukenborg, George J; Turrentine, Florence E; Kozower, Benjamin D; Jones, R Scott
2016-01-01
Background The Hospital Value-Based Purchasing Program measures value of care provided by participating Medicare hospitals while creating financial incentives for quality improvement and fostering increased transparency. Limited information is available comparing hospital performance across healthcare business models. Study Design 2015 hospital Value-Based Purchasing Program results were used to examine hospital performance by business model. General linear modeling assessed differences in mean total performance score, hospital case mix index, and differences after adjustment for differences in hospital case mix index. Results Of 3089 hospitals with Total Performance Scores (TPS), categories of representative healthcare business models included 104 Physician-owned Surgical Hospitals (POSH), 111 University HealthSystem Consortium (UHC), 14 US News & World Report Honor Roll (USNWR) Hospitals, 33 Kaiser Permanente, and 124 Pioneer Accountable Care Organization affiliated hospitals. Estimated mean TPS for POSH (64.4, 95% CI 61.83, 66.38) and Kaiser (60.79, 95% CI 56.56, 65.03) were significantly higher compared to all remaining hospitals while UHC members (36.8, 95% CI 34.51, 39.17) performed below the mean (p < 0.0001). Significant differences in mean hospital case mix index included POSH (mean 2.32, p<0.0001), USNWR honorees (mean 2.24, p 0.0140) and UHC members (mean =1.99, p<0.0001) while Kaiser Permanente hospitals had lower case mix value (mean =1.54, p<0.0001). Re-estimation of TPS did not change the original results after adjustment for differences in hospital case mix index. Conclusions The Hospital Value-Based Purchasing Program revealed superior hospital performance associated with business model. Closer inspection of high-value hospitals may guide value improvement and policy-making decisions for all Medicare Value-Based Purchasing Program Hospitals. PMID:27502368
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-2336-PN] Medicare and Medicaid Programs; Application by Det Norske Veritas Healthcare for Deeming Authority for... application from Det Norske Veritas Healthcare (DNVHC) for recognition as a national accrediting organization...
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Cost of schizophrenia in the Medicare program.
Feldman, Rachel; Bailey, Robert A; Muller, James; Le, Jennifer; Dirani, Riad
2014-06-01
Medicare beneficiaries diagnosed with non-schizoaffective schizophrenia (MBS) in a 5% national Medicare fee-for-service sample from 2003-2007 were followed for 1-6 years. Medicare population and cost estimates also were made from 2001-2009. Service utilization and Medicare (and beneficiary share) payments for all services except prescription drugs were analyzed. Although adults with schizophrenia make up approximately 1% of the US adult population, they represent about 1.5% of Medicare beneficiaries. MBSs are disproportionately male and minority compared to national data describing the overall schizophrenia population. They also are younger than the general Medicare population (GMB): males are 9 years younger than females on average, and most enter Medicare long before age 65 through eligibility for social security disability, remaining in the program until death. The cost of care for MBSs in 2009 was, on average, 80% higher than for the average GMB per patient year (2010 dollars), and more than 50% of these costs are attributable to a combination of psychiatric and medical hospitalizations, concentrated in about 30% of MBSs with 1 or more hospitalizations per year. From 2004-2009, total estimated Medicare fee-for-service payments for MBSs increased from $9.4 billion to $11.5 billion, excluding Part D prescription drugs and payments for services to MBSs in Medicare for less than 1 year. Study results characterize utilization and costs for other services and suggest opportunities for further study to inform policy to improve access and continuity of care and decrease costs to the Medicare program associated with this population.
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75 FR 21207 - Medicare Program; Ambulatory Surgical Centers, Conditions for Coverage
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-23
..., Department of Health and Human Services, Attention: CMS-3217-P, P.O. Box 8010, Baltimore, MD 21244-8010... for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-3217-P, Mail... under section 1833(i)(2) of the Act as full payment for services, and to accept assignment of benefits...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-17
... ESRD Care Model would result in improved health outcomes for beneficiaries with ESRD regarding the... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-5506-N2] Medicare Program; Comprehensive ESRD Care Initiative; Extension of the Submission Deadlines for the Letters...
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42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 2 2013-10-01 2013-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...
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42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 2 2011-10-01 2011-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...
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42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 2 2014-10-01 2014-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...
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42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 2 2012-10-01 2012-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...
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42 CFR 413.87 - Payments for Medicare+Choice nursing and allied health education programs.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Payments for Medicare+Choice nursing and allied... NURSING FACILITIES Specific Categories of Costs § 413.87 Payments for Medicare+Choice nursing and allied... reimbursement for approved nursing and allied health education programs and the methodology for determining the...
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Thomas, Cindy Parks; Sussman, Jeffrey
2007-05-30
On January 1, 2006, the Centers for Medicare and Medicaid Services (CMS) implemented the Medicare Drug Benefit, or "Medicare Part D." The program offers prescription drug coverage for the one million Medicare beneficiaries in Massachusetts. Part D affects Massachusetts state health programs and beneficiaries in a number of ways. The program: (1) provides prescription drug insurance, including catastrophic coverage, through a choice of private prescription drug plans (PDPs) or integrated Medicare Advantage (MA-PD) health plans; (2) shifts prescription drug coverage for dual-eligible Medicare / Medicaid beneficiaries from Medicaid to Medicare Part D drug plans; (3) requires a maintenance-of-effort, or "clawback" payments from states to CMS designed to capture a portion of states' Medicaid savings to help finance the benefit; (4) offers additional help for premiums and cost sharing to low income beneficiaries through the Low Income Subsidy (LIS); and (5) provides a subsidy to employer groups that maintain their own prescription drug coverage for retired beneficiaries. This paper summarizes the activities involved in implementing Medicare Part D, the impact it has had on Massachusetts health programs, and the experiences of beneficiaries and others conducting outreach and enrollment. The data are drawn from interviews with officials and documents provided by state health programs, CMS and the Social Security Administration, and representatives of provider and advocacy groups involved in the enrollment and ongoing support of Medicare beneficiaries.
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Results of the Medicare Health Support disease-management pilot program.
McCall, Nancy; Cromwell, Jerry
2011-11-03
In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-09
... quality of care for this population, while lowering total per-capita expenditures under the Medicare program. We anticipate that the Comprehensive ESRD Care Model would result in improved health outcomes for... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-5506-N3...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-08
... Evaluation; Medicare Program; Meeting of the Technical Advisory Panel on Medicare Trustee Reports AGENCY... announces a public meeting of the Technical Advisory Panel on Medicare Trustee Reports (Panel). Notice of... long run. The Panel's discussion is expected to be very technical in nature and will focus on the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-09
... [CMS-1450-CN] RIN 0938-AR52 Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements, and Cost Allocation of Home Health Survey... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...
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Ramirez, Adriana G; Tracci, Margaret C; Stukenborg, George J; Turrentine, Florence E; Kozower, Benjamin D; Jones, R Scott
2016-10-01
The Hospital Value-Based Purchasing Program measures value of care provided by participating Medicare hospitals and creates financial incentives for quality improvement and fosters increased transparency. Limited information is available comparing hospital performance across health care business models. The 2015 Hospital Value-Based Purchasing Program results were used to examine hospital performance by business model. General linear modeling assessed differences in mean total performance score, hospital case mix index, and differences after adjustment for differences in hospital case mix index. Of 3,089 hospitals with total performance scores, categories of representative health care business models included 104 physician-owned surgical hospitals, 111 University HealthSystem Consortium, 14 US News & World Report Honor Roll hospitals, 33 Kaiser Permanente, and 124 Pioneer accountable care organization affiliated hospitals. Estimated mean total performance scores for physician-owned surgical hospitals (64.4; 95% CI, 61.83-66.38) and Kaiser Permanente (60.79; 95% CI, 56.56-65.03) were significantly higher compared with all remaining hospitals, and University HealthSystem Consortium members (36.8; 95% CI, 34.51-39.17) performed below the mean (p < 0.0001). Significant differences in mean hospital case mix index included physician-owned surgical hospitals (mean 2.32; p < 0.0001), US News & World Report honorees (mean 2.24; p = 0.0140), and University HealthSystem Consortium members (mean 1.99; p < 0.0001), and Kaiser Permanente hospitals had lower case mix value (mean 1.54; p < 0.0001). Re-estimation of total performance scores did not change the original results after adjustment for differences in hospital case mix index. The Hospital Value-Based Purchasing Program revealed superior hospital performance associated with business model. Closer inspection of high-value hospitals can guide value improvement and policy-making decisions for all Medicare Value
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-26
... achieving better health for populations, better health care for individuals, and lower growth in expenditures through continuous improvement for Medicare, Medicaid, and Children's Health Insurance Program... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-5505-N3...
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Making Medicare Advantage a Middle-Class Program
Glazer, Jacob; McGuire, Thomas
2013-01-01
This paper studies the role of Medicare's premium policy in sorting beneficiaries between traditional Medicare (TM) and managed care plans in the Medicare Advantage (MA) program. Beneficiaries vary in their demand for care. TM fully accommodates demand but creates a moral hazard inefficiency. MA rations care but disregards some elements of the demand. We describe an efficient assignment of beneficiaries to these two options, and argue that efficiency requires an MA program oriented to serve the large middle part of the distribution of demand: the “middle class.” Current Medicare policy of a “single premium” for MA plans cannot achieve efficient sorting. We characterize the demand-based premium policy that can implement the efficient assignment of enrollees to plans. If only a single premium is feasible, the second-best policy involves too many of the low-demand individuals in MA and a too low level of services relative to the first best. We identify approaches to using premium policy to revitalize MA and improve the efficiency of Medicare. PMID:23454916
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Making Medicare advantage a middle-class program.
Glazer, Jacob; McGuire, Thomas G
2013-03-01
This paper studies the role of Medicare's premium policy in sorting beneficiaries between traditional Medicare (TM) and managed care plans in the Medicare advantage (MA) program. Beneficiaries vary in their demand for care. TM fully accommodates demand but creates a moral hazard inefficiency. MA rations care but disregards some elements of the demand. We describe an efficient assignment of beneficiaries to these two options, and argue that efficiency requires an MA program oriented to serve the large middle part of the distribution of demand: the "middle class." Current Medicare policy of a "single premium" for MA plans cannot achieve efficient sorting. We characterize the demand-based premium policy that can implement the efficient assignment of enrollees to plans. If only a single premium is feasible, the second-best policy involves too many of the low-demand individuals in MA and a too low level of services relative to the first best. We identify approaches to using premium policy to revitalize MA and improve the efficiency of Medicare. Copyright © 2012 Elsevier B.V. All rights reserved.
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Suppression of Υ production in d + Au + and Au + Au collisions at √ sNN =200 GeV
None
2014-07-01
We report measurements of Upsilon meson production in p + p, d +Au, and Au+Au collisions using the STAR detector at RHIC. We compare the Upsilon yield to the measured cross section in p + p collisions in order to quantify any modifications of the yield in cold nuclear matter using d +Au data and in hot nuclear matter using Au+Au data separated into three centrality classes. Our p +p measurement is based on three times the statistics of our previous result. We obtain a nuclear modification factor for Upsilon (1S + 2S + 3S) in the rapidity range |y|more » < 1 in d + Au collisions of R dAu = 0.79 ± 0.24(stat.) ± 0.03(syst.) ± 0.10(p + p syst.). A comparison with models including shadowing and initial state part on energy loss indicates the presence of additional cold-nuclear matter suppression. Similarly, in the top 10% most-central Au + Au collisions, we measure a nuclear modification factor of R AA = 0.49 ±0.1(stat.) ±0.02(syst.) ±0.06(p + p syst.), which is a larger suppression factor than that seen in cold nuclear matter. Our results are consistent with complete suppression of excited-state Upsilon mesons in Au + Au collisions. The additional suppression in Au + Au is consistent with the level expected in model calculations that include the presence of a hot, deconfined Quark–Gluon Plasma. However, understanding the suppression seen in d + Au is still needed before any definitive statements about the nature of the suppression in Au + Au can be made.« less
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76 FR 2453 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-13
... requirements under the Hospital IQR program in the FY 2006 IPPS final rule (70 FR 47420). C. Hospital Inpatient... it was amended by section 3001(a)(2)(C) of the Affordable Care Act, required that the Secretary... discharge of 1%, as required by section 1886(o)(7). Section 1886(o)(1)(C) provides that the Hospital VBP...
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Lessons learned from the National Medicare & You Education Program.
Goldstein, E; Teichman, L; Crawley, B; Gaumer, G; Joseph, C; Reardon, L
2001-01-01
In fall 1998 CMS implemented the National Medicare Education Program (NMEP) to educate beneficiaries about their Medicare program benefits; health plan choices; supplemental health insurance; beneficiary rights, responsibilities, and protections; and health behaviors. CMS has been monitoring the implementation of the NMEP in six case study sites as well as monitoring each of the information channels for communicating with beneficiaries. This article describes select findings from the case studies, and highlights from assessment activities related to the Medicare & You handbook, the toll-free 1-800-MEDICARE Helpline, Internet, and Regional Education About Choices in Health (REACH).
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Medicare's Drug Discount Card Program: Beneficiaries' Experience with Choice
Hassol, Andrea; Wrobel, Marian V.; Doksum, Teresa
2007-01-01
This article describes Medicare beneficiaries' experience with the choice among Medicare drug discount cards and is based primarily on surveys and focus groups with beneficiaries as well as interviews with other stakeholders. Although competition and choice have the potential to reduce cost and enhance quality in the Medicare Program, our findings highlight some of the challenges involved in making choice work in practice. Despite the unique and temporary nature of the drug discount card program, these findings have considerable relevance to the Part D drug benefit and to other Medicare initiatives that rely on choice. PMID:17722747
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Lessons Learned from the National Medicare & You Education Program
Goldstein, Elizabeth; Teichman, Lori; Crawley, Barbara; Gaumer, Gary; Joseph, Catherine; Reardon, Leo
2001-01-01
In fall 1998 CMS implemented the National Medicare Education Program (NMEP) to educate beneficiaries about their Medicare program benefits; health plan choices; supplemental health insurance; beneficiary rights, responsibilities, and protections; and health behaviors. CMS has been monitoring the implementation of the NMEP in six case study sites as well as monitoring each of the information channels for communicating with beneficiaries. This article describes select findings from the case studies, and highlights from assessment activities related to the Medicare & You handbook, the toll-free 1-800-MEDICARE Helpline, Internet, and Regional Education About Choices in Health (REACH). PMID:12500359
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-27
...This proposed rule would implement provisions of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act) which require us to provide a right of appeal and an appeal process for liability insurance (including self-insurance), no-fault insurance, and workers' compensation laws or plans when Medicare pursues a Medicare Secondary Payer (MSP) recovery claim directly from the liability insurance (including self-insurance), no fault insurance, or workers' compensation law or plan.
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Zeng, Wu; Stason, William B; Fournier, Stephen; Razavi, Moaven; Ritter, Grant; Strickler, Gail K; Bhalotra, Sarita M; Shepard, Donald S
2013-05-01
This study reports outcomes of a Medicare-sponsored demonstration of two intensive lifestyle modification programs (LMPs) in patients with symptomatic coronary heart disease: the Cardiac Wellness Program of the Benson-Henry Mind Body Institute (MBMI) and the Dr Dean Ornish Program for Reversing Heart Disease® (Ornish). This multisite demonstration, conducted between 2000 and 2008, enrolled Medicare beneficiaries who had had an acute myocardial infarction or a cardiac procedure within the preceding 12 months or had stable angina pectoris. Health and economic outcomes are compared with matched controls who had received either traditional or no cardiac rehabilitation following similar cardiac events. Each program included a 1-year active intervention of exercise, diet, small-group support, and stress reduction. Medicare claims were used to examine 3-year outcomes. The analysis includes 461 elderly, fee-for-service, Medicare participants and 1,795 controls. Cardiac and non-cardiac hospitalization rates were lower in participants than controls in each program and were statistically significant in MBMI (P < .01). Program costs of $3,801 and $4,441 per participant for the MBMI and Ornish Programs, respectively, were offset by reduced health care costs yielding non-significant three-year net savings per participant of about $3,500 in MBMI and $1,000 in Ornish. A trend towards lower mortality compared with controls was observed in MBMI participants (P = .07). Intensive, year-long LMPs reduced hospitalization rates and suggest reduced Medicare costs in elderly beneficiaries with symptomatic coronary heart disease. Copyright © 2013 Mosby, Inc. All rights reserved.
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Medicare program; clarification of Medicare's accrual basis of accounting policy--HCFA. Final rule.
1995-06-27
This final rule revises the Medicare regulations to clarify the concept of "accrual basis of accounting" to indicate that expenses must be incurred by a provider of health care services before Medicare will pay its share of those expenses. This rule does not signify a change in policy but, rather, incorporates into the regulations Medicare's longstanding policy regarding the circumstances under which we recognize, for the purposes of program payment, a provider's claim for costs for which it has not actually expended funds during the current cost reporting period.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-03
...] Medicare, Medicaid, and Children's Health Insurance Programs; Renewal, Expansion, and Renaming of the...'s Health Insurance Program (CHIP) about options for selecting health care coverage under these and... needs are for experts in health disparities, State Health Insurance Assistance Programs (SHIPs), health...
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Lovett, Annesha
2013-01-01
Background There is much debate currently about how to restructure the Medicare program to achieve better value for the money. Many have cited the Federal Employees Health Benefits Program (FEHBP) as a model for reform. Objective To compare drug coverage and cost-sharing between Medicare Part D and the FEHBP plans. Methods A cross-sectional comparison was conducted of January 2009 data obtained from the Centers for Medicare & Medicaid Services, the Office of Personnel Management, and 3 health plan websites. Regression analysis and t-tests were used to examine drug coverage, copayment, and coinsurance amounts among Medicare Part D and FEHBP plans. The final study sample of Medicare Part D plans consisted of 19 formularies, covering 63% of total Part D enrollment. These 19 formularies represented 232 stand-alone prescription drug plans. In addition, 5 prescription drug plans or formularies in the FEHBP plans were included, which represents 70% of total FEHBP enrollment. Results The results of this study reveal that formulary coverage of the top drugs dispensed and sold in the United States in 2009 ranged from 72% to 94% (average, 84%) in Medicare Part D plans and from 85% to 99% (average, 94%) in the FEHBP plans (P <.01). The mean copayment for generic drugs in Medicare Part D plans was $4.53 compared with a mean of $7.67 (P <.05) in the FEHBP plans. The difference between the 2 programs in mean copayment for brand-name drugs was nonsignificant. For generic drugs, the mean coinsurance rate was 17% for Medicare Part D plans and a mean of 20% for the FEHBP plans (P <.05). Conclusions This analysis shows that there are differences in prescription drug coverage and cost-sharing among plans within Medicare Part D and the FEHBP. To avoid extreme increases in payroll taxes and other revenues or major cutbacks in services, Medicare must explore ways to change the healthcare system to achieve better value for the money. The experience of the FEHBP suggests a possible means of
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75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-28
... care issues. Frank Szeflinski, (303) 844-7119, Medicare Advantage issues. SUPPLEMENTARY INFORMATION... MCO Managed Care Organization MITA Medicaid Information Technology Architecture MMIS Medicaid... Payment Calculation for Eligible Hospitals c. Medicare Share d. Charity Care e. Transition Factor f...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-16
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1586-N] Medicare Program; First Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment (HOP--Formerly Known as the Advisory Panel on Ambulatory Payment Classification Groups--APC Panel)--February 27...
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The spillover effects of Medicare managed care: Medicare Advantage and hospital utilization.
Baicker, Katherine; Chernew, Michael E; Robbins, Jacob A
2013-12-01
More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial - offsetting more than 10% of increased payments to Medicare Advantage plans. Copyright © 2013 Elsevier B.V. All rights reserved.
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The Spillover Effects of Medicare Managed Care: Medicare Advantage and Hospital Utilization
Baicker, Katherine; Chernew, Michael; Robbins, Jacob
2013-01-01
More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial – offsetting more than 10% of increased payments to Medicare Advantage plans. PMID:24308880
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NASA Astrophysics Data System (ADS)
Muts, Ihor; Kharkhalis, Anton; Hlukhyy, Viktor; Kaczorowski, Dariusz; Rodewald, Ute Ch.; Pöttgen, Rainer; Zaremba, Vasyl` I.
2017-09-01
The ternary aurides La4In3Au10 and Yb4In3Au10 and the platinide U4In3Pt10 with ordered Zr7Ni10 type structure were synthesized from the elements by induction-melting in sealed tantalum tubes or via arc-melting. The polycrystalline samples were characterized by powder X-ray diffraction and the structures were refined from single crystal X-ray diffractometer data: Cmce, a = 1426.7(3), b = 1020.3(2), c = 1025.2(2) pm, wR2 = 0.0441, 1510 F2 values, 46 variables for La4In3Au10, a = 1361.5(3), b = 998.3(2), c = 1007.8(2), wR2 = 0.0804, 1404 F2 values, 46 variables for Yb4In3Au10 and a = 1344.4(3), b = 973.9(2), c = 978.9(2), wR2 = 0.0922, 741 F2 values, 48 variables for U4.15In3.03Pt9.82 (with small degrees of In/U, respectively Pt/In mixing on Wyckoff sites 4a and 8 f). The La4In3Au10, Yb4In3Au10 and U4In3Pt10 structures contain pronounced two-dimensional gold, respectively platinum substructures which are filled and condensed by two crystallographically independent indium and rare earth atoms. The crystal chemical features clearly classify these intermetallics as aurides and platinides. The physical properties of U4In3Pt10 were characterized by means of magnetic and electrical transport measurements. The compound exhibits metallic conductivity and shows no magnetic ordering down to 1.72 K. Its magnetic behavior is governed by hybridization between 5f and ligand electrons that results in significant delocalization of the 5f states.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-03
... Work) The Patient Safety initiatives are designed to help achieve the goals of improving individual... coordinating center, the Center for Medicare and Medicaid Innovation, and the Agency for Healthcare Research... outreach activities required to complete all Aims of the 10th SOW successfully. The CRISP Model is designed...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-27
...] Medicare Program; Application by the American Association of Diabetes Educators (AADE) for Continued Recognition as a National Accreditation Organization for Accrediting Entities To Furnish Outpatient Diabetes... of Diabetes Educators for continued recognition as a national accreditation program for accrediting...
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78 FR 8535 - Medicare Program: Comprehensive End-Stage Renal Disease Care Model Announcement
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-06
... develop and test innovative health care payment and service delivery models that show promise of reducing program expenditures, while preserving or enhancing the quality of care for Medicare, Medicaid, and... disease (ESRD). This population has complex health care needs, typically with comorbid conditions and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-27
...] Medicare and Medicaid Programs; Approval of the Accreditation Association for Ambulatory Health Care (AAAHC... announces our decision to approve the Accreditation Association for Ambulatory Health Care (AAAHC) for... Ambulatory Health Care's (AAAHC) current term of approval for their ASC accreditation program expires on...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-13
... Insurance; and Program No. 93.774, Medicare-- Supplementary Medical Insurance Program) Dated: July 7, 2011...), HHS. ACTION: Correction of proposed rule. SUMMARY: This document corrects technical errors that... explanation of publishing such Tables on the Internet), reflect an error in the calculation of the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-30
...] Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on Outreach and..., Medicaid and the Children's Health Insurance Program (CHIP). This meeting is open to the public. DATES... Children's Health Insurance Program (CHIP). Enhancing the federal government's effectiveness in informing...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-26
... information relating to the RFP. ADDRESSES: Proposals for the contracts must be submitted to the Centers for...] Medicare Program; Quality Improvement Organization (QIO) Contracts: Solicitation of Proposals From In-State... QIOs' contracts. It also specifies the period of time in which in-State QIOs may submit a proposal for...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-29
... Hospital Outpatient Quality Data Reporting Program AGENCY: Centers for Medicare & Medicaid Services (CMS... Quality Data Reporting Program (HOP QDRP), which is authorized under section 1833(t)(17) of the Social... participate either in person or via teleconference. The meeting is open to the public, but attendance is...
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76 FR 15105 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-18
... Nursing Homes; Final Rule #0;#0;Federal Register / Vol. 76 , No. 53 / Friday, March 18, 2011 / Rules and... Services 42 CFR Part 488 [CMS-2435-F] Medicare and Medicaid Programs; Civil Money Penalties for Nursing... collection of civil money penalties by CMS when nursing homes are not in compliance with Federal...
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The financial status of Medicare.
Foster, R S
1998-01-01
Medicare is the largest health care program in the country, providing medical care to 38 million aged and disabled Americans. Concerns over rapid cost increases and the imminent insolvency of the Medicare Hospital Insurance trust fund led to enactment of sweeping Medicare legislation as part of the Balanced Budget Act of 1997. Preliminary estimates indicate that this legislation will result in program savings of $150 billion in the first five years and will postpone the depletion of the Hospital Insurance fund from the year 2001 until about 2010. While the Balanced Budget Act significantly reduces Hospital Insurance expenditure in the long range, serious deficits are still expected when the "baby boom" generation reaches retirement. The Medicare Supplementary Medical Insurance trust fund is automatically in financial balance, but policy makers remain concerned about continuing rapid cost increases. A new National Bipartisan Commission on the Future of Medicare will attempt to determine effective solutions to these long-range problems. Images p110-a p111-a p111-b PMID:9719810
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42 CFR 412.110 - Total Medicare payment.
Code of Federal Regulations, 2010 CFR
2010-10-01
... PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Payments to Hospitals Under the Prospective Payment Systems § 412.110 Total Medicare payment. Under the prospective payment systems, Medicare... 42 Public Health 2 2010-10-01 2010-10-01 false Total Medicare payment. 412.110 Section 412.110...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-18
... for electronic medication administration record (eMAR). In addition, in Sec. 495.6(m)(1)(iii) we... description contact information TBD Title: Closing the referral loop: Centers for Medicare Care Coordination... corrected to read ``(ii) Measure. More than 10 percent of medication orders created by authorized providers...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-22
...] Medicare and Medicaid Programs; Application From the Accreditation Association for Ambulatory Health Care... of an application from the Accreditation Association for Ambulatory Health Care for continued... by CMS. The Accreditation Association for Ambulatory Health Care (AAAHC) current term of approval for...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-22
... to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility (NF) in the Medicaid program. We are proposing these requirements to ensure that long... According to CMS data, at any point in time, approximately 1.4 million elderly and disabled nursing home...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-14
... 0938-AP87 Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing... Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2011.'' DATES: Effective... illustrate the skilled nursing facility (SNF) prospective payment system (PPS) payment rate computations for...
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Adamczyk, L.
2015-04-01
We report measurements of Υ meson production in p + p, d + Au, and Au+Au collisions using the STAR detector at RHIC. We compare the Υ yield to the measured cross section in p + p collisions in order to quantify any modifications of the yield in cold nuclear matter using d + Au data and in hot nuclear matter using Au+Au data separated into three centrality classes. Our p + p measurement is based on three times the statistics of our previous result. We obtain a nuclear modification factor for Upsilon (1S + 2S + 3S) in themore » rapidity range |y| < 1 in d + Au collisions of R dAu = 0.79 ± 0.24(stat.) ± 0.03(syst.) ± 0.10(p + p syst.). A comparison with models including shadowing and initial state parton energy loss indicates the presence of additional cold-nuclear matter suppression. Similarly, in the top 10% most-central Au + Au collisions, we measure a nuclear modification factor of R AA = 0.49 ±0.1(stat.) ±0.02(syst.) ±0.06(p + p syst.), which is a larger suppression factor than that seen in cold nuclear matter. Our results are consistent with complete suppression of excited-state Upsilon mesons in Au + Au collisions. The additional suppression in Au + Au is consistent with the level expected in model calculations that include the presence of a hot, deconfined Quark–Gluon Plasma. However, understanding the suppression seen in d + Au is still needed before any definitive statements about the nature of the suppression in Au + Au can be made.« less
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Adamczyk, L.
We report measurements of Υ meson production in p + p, d + Au, and Au+Au collisions using the STAR detector at RHIC. We compare the Υ yield to the measured cross section in p + p collisions in order to quantify any modifications of the yield in cold nuclear matter using d + Au data and in hot nuclear matter using Au+Au data separated into three centrality classes. Our p + p measurement is based on three times the statistics of our previous result. We obtain a nuclear modification factor for Upsilon (1S + 2S + 3S) in themore » rapidity range |y| < 1 in d + Au collisions of R dAu = 0.79 ± 0.24(stat.) ± 0.03(syst.) ± 0.10(p + p syst.). A comparison with models including shadowing and initial state parton energy loss indicates the presence of additional cold-nuclear matter suppression. Similarly, in the top 10% most-central Au + Au collisions, we measure a nuclear modification factor of R AA = 0.49 ±0.1(stat.) ±0.02(syst.) ±0.06(p + p syst.), which is a larger suppression factor than that seen in cold nuclear matter. Our results are consistent with complete suppression of excited-state Upsilon mesons in Au + Au collisions. The additional suppression in Au + Au is consistent with the level expected in model calculations that include the presence of a hot, deconfined Quark–Gluon Plasma. However, understanding the suppression seen in d + Au is still needed before any definitive statements about the nature of the suppression in Au + Au can be made.« less
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-09
... 0938-AP86 Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services.... SUMMARY: This notice announces the inpatient hospital deductible and the hospital and extended care... extended care services in a skilled nursing facility in a benefit period. DATES: Effective Date: This...
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NASA Astrophysics Data System (ADS)
Eschen, Marcus; Jeitschko, Wolfgang
2002-05-01
The polyphosphide Au2PbP2 was prepared by reaction of the elemental components using liquid lead as a reaction medium. Well-developed crystals were obtained after dissolving the matrix in hydrochloric acid. Their crystal structure was determined from four-circle X-ray diffractometer data: Cmcm, a=323.6(1) pm, b=1137.1(2) pm, c=1121.8(1) pm, Z=4, R=0.023 for 478 structure factors and 20 variable parameters. The structure contains zigzag chains of phosphorus atoms with a typical single-bond distance of 219.4(2) pm. The two different kinds of gold atoms are both in linear phosphorus coordination with typical single-bond distances of 232.6(2) and 234.2(2) pm, and the lead atoms have only metal neighbors (7 Au and 2 Pb). Accordingly, chemical bonding of the compound may be expressed by the formula (Au+1)2Pb±0(P-1)2. The corresponding thallium and mercury polyphosphides Au2TlP2 (a=324.1(1) pm, b=1136.1(1) pm, c=1122.1(1) pm) and Au2HgP2 (a=322.1(1) pm, b=1131.4(2) pm, c=1122.6(1) pm) were found to be almost isotypic with Au2PbP2. Their crystal structures were refined from single-crystal X-ray data to R=0.036 (682 F values, 25 variables) and R=0.026 (539 F values, 35 variables), respectively. The structure of these compounds may also be described as consisting of a three-dimensional network of condensed 8- and 10-membered Au2P6 and Au4P6 rings forming parallel channels, which are filled by the lead, thallium, and mercury atoms. The lead atoms are well localized in these channels, while the thallium and even more the mercury atoms occupy additional positions within these channels. Freshly prepared samples of Au2HgP2 show reproducibly slightly different axial ratios and larger cell volumes (ΔV=0.5%) than those after exposure of the samples to air for several days.
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Osborne, Nicholas H; Nicholas, Lauren H; Ryan, Andrew M; Thumma, Jyothi R; Dimick, Justin B
2015-02-03
The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) provides feedback to hospitals on risk-adjusted outcomes. It is not known if participation in the program improves outcomes and reduces costs relative to nonparticipating hospitals. To evaluate the association of enrollment and participation in the ACS NSQIP with outcomes and Medicare payments compared with control hospitals that did not participate in the program. Quasi-experimental study using national Medicare data (2003-2012) for a total of 1,226,479 patients undergoing general and vascular surgery at 263 hospitals participating in ACS NSQIP and 526 nonparticipating hospitals. A difference-in-differences analytic approach was used to evaluate whether participation in ACS NSQIP was associated with improved outcomes and reduced Medicare payments compared with nonparticipating hospitals that were otherwise similar. Control hospitals were selected using propensity score matching (2 control hospitals for each ACS NSQIP hospital). Thirty-day mortality, serious complications (eg, pneumonia, myocardial infarction, or acute renal failure and a length of stay >75th percentile), reoperation, and readmission within 30 days. Hospital costs were assessed using price-standardized Medicare payments during hospitalization and 30 days after discharge. After accounting for patient factors and preexisting time trends toward improved outcomes, there were no statistically significant improvements in outcomes at 1, 2, or 3 years after (vs before) enrollment in ACS NSQIP. For example, in analyses comparing outcomes at 3 years after (vs before) enrollment, there were no statistically significant differences in risk-adjusted 30-day mortality (4.3% after enrollment vs 4.5% before enrollment; relative risk [RR], 0.96 [95% CI, 0.89 to 1.03]), serious complications (11.1% after enrollment vs 11.0% before enrollment; RR, 0.96 [95% CI, 0.91 to 1.00]), reoperations (0.49% after enrollment vs 0.45% before
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Code of Federal Regulations, 2010 CFR
2010-10-01
... for improving Medicare program efficiency and to reward suggesters for monetary savings. 420.410... Program Efficiency and to Reward Suggesters for Monetary Savings § 420.410 Establishment of a program to collect suggestions for improving Medicare program efficiency and to reward suggesters for monetary...
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Code of Federal Regulations, 2011 CFR
2011-10-01
... for improving Medicare program efficiency and to reward suggesters for monetary savings. 420.410... Program Efficiency and to Reward Suggesters for Monetary Savings § 420.410 Establishment of a program to collect suggestions for improving Medicare program efficiency and to reward suggesters for monetary...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-03
...] Medicare and Medicaid Programs: Application From the Accreditation Commission for Health Care for Continued... from the Accreditation Commission for Health Care (ACHC) for continued recognition as a national... program every 6 years or as determined by CMS. The Accreditation Commission for Health Care's (ACHC's...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-28
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3264-FN... Accreditation Program (AOA/HFAP) Application for Continuing CMS-Approval of Its Ambulatory Surgical Center (ASC... 6 years or sooner as determined by CMS. AOA/HFAP's current term of approval for their ASC...
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Identifying the Transgender Population in the Medicare Program
Proctor, Kimberly; Haffer, Samuel C.; Ewald, Erin; Hodge, Carla; James, Cara V.
2016-01-01
Abstract Purpose: To identify and describe the transgender population in the Medicare program using administrative data. Methods: Using a combination of International Classification of Diseases ninth edition (ICD-9) codes relating to transsexualism and gender identity disorder, we analyzed 100% of the 2013 Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service (FFS) “final action” claims from both institutional and noninstitutional providers (∼1 billion claims) to identify individuals who may be transgender Medicare beneficiaries. To confirm, we developed and applied a multistage validation process. Results: Four thousand ninety-eight transgender beneficiaries were identified, of which ∼90% had confirmatory diagnoses, billing codes, or evidence of a hormone prescription. In general, the racial, ethnic, and geographic distribution of the Medicare transgender population tends to reflect the broader Medicare population. However, age, original entitlement status, and disease burden of the transgender population appear substantially different. Conclusions: Using a variety of claims information, ranging from claims history to additional diagnoses, billing modifiers, and hormone prescriptions, we demonstrate that administrative data provide a valuable resource for identifying a lower bound of the Medicare transgender population. In addition, we provide a baseline description of the diversity and disease burden of the population and a framework for future research. PMID:28861539
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76 FR 26805 - Medicare Program; Hospice Wage Index for Fiscal Year 2012
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-09
... returned to Medicare by the hospice. CMS' contractors calculate each hospice's aggregate cap every year... Medicare contractor recalculate the hospice's aggregate cap using longer timeframes. Option 2: In this... individual hospices to request the Medicare contractor to apply a patient-by-patient proportional methodology...
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76 FR 33565 - Medicare Program; Availability of Medicare Data for Performance Measurement
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-08
... data from two or more other sources. For example, a qualified entity would need to have claims data... help further alleviate some of the methodological issues associated with performance measurement based... Medicare parts A, B, and D claims data available to the qualified entity. For example, several measures in...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-30
... 0938-AR59 Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services.... SUMMARY: This notice announces the inpatient hospital deductible and the hospital and extended care... lifetime reserve days; and $152 for the 21st through 100th day of extended care services in a skilled...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-21
... 0938-AR14 Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services.... SUMMARY: This notice announces the inpatient hospital deductible and the hospital and extended care... lifetime reserve days; and $148 for the 21st through 100th day of extended care services in a skilled...
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75 FR 43178 - Medicare Program; Solicitation for Proposals for the Medicare Imaging Demonstration
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-23
..., medical specialty societies, physician groups, integrated health care delivery systems, independent practice associations, radiology benefit managers, health plans, information technology vendors, and... societies. The Centers for Medicare & Medicaid Services (CMS) worked with medical specialty societies and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-05
...] Medicare & Medicaid Programs: Application From the Accreditation Commission for Health Care for Continued... Accreditation Commission for Health Care (ACHC) for continued recognition as a national accrediting organization...) announcing Accreditation Commission for Health Care's request for approval of its hospice accreditation...
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75 FR 11185 - Centers for Medicare & Medicaid Services; Delegation of Authority
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-10
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Centers for Medicare & Medicaid..., Centers for Medicare & Medicaid Services (CMS), or his or her successor, the authorities currently vested... or disasters that are related to Medicare, Medicaid, and the Children's Health Insurance Programs as...
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76 FR 28195 - Medicare Program; Hospice Wage Index for Fiscal Year 2012
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-16
... area index 1 Alabama 0.8000 2 Alaska 1.3073 3 Arizona 0.9417 4 Arkansas 0.8000 5 California 1.2483 6 Colorado 1.0285 7 Connecticut 1.1522 8 Delaware 1.0103 9 District of Columbia \\1\\......... 10 Florida 0... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 418...
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Adams, J; Aggarwal, M M; Ahammed, Z; Amonett, J; Anderson, B D; Arkhipkin, D; Averichev, G S; Badyal, S K; Bai, Y; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellwied, R; Berger, J; Bezverkhny, B I; Bharadwaj, S; Bhasin, A; Bhati, A K; Bhatia, V S; Bichsel, H; Billmeier, A; Bland, L C; Blyth, C O; Bonner, B E; Botje, M; Boucham, A; Brandin, A V; Bravar, A; Bystersky, M; Cadman, R V; Cai, X Z; Caines, H; Calderón de la Barca Sánchez, M; Carroll, J; Castillo, J; Cebra, D; Chajecki, Z; Chaloupka, P; Chattopdhyay, S; Chen, H F; Chen, Y; Cheng, J; Cherney, M; Chikanian, A; Christie, W; Coffin, J P; Cormier, T M; Cramer, J G; Crawford, H J; Das, D; Das, S; de Moura, M M; Derevschikov, A A; Didenko, L; Dietel, T; Dogra, S M; Dong, W J; Dong, X; Draper, J E; Du, F; Dubey, A K; Dunin, V B; Dunlop, J C; Dutta Mazumdar, M R; Eckardt, V; Edwards, W R; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Estienne, M; Fachini, P; Faivre, J; Fatemi, R; Fedorisin, J; Filimonov, K; Filip, P; Finch, E; Fine, V; Fisyak, Y; Foley, K J; Fomenko, K; Fu, J; Gagliardi, C A; Gans, J; Ganti, M S; Gaudichet, L; Geurts, F; Ghazikhanian, V; Ghosh, P; Gonzalez, J E; Grachov, O; Grebenyuk, O; Grosnick, D; Guertin, S M; Guo, Y; Gupta, A; Gutierrez, T D; Hallman, T J; Hamed, A; Hardtke, D; Harris, J W; Heinz, M; Henry, T W; Hepplemann, S; Hippolyte, B; Hirsch, A; Hjort, E; Hoffmann, G W; Huang, H Z; Huang, S L; Hughes, E W; Humanic, T J; Igo, G; Ishihara, A; Jacobs, P; Jacobs, W W; Janik, M; Jiang, H; Jones, P G; Judd, E G; Kabana, S; Kang, K; Kaplan, M; Keane, D; Khodyrev, V Yu; Kiryluk, J; Kisiel, A; Kislov, E M; Klay, J; Klein, S R; Klyachko, A; Koetke, D D; Kollegger, T; Kopytine, M; Kotchenda, L; Kramer, M; Kravtsov, P; Kravtsov, V I; Krueger, K; Kuhn, C; Kulikov, A I; Kumar, A; Kunz, C L; Kutuev, R Kh; Kuznetsov, A A; Lamont, M A C; Landgraf, J M; Lange, S; Laue, F; Lauret, J; Lebedev, A; Lednicky, R; Lehocka, S; LeVine, M J; Li, C; Li, Q; Li, Y; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, L; Liu, Q J; Liu, Z; Ljubicic, T; Llope, W J; Long, H; Longacre, R S; Lopez-Noriega, M; Love, W A; Lu, Y; Ludlam, T; Lynn, D; Ma, G L; Ma, J G; Ma, Y G; Magestro, D; Mahajan, S; Mahapatra, D P; Majka, R; Mangotra, L K; Manweiler, R; Margetis, S; Markert, C; Martin, L; Marx, J N; Matis, H S; Matulenko, Yu A; McClain, C J; McShane, T S; Meissner, F; Melnick, Yu; Meschanin, A; Miller, M L; Milosevich, Z; Minaev, N G; Mironov, C; Mischke, A; Mishra, D K; Mitchell, J; Mohanty, B; Molnar, L; Moore, C F; Morozov, D A; Munhoz, M G; Nandi, B K; Nayak, S K; Nayak, T K; Nelson, J M; Netrakanti, P K; Nikitin, V A; Nogach, L V; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Pal, S K; Panebratsev, Y; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Peitzmann, T; Perevoztchikov, V; Perkins, C; Peryt, W; Petrov, V A; Phatak, S C; Picha, R; Planinic, M; Pluta, J; Porile, N; Porter, J; Poskanzer, A M; Potekhin, M; Potrebenikova, E; Potukuchi, B V K S; Prindle, D; Pruneau, C; Putschke, J; Rai, G; Rakness, G; Raniwala, R; Raniwala, S; Ravel, O; Ray, R L; Razin, S V; Reichhold, D; Reid, J G; Renault, G; Retiere, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevskiy, O V; Romero, J L; Rose, A; Roy, C; Ruan, L; Sahoo, R; Sakrejda, I; Salur, S; Sandweiss, J; Savin, I; Sazhin, P S; Schambach, J; Scharenberg, R P; Schmitz, N; Schroeder, L S; Schweda, K; Seger, J; Seyboth, P; Shahaliev, E; Shao, M; Shao, W; Sharma, M; Shen, W Q; Shestermanov, K E; Shimanskiy, S S; Sichtermann, E; Simon, F; Singaraju, R N; Skoro, G; Smirnov, N; Snellings, R; Sood, G; Sorensen, P; Sowinski, J; Speltz, J; Spinka, H M; Srivastava, B; Stadnik, A; Stanislaus, T D S; Stock, R; Stolpovsky, A; Strikhanov, M; Stringfellow, B; Suaide, A A P; Sugarbaker, E; Suire, C; Sumbera, M; Surrow, B; Symons, T J M; Szanto de Toledo, A; Szarwas, P; Tai, A; Takahashi, J; Tang, A H; Tarnowsky, T; Thein, D; Thomas, J H; Timoshenko, S; Tokarev, M; Trentalange, S; Tribble, R E; Tsai, O D; Ulery, J; Ullrich, T; Underwood, D G; Urkinbaev, A; Van Buren, G; van Leeuwen, M; Vander Molen, A M; Varma, R; Vasilevski, I M; Vasiliev, A N; Vernet, R; Vigdor, S E; Viyogi, Y P; Vokal, S; Voloshin, S A; Vznuzdaev, M; Waggoner, W T; Wang, F; Wang, G; Wang, G; Wang, X L; Wang, Y; Wang, Y; Wang, Z M; Ward, H; Watson, J W; Webb, J C; Wells, R; Westfall, G D; Wetzler, A; Whitten, C; Wieman, H; Wissink, S W; Witt, R; Wood, J; Wu, J; Xu, N; Xu, Z; Xu, Z Z; Yamamoto, E; Yepes, P; Yurevich, V I; Zanevsky, Y V; Zhang, H; Zhang, W M; Zhang, Z P; Zolnierczuk, P A; Zoulkarneev, R; Zoulkarneeva, Y; Zubarev, A N
2004-12-17
Results on high transverse momentum charged particle emission with respect to the reaction plane are presented for Au + Au collisions at square root s(NN)=200 GeV. Two- and four-particle correlations results are presented as well as a comparison of azimuthal correlations in Au + Au collisions to those in p + p at the same energy. The elliptic anisotropy v(2) is found to reach its maximum at p(t) approximately 3 GeV/c, then decrease slowly and remain significant up to p(t) approximately 7-10 GeV/c. Stronger suppression is found in the back-to-back high-p(t) particle correlations for particles emitted out of plane compared to those emitted in plane. The centrality dependence of v(2) at intermediate p(t) is compared to simple models based on jet quenching.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-27
...--(1) is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of Application from Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-04
... waiver--(1) is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of Application From Hospital Requesting Waiver for Organ... the requirement to have an agreement with its designated Organ Procurement Organization (OPO). The...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-03
...--(1) is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of Applications From Hospitals Requesting Waiver for Organ... otherwise require the hospitals to enter into an agreement with their designated Organ Procurement...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-10
...] Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration... code under the Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration. The deadline for... interested parties of an opportunity to participate in the Treatment of Certain Complex Diagnostic Laboratory...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-02-18
... nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program. These..., as of April 2010, there are 15,713 long-term care (LTC) facilities (commonly referred to as nursing homes) in the U.S. LTC facilities are also referred to as skilled nursing facilities (SNFs) in the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-22
... offered in a service area by identifying for non-renewal plans with sustained low enrollment. In our April... seeking to expand their service areas may continue to offer DE SNPs through the 2012 contract. For... Part II Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-17
... collections of information in CMS regulations and a list of Medicare- approved carotid stent facilities.... Questions concerning Medicare-approved carotid stent facilities in Addendum VIII may be addressed to Sarah J... 20 of the CFR. Addendum VIII includes listings of Medicare-approved carotid stent facilities. All...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-11
...This rule proposes to update and make revisions to the End- Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2013. This rule also proposes to set forth requirements for the ESRD quality incentive program (QIP), including for payment year (PY) 2015 and beyond. This proposed rule will implement changes to bad debt reimbursement for all Medicare providers, suppliers, and other entities eligible to receive bad debt. (See the Table of Contents for a listing of the specific issues addressed in this proposed rule.)
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-20
... must determine that the waiver--(1) is expected to increase organ donations; and (2) will ensure...] Medicare and Medicaid Programs; Announcement of Application From Hospital Requesting Waiver for Organ... Hospital to participate in an Organ Procurement Organization (OPO) outside of its designated OPO. The...
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Size control of Au NPs supported by pH operation
NASA Astrophysics Data System (ADS)
Ichiji, Masumi; Akiba, Hiroko; Hirasawa, Izumi
2017-07-01
Au NPs are expected to become useful functional particles, as particle gun used for plant gene transfer and also catalysts. We have studied PSD (particle size distribution) control of Au NPs by reduction crystallization. Previous study found out importance of seeds policy and also feeding profile. In this paper, effect of pH in the reduction crystallization was investigated to clarify the possibility of Au NPs PSD control by pH operation and also their growth process. Au NPs of size range 10-600 nm were obtained in single-jet system using ascorbic acid (AsA) as a reducing agent with adjusting pH of AsA. Au NPs are found to grow in the process of nucleation, agglomeration, agglomeration growth and surface growth. Au NPs tend to grow by agglomeration and become larger size in lower pH regions, and to grow only by surface growth and become smaller size in higher pH regions.
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{phi} meson production in Au + Au and p + p collisions at {radical}s{sub NN}=200 GeV
DOE Office of Scientific and Technical Information (OSTI.GOV)
Adams, J.; Adler, C.; Aggarwal, M.M.
2004-06-01
We report the STAR measurement of {psi} meson production in Au + Au and p + p collisions at {radical}s{sub NN} = 200 GeV. Using the event mixing technique, the {psi} spectra and yields are obtained at midrapidity for five centrality bins in Au+Au collisions and for non-singly-diffractive p+p collisions. It is found that the {psi} transverse momentum distributions from Au+Au collisions are better fitted with a single-exponential while the p+p spectrum is better described by a double-exponential distribution. The measured nuclear modification factors indicate that {psi} production in central Au+Au collisions is suppressed relative to peripheral collisions when scaledmore » by the number of binary collisions (
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42 CFR 405.455 - Application to Medicare+Choice contracts.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Application to Medicare+Choice contracts. 405.455 Section 405.455 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.455...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-20
...] Medicare and Medicaid Programs; Application from the Compliance Team for Initial CMS-Approval of its Rural... Compliance Team for initial recognition as a national accrediting organization for rural health clinics (RHCs... Compliance Team's request for initial CMS approval of its RHC accreditation program. This notice also...
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Bellinger, Adam S.; Elliott, Sean P.; Yang, Liu; Wei, John T.; Saigal, Christopher S.; Smith, Alexandria; Wilt, Timothy J.; Strope, Seth A.
2012-01-01
Introduction Benign prostatic hyperplasia (BPH) creates significant expenses for the Medicare program. We sought to determine trends in expenditures for BPH evaluative testing after urologist consultation, and place these trends in the context of overall Medicare expenditures. Methods Using a 5% national sample of Medicare beneficiaries from 2000 to 2007, we developed a cohort of men with claims for new visits to urologists for diagnoses consistent with symptomatic BPH (n=40,253). We assessed trends in initial expenditures (within 12 months of diagnosis; inflation and geography adjusted) by categories of evaluative tests derived from the 2003 AUA Guideline on the Management of BPH. Using governmental reports on Medicare expenditures, trends in BPH expenditures were compared to overall and imaging-specific Medicare expenditures. Comparisons were assessed by Z-tests and regression analysis for linear trends as appropriate. Results Between 2000 and 2007 inflation adjusted total Medicare expenditure per patient for the initial evaluation of BPH patients seen by urologists increased from $255.44 to $343.98 (p<0.0001). Increases in BPH related imaging (55%), were significantly less than increases in overall Medicare expenditures on imaging (104%; p<0.001). The 35% increase in per patient expenditures for BPH was significantly lower than the increase in overall Medicare expenditure per enrollee (45%; p=0.0.0015). Conclusion From 2000 to 2007, inflation adjusted expenditures on BPH related evaluations increased. This growth was slower than overall growth in Medicare expenditures, and increases in imaging expenditures related to BPH were restrained compared to the Medicare program as a whole. PMID:22425128
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-12
... DEPARTMENT OF DEFENSE Office of the Secretary DoD Medicare-Eligible Retiree Health Care Board of... Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 2, 2013, from 10:00 a.m. to... assumptions to be used in the valuation of benefits under DoD retiree health care programs for Medicare...
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Effects of a Community-Based Fall Management Program on Medicare Cost Savings.
Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael
2015-12-01
Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.
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Medicare's chronic care improvement pilot program: what is its potential?
Super, Nora
2004-05-10
This paper describes the voluntary chronic care improvement program under traditional fee-for-service Medicare as authorized by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Public Law 108-173; section 721). This brief analyzes the emerging issues raised by this new program, including which chronic conditions and regional areas will be targeted, the types of entities that may participate, the physician's role in care management, and the adoption and use of health information technology and evidence-based clinical guidelines.
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The Velocity Distribution Of Pickup He+ Measured at 0.3 AU by MESSENGER
NASA Astrophysics Data System (ADS)
Gershman, Daniel J.; Fisk, Lennard A.; Gloeckler, George; Raines, Jim M.; Slavin, James A.; Zurbuchen, Thomas H.; Solomon, Sean C.
2014-06-01
During its interplanetary trajectory in 2007-2009, the MErcury Surface, Space ENvrionment, GEochemistry, and Ranging (MESSENGER) spacecraft passed through the gravitational focusing cone for interstellar helium multiple times at a heliocentric distance R ≈ 0.3 AU. Observations of He+ interstellar pickup ions made by the Fast Imaging Plasma Spectrometer sensor on MESSENGER during these transits provide a glimpse into the structure of newly formed inner heliospheric pickup-ion distributions. This close to the Sun, these ions are picked up in a nearly radial interplanetary magnetic field. Compared with the near-Earth environment, pickup ions observed near 0.3 AU will not have had sufficient time to be energized substantially. Such an environment results in a nearly pristine velocity distribution function that should depend only on pickup-ion injection velocities (related to the interstellar gas), pitch-angle scattering, and cooling processes. From measured energy-per-charge spectra obtained during multiple spacecraft observational geometries, we have deduced the phase-space density of He+ as a function of magnetic pitch angle. Our measurements are most consistent with a distribution that decreases nearly monotonically with increasing pitch angle, rather than the more commonly modeled isotropic or hemispherically symmetric forms. These results imply that pitch-angle scattering of He+ may not be instantaneous, as is often assumed, and instead may reflect the velocity distribution of initially injected particles. In a slow solar wind stream, we find a parallel-scattering mean free path of λ || ~ 0.1 AU and a He+ production rate of ~0.05 m-3 s-1 within 0.3 AU.
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The Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+Choice Plans
Buntin, Melinda Beeuwkes; Garber, Alan M; McClellan, Mark; Newhouse, Joseph P
2004-01-01
Objective To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life—a group that accounts for more than one-quarter of Medicare's annual expenditures. Data Source Medicare administrative claims for 1994 and 1995. Study Design We calculated the payment a plan would have received under three risk-adjustment systems for each beneficiary in our 1995 sample based on his or her age, gender, county of residence, original reason for Medicare entitlement, and principal inpatient diagnoses received during any hospital stays in 1994. We compared these amounts to the actual costs incurred by those beneficiaries. We then looked for clinical categories that were predictive of costs, including costs in a beneficiary's last year of life, not accounted for by the risk adjusters. Data Extraction Methods The analyses were conducted using claims for a 5 percent random sample of Medicare beneficiaries who died in 1995 and a matched group of survivors. Principal Findings Medicare is currently implementing the Principal Inpatient Diagnostic Cost Groups (PIP-DCG) risk adjustment payment system to address the problem of risk selection in the Medicare+Choice program. We quantify the strong financial disincentives to enroll terminally ill beneficiaries that plans still have under this risk adjustment system. We also show that up to one-third of the selection observed between Medicare HMOs and the traditional fee-for-service system could be due to differential enrollment of decedents. A risk adjustment system that incorporated more of the available diagnostic information would attenuate this disincentive; however, plans could still use clinical information (not included in the risk adjustment scheme) to identify beneficiaries whose expected costs exceed expected payments. Conclusions More disaggregated prospective
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Code of Federal Regulations, 2010 CFR
2017-10-01
... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2017-10-01 2017-10-01 false Treatment of incentive programs or add-on payments...
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Code of Federal Regulations, 2010 CFR
2016-10-01
... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2016-10-01 2016-10-01 false Treatment of incentive programs or add-on payments...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-24
... increase organ donations; and (2) will ensure equitable treatment of patients referred for transplants...] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-24
... expected to increase organ donations; and (2) will ensure equitable treatment of patients referred for...] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ... the requirement to have an agreement with its designated Organ Procurement Organization (OPO). The...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-03
... Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality... entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-27
..., and in view of the slight differences between these rules, we requested public comment on whether the...: This final rule will revise the requirements that an institution will have to meet in order to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-16
... nation's health care expenditures in 2006.\\7\\ Furthermore, dual eligibles account for a..., Federal Coordinated Health Care Office, at (410) 786-8911 or [email protected] . SUPPLEMENTARY... Coordinated Health Care Office (``Medicare-Medicaid Coordination Office'') and charged the new office with...
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Use of Medicare summary notice inserts to generate interest in the Medicare stop smoking program.
Maglione, Margaret; Larson, Carrie; Giannotti, Tierney; Lapin, Pauline
2007-01-01
Evaluations of outreach strategies that effectively and efficiently reach the senior population often go unreported. The Medicare Stop Smoking Program (MSSP) was a seven-state demonstration project funded by the Centers for Medicare and Medicaid Services. The 1-year recruitment plan for MSSP included a multifaceted paid media campaign; however, enrollment was slower than anticipated. The purpose of this substudy was to test the effects of including envelope-sized advertisement inserts with Medicare Summary Notices (MSNs) as a supplemental recruitment strategy. Information obtained from enrollees on where they had learned about the program as well as overall enrollment rates were analyzed and compared with the time periods during which the inserts were included in MSN mailings. Average call volume to the enrollment center increased by 65.7% in Alabama, the pilot state, and by more than 200% in the subsequent demonstration states. Despite the introduction of the MSN inserts late in the recruitment period, 32.2 % of the 7354 total enrollees stated that they learned about the project through the inserts. This recruitment method is highly recommended as a cost-effective way to reach the senior population.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-06
... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA 2012-0015] Privacy Act of 1974, as Amended; Computer Matching Program (SSA/ Centers for Medicare and Medicaid Services (CMS))--Match Number 1094 AGENCY: Social Security Administration (SSA). ACTION: Notice of a new computer matching program that will expire...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-18
... (Destination Therapy) Facilities. XIII Medicare-Approved Lung Volume Reduction Surgery JoAnna Baldwin, MS (410) 786-7205 Facilities. XIV Medicare-Approved Bariatric Surgery Facilities........ Kate Tillman, RN, MAS...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-11
... Prospective Payment System and CY 2011 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2011 Payment Rates; Changes to Payments to Hospitals for Graduate Medical Education Costs..., 2010, entitled ``Medicare Program: Hospital Outpatient Prospective Payment System and CY 2011 Payment...
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Au-Doped Indium Tin Oxide Ohmic Contacts to p-Type GaN
NASA Astrophysics Data System (ADS)
Guo, H.; Andagana, H. B.; Cao, X. A.
2010-05-01
Indium tin oxide (ITO) thin films doped with Au, Ni, or Pt (3.5 at.% to 10.5 at.%) were deposited on p-GaN epilayers (Mg ~4 × 1019 cm-3) using direct-current (DC) sputter codeposition. It was found that undoped ITO con- tacts to p-GaN exhibited leaky Schottky behavior, whereas the incorporation of a small amount of Au (3.5 at.% to 10.5 at.%) significantly improved their ohmic characteristics. Compared with standard Ni/ITO contacts, the Au-doped ITO contacts had a similar specific contact resistance in the low 10-2 Ω cm-2 range, but were more stable above 600°C and more transparent at blue wavelengths. These results provide support for the use of Au-doped ITO ohmic contact to p-type GaN in high-brightness blue light-emitting diodes.
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The Medicare bundled payment pilot program participation considerations.
Pearce, Jonathan W; Harris, John M
2010-09-01
The Medicare bundled payment pilot program is scheduled to begin in January 2013 and will run for five years. The program holds the promise of increased alignment between hospitals and physicians, presenting opportunities for hospital cost reduction and improvements in quality. Nonetheless, the program carries fixed costs and assumption of risks that hospitals need to evaluate as they deliberate over whether to seek to participate in the program.
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42 CFR 405.425 - Effects of opting-out of Medicare.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Effects of opting-out of Medicare. 405.425 Section 405.425 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.425...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-09
...) Facilities. XIII Medicare-Approved Lung JoAnna Baldwin, MS. (410) 786-7205 Volume Reduction Surgery Facilities. XIV Medicare-Approved Bariatric Kate Tillman, RN, (410) 786-9252 Surgery Facilities. MAS. XV...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-27
... waiver--(1) is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of an Application from a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-02
... Secretary must determine that the waiver--(1) is expected to increase organ donations; and (2) will assure...] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-23
... waiver, the Secretary must determine that the waiver--(1) is expected to increase organ donations; and (2...] Medicare and Medicaid Programs; Announcement of an Application From a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-23
... waiver--(1) Is expected to increase organ donations; and (2) will ensure equitable treatment of patients...] Medicare and Medicaid Programs; Announcement of an Application From a Hospital Requesting Waiver for Organ... require the hospital to enter into an agreement with its designated Organ Procurement Organization (OPO...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-17
... [CMS-1588-F2] RIN 0938-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for...
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75 FR 49215 - Medicare Program; End-Stage Renal Disease Quality Incentive Program
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-12
... new feature on http://www.medicare.gov that was modeled after Nursing Home Compare and continues to be... for the three finalized measures. We believe that this is the performance period that best balances...
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How does beneficiary knowledge of the Medicare program vary by type of insurance?
McCormack, Lauren A; Uhrig, Jennifer D
2003-08-01
Prior research found that Medicare beneficiaries' knowledge of the Medicare program varied by the type of supplemental insurance they had. However, none of these studies used both multivariate methods and nationally representative data to examine the issue. OBJECTIVES To measure beneficiary knowledge of the Medicare program and to evaluate how knowledge varies by type of supplemental insurance. A mail survey with telephone follow-up to a nationally representative random sample of Medicare beneficiaries, which had a 76% response rate. The purpose of the study was to evaluate the effects of providing the Medicare & You handbook on beneficiary knowledge, information needs, and health plan decision making. A total of 3738 Medicare beneficiaries who completed the survey. A psychometrically validated 22-item index that reflects Medicare-related knowledge in seven different content areas. RESULTS Overall, beneficiaries with a Medicare HMO or non-employer-sponsored supplemental insurance were more knowledgeable about Medicare than those who had Medicare only. In general, beneficiaries tended to be more knowledgeable about issues related to the type of insurance they had (fee-for-service or managed care) than other types of insurance. Higher levels of knowledge about one's own type of insurance may suggest that beneficiaries learn by experience or they learn more about that type of insurance before enrollment. Further research is needed to better understand how and when beneficiaries learn about insurance and what educational strategies are more effective at increasing knowledge.
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Bellinger, Adam S; Elliott, Sean P; Yang, Liu; Wei, John T; Saigal, Christopher S; Smith, Alexandria; Wilt, Timothy J; Strope, Seth A
2012-05-01
Benign prostatic hyperplasia creates significant expenses for the Medicare program. We determined expenditure trends for benign prostatic hyperplasia evaluative testing after urologist consultation and placed these trends in the context of overall Medicare expenditures. Using a 5% national sample of Medicare beneficiaries from 2000 to 2007 we developed a cohort of 40,253 with claims for new visits to urologists for diagnoses consistent with symptomatic benign prostatic hyperplasia. We assessed trends in initial inflation and geography adjusted expenditures within 12 months of diagnosis by evaluative test categories derived from the 2003 American Urological Association guideline on the management of benign prostatic hyperplasia. Using governmental reports on Medicare expenditure trends for benign prostatic hyperplasia we compared expenditures to overall and imaging specific Medicare expenditures. Comparisons were assessed by the Z-test and regression analysis for linear trends, as appropriate. Between 2000 and 2007 inflation adjusted total Medicare expenditures per patient for the initial evaluation of patients with benign prostatic hyperplasia seen by urologists increased from $255.44 to $343.98 (p <0.0001). Benign prostatic hyperplasia related imaging increases were significantly less than overall Medicare imaging expenditure increases (55% vs 104%, p <0.001). The increase in per patient expenditures for benign prostatic hyperplasia was significantly lower than the increase in overall Medicare expenditures per enrollee (35% vs 45%, p = 0.0015). From 2000 to 2007 inflation adjusted expenditures increased for benign prostatic hyperplasia related evaluations. This growth was slower than the overall growth in Medicare expenditures. The increase in BPH related imaging expenditures was restrained compared to that of the Medicare program as a whole. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights
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42 CFR 405.377 - Withholding Medicare payments to recover Medicaid overpayments.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Withholding Medicare payments to recover Medicaid overpayments. 405.377 Section 405.377 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...
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42 CFR 405.377 - Withholding Medicare payments to recover Medicaid overpayments.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 2 2011-10-01 2011-10-01 false Withholding Medicare payments to recover Medicaid overpayments. 405.377 Section 405.377 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3259-PN... Self-Management Training AGENCY: Centers for Medicare & Medicare Services (CMS), HHS. ACTION: Proposed... comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-02-18
... [CMS-1510-F2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home Health Agencies and Hospices; Correction... set forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: The...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-18
..., Center for Medicare & Medicaid Innovation, Attention: Alexandre Laberge, Mail Stop: WB-06-05, 7500... underserved areas. On March 22, 2012, we posted a solicitation for proposals on the Innovation Center Web site... Innovation Center Web site at http://www.innovations.cms.gov/initiatives/GNE/index.html . II. Provisions of...
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The Centers for Medicare & Medicaid Services administers Medicare, a Health Insurance Program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease.
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Evaluation of the Effectiveness of a Surgical Checklist in Medicare Patients.
Reames, Bradley N; Scally, Christopher P; Thumma, Jyothi R; Dimick, Justin B
2015-01-01
Surgical checklists are increasingly used to improve compliance with evidence-based processes in the perioperative period. Although enthusiasm exists for using checklists to improve outcomes, recent studies have questioned their effectiveness in large populations. We sought to examine the association of Keystone Surgery, a statewide implementation of an evidence-based checklist and Comprehensive Unit-based Safety Program, on surgical outcomes and health care costs. We performed a study using national Medicare claims data for patients undergoing general and vascular surgery (n=1,002,241) from 2006 to 2011. A difference-in-differences approach was used to evaluate whether implementation was associated with improved surgical outcomes and decreased costs when compared with a national cohort of nonparticipating hospitals. Propensity score matching was used to select 10 control hospitals for each participating hospital. Costs were assessed using price-standardized 30-day Medicare payments for acute hospitalizations, readmissions, and high-cost outliers. Keystone Surgery implementation in participating centers (N=95 hospitals) was not associated with improved outcomes. Difference-in-differences analysis accounting for trends in nonparticipating hospitals (N=950 hospitals) revealed no differences in adjusted rates of 30-day mortality [relative risk (RR)=1.03; 95% confidence intervals (CI), 0.97-1.10], any complication (RR=1.03; 95% CI, 0.99-1.07), reoperations (RR=0.89; 95% CI, 0.56-1.22), or readmissions (RR=1.01; 95% CI, 0.97-1.05). Medicare payments for the index admission increased following implementation ($516 average increase in payments; 95% CI, $210-$823 increase), as did readmission payments ($564 increase; 95% CI, $89-$1040 increase). High-outlier payments ($965 increase; 95% CI, $974decrease to $2904 increase) did not change. Implementation of Keystone Surgery in Michigan was not associated with improved outcomes or decreased costs in Medicare patients.
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Abelev, B I; Aggarwal, M M; Ahammed, Z; Anderson, B D; Arkhipkin, D; Averichev, G S; Bai, Y; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Baumgart, S; Belaga, V V; Bellingeri-Laurikainen, A; Bellwied, R; Benedosso, F; Betts, R R; Bhardwaj, S; Bhasin, A; Bhati, A K; Bichsel, H; Bielcik, J; Bielcikova, J; Bland, L C; Blyth, S-L; Bombara, M; Bonner, B E; Botje, M; Bouchet, J; Brandin, A V; Bravar, A; Burton, T P; Bystersky, M; Cadman, R V; Cai, X Z; Caines, H; Calderón de la Barca Sánchez, M; Callner, J; Catu, O; Cebra, D; Chajecki, Z; Chaloupka, P; Chattopadhyay, S; Chen, H F; Chen, J H; Chen, J Y; Cheng, J; Cherney, M; Chikanian, A; Christie, W; Chung, S U; Coffin, J P; Cormier, T M; Cosentino, M R; Cramer, J G; Crawford, H J; Das, D; Dash, S; Daugherity, M; de Moura, M M; Dedovich, T G; Dephillips, M; Derevschikov, A A; Didenko, L; Dietel, T; Djawotho, P; Dogra, S M; Dong, X; Drachenberg, J L; Draper, J E; Du, F; Dunin, V B; Dunlop, J C; Dutta Mazumdar, M R; Eckardt, V; Edwards, W R; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Estienne, M; Fachini, P; Fatemi, R; Fedorisin, J; Feng, A; Filip, P; Finch, E; Fine, V; Fisyak, Y; Fu, J; Gagliardi, C A; Gaillard, L; Ganti, M S; Garcia-Solis, E; Ghazikhanian, V; Ghosh, P; Gorbunov, Y G; Gos, H; Grebenyuk, O; Grosnick, D; Guertin, S M; Guimaraes, K S F F; Gupta, N; Haag, B; Hallman, T J; Hamed, A; Harris, J W; He, W; Heinz, M; Henry, T W; Heppelmann, S; Hippolyte, B; Hirsch, A; Hjort, E; Hoffman, A M; Hoffmann, G W; Hofman, D; Hollis, R; Horner, M J; Huang, H Z; Hughes, E W; Humanic, T J; Igo, G; Iordanova, A; Jacobs, P; Jacobs, W W; Jakl, P; Jia, F; Jones, P G; Judd, E G; Kabana, S; Kang, K; Kapitan, J; Kaplan, M; Keane, D; Kechechyan, A; Kettler, D; Khodyrev, V Yu; Kim, B C; Kiryluk, J; Kisiel, A; Kislov, E M; Klein, S R; Knospe, A G; Kocoloski, A; Koetke, D D; Kollegger, T; Kopytine, M; Kotchenda, L; Kouchpil, V; Kowalik, K L; Kravtsov, P; Kravtsov, V I; Krueger, K; Kuhn, C; Kulikov, A I; Kumar, A; Kurnadi, P; Kuznetsov, A A; Lamont, M A C; Landgraf, J M; Lange, S; Lapointe, S; Laue, F; Lauret, J; Lebedev, A; Lednicky, R; Lee, C-H; Lehocka, S; LeVine, M J; Li, C; Li, Q; Li, Y; Lin, G; Lin, X; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, H; Liu, J; Liu, L; Ljubicic, T; Llope, W J; Longacre, R S; Love, W A; Lu, Y; Ludlam, T; Lynn, D; Ma, G L; Ma, J G; Ma, Y G; Magestro, D; Mahapatra, D P; Majka, R; Mangotra, L K; Manweiler, R; Margetis, S; Markert, C; Martin, L; Matis, H S; Matulenko, Yu A; McClain, C J; McShane, T S; Melnick, Yu; Meschanin, A; Millane, J; Miller, M L; Minaev, N G; Mioduszewski, S; Mironov, C; Mischke, A; Mitchell, J; Mohanty, B; Morozov, D A; Munhoz, M G; Nandi, B K; Nattrass, C; Nayak, T K; Nelson, J M; Nepali, N S; Netrakanti, P K; Nogach, L V; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Pachr, M; Pal, S K; Panebratsev, Y; Pavlinov, A I; Pawlak, T; Peitzmann, T; Perevoztchikov, V; Perkins, C; Peryt, W; Phatak, S C; Planinic, M; Pluta, J; Poljak, N; Porile, N; Poskanzer, A M; Potekhin, M; Potrebenikova, E; Potukuchi, B V K S; Prindle, D; Pruneau, C; Putschke, J; Qattan, I A; Raniwala, R; Raniwala, S; Ray, R L; Relyea, D; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevskiy, O V; Romero, J L; Rose, A; Roy, C; Ruan, L; Russcher, M J; Sahoo, R; Sakrejda, I; Sakuma, T; Salur, S; Sandweiss, J; Sarsour, M; Sazhin, P S; Schambach, J; Scharenberg, R P; Schmitz, N; Seger, J; Selyuzhenkov, I; Seyboth, P; Shabetai, A; Shahaliev, E; Shao, M; Sharma, M; Shen, W Q; Shimanskiy, S S; Sichtermann, E P; Simon, F; Singaraju, R N; Smirnov, N; Snellings, R; Sorensen, P; Sowinski, J; Speltz, J; Spinka, H M; Srivastava, B; Stadnik, A; Stanislaus, T D S; Staszak, D; Stock, R; Strikhanov, M; Stringfellow, B; Suaide, A A P; Suarez, M C; Subba, N L; Sumbera, M; Sun, X M; Sun, Z; Surrow, B; Symons, T J M; Szanto de Toledo, A; Takahashi, J; Tang, A H; Tarnowsky, T; Thomas, J H; Timmins, A R; Timoshenko, S; Tokarev, M; Trainor, T A; Trentalange, S; Tribble, R E; Tsai, O D; Ulery, J; Ullrich, T; Underwood, D G; Van Buren, G; van der Kolk, N; van Leeuwen, M; Vander Molen, A M; Varma, R; Vasilevski, I M; Vasiliev, A N; Vernet, R; Vigdor, S E; Viyogi, Y P; Vokal, S; Voloshin, S A; Waggoner, W T; Wang, F; Wang, G; Wang, J S; Wang, X L; Wang, Y; Watson, J W; Webb, J C; Westfall, G D; Wetzler, A; Whitten, C; Wieman, H; Wissink, S W; Witt, R; Wu, J; Wu, Y; Xu, N; Xu, Q H; Xu, Z; Yepes, P; Yoo, I-K; Yue, Q; Yurevich, V I; Zhan, W; Zhang, H; Zhang, W M; Zhang, Y; Zhang, Z P; Zhao, Y; Zhong, C; Zhou, J; Zoulkarneev, R; Zoulkarneeva, Y; Zubarev, A N; Zuo, J X
2007-05-11
The STAR collaboration at the BNL Relativistic Heavy-Ion Collider (RHIC) reports measurements of the inclusive yield of nonphotonic electrons, which arise dominantly from semileptonic decays of heavy flavor mesons, over a broad range of transverse momenta (1.2<p(T)<10 GeV/c) in p+p, d+Au, and Au+Au collisions at sqrt[s_{NN}]=200 GeV. The nonphotonic electron yield exhibits an unexpectedly large suppression in central Au+Au collisions at high p(T), suggesting substantial heavy-quark energy loss at RHIC. The centrality and p(T) dependences of the suppression provide constraints on theoretical models of suppression.
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Strange baryon resonance production in sqrt s NN=200 GeV p+p and Au+Au collisions.
Abelev, B I; Aggarwal, M M; Ahammed, Z; Amonett, J; Anderson, B D; Anderson, M; Arkhipkin, D; Averichev, G S; Bai, Y; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellingeri-Laurikainen, A; Bellwied, R; Benedosso, F; Bhardwaj, S; Bhasin, A; Bhati, A K; Bichsel, H; Bielcik, J; Bielcikova, J; Bland, L C; Blyth, S-L; Bonner, B E; Botje, M; Bouchet, J; Brandin, A V; Bravar, A; Burton, T P; Bystersky, M; Cadman, R V; Cai, X Z; Caines, H; Calderón de la Barca Sánchez, M; Castillo, J; Catu, O; Cebra, D; Chajecki, Z; Chaloupka, P; Chattopadhyay, S; Chen, H F; Chen, J H; Cheng, J; Cherney, M; Chikanian, A; Christie, W; Coffin, J P; Cormier, T M; Cosentino, M R; Cramer, J G; Crawford, H J; Das, D; Das, S; Dash, S; Daugherity, M; de Moura, M M; Dedovich, T G; DePhillips, M; Derevschikov, A A; Didenko, L; Dietel, T; Djawotho, P; Dogra, S M; Dong, W J; Dong, X; Draper, J E; Du, F; Dunin, V B; Dunlop, J C; Dutta Mazumdar, M R; Eckardt, V; Edwards, W R; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Estienne, M; Fachini, P; Fatemi, R; Fedorisin, J; Filimonov, K; Filip, P; Finch, E; Fine, V; Fisyak, Y; Fu, J; Gagliardi, C A; Gaillard, L; Ganti, M S; Gaudichet, L; Ghazikhanian, V; Ghosh, P; Gonzalez, J E; Gorbunov, Y G; Gos, H; Grebenyuk, O; Grosnick, D; Guertin, S M; Guimaraes, K S F F; Gupta, N; Gutierrez, T D; Haag, B; Hallman, T J; Hamed, A; Harris, J W; He, W; Heinz, M; Henry, T W; Hepplemann, S; Hippolyte, B; Hirsch, A; Hjort, E; Hoffman, A M; Hoffmann, G W; Horner, M J; Huang, H Z; Huang, S L; Hughes, E W; Humanic, T J; Igo, G; Jacobs, P; Jacobs, W W; Jakl, P; Jia, F; Jiang, H; Jones, P G; Judd, E G; Kabana, S; Kang, K; Kapitan, J; Kaplan, M; Keane, D; Kechechyan, A; Khodyrev, V Yu; Kim, B C; Kiryluk, J; Kisiel, A; Kislov, E M; Klein, S R; Kocoloski, A; Koetke, D D; Kollegger, T; Kopytine, M; Kotchenda, L; Kouchpil, V; Kowalik, K L; Kramer, M; Kravtsov, P; Kravtsov, V I; Krueger, K; Kuhn, C; Kulikov, A I; Kumar, A; Kuznetsov, A A; Lamont, M A C; Landgraf, J M; Lange, S; LaPointe, S; Laue, F; Lauret, J; Lebedev, A; Lednicky, R; Lee, C-H; Lehocka, S; LeVine, M J; Li, C; Li, Q; Li, Y; Lin, G; Lin, X; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, H; Liu, J; Liu, L; Liu, Z; Ljubicic, T; Llope, W J; Long, H; Longacre, R S; Love, W A; Lu, Y; Ludlam, T; Lynn, D; Ma, G L; Ma, J G; Ma, Y G; Magestro, D; Mahapatra, D P; Majka, R; Mangotra, L K; Manweiler, R; Margetis, S; Markert, C; Martin, L; Matis, H S; Matulenko, Yu A; McClain, C J; McShane, T S; Melnick, Yu; Meschanin, A; Millane, J; Miller, M L; Minaev, N G; Mioduszewski, S; Mironov, C; Mischke, A; Mishra, D K; Mitchell, J; Mohanty, B; Molnar, L; Moore, C F; Morozov, D A; Munhoz, M G; Nandi, B K; Nattrass, C; Nayak, T K; Nelson, J M; Netrakanti, P K; Nogach, L V; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Pachr, M; Pal, S K; Panebratsev, Y; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Peitzmann, T; Perevoztchikov, V; Perkins, C; Peryt, W; Phatak, S C; Picha, R; Planinic, M; Pluta, J; Poljak, N; Porile, N; Porter, J; Poskanzer, A M; Potekhin, M; Potrebenikova, E; Potukuchi, B V K S; Prindle, D; Pruneau, C; Putschke, J; Rakness, G; Raniwala, R; Raniwala, S; Ray, R L; Razin, S V; Reinnarth, J; Relyea, D; Retiere, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevskiy, O V; Romero, J L; Rose, A; Roy, C; Ruan, L; Russcher, M J; Sahoo, R; Sakuma, T; Salur, S; Sandweiss, J; Sarsour, M; Sazhin, P S; Schambach, J; Scharenberg, R P; Schmitz, N; Schweda, K; Seger, J; Selyuzhenkov, I; Seyboth, P; Shabetai, A; Shahaliev, E; Shao, M; Sharma, M; Shen, W Q; Shimanskiy, S S; Sichtermann, E; Simon, F; Singaraju, R N; Smirnov, N; Snellings, R; Sood, G; Sorensen, P; Sowinski, J; Speltz, J; Spinka, H M; Srivastava, B; Stadnik, A; Stanislaus, T D S; Stock, R; Stolpovsky, A; Strikhanov, M; Stringfellow, B; Suaide, A A P; Sugarbaker, E; Sumbera, M; Sun, Z; Surrow, B; Swanger, M; Symons, T J M; Szanto de Toledo, A; Tai, A; Takahashi, J; Tang, A H; Tarnowsky, T; Thein, D; Thomas, J H; Timmins, A R; Timoshenko, S; Tokarev, M; Trainor, T A; Trentalange, S; Tribble, R E; Tsai, O D; Ulery, J; Ullrich, T; Underwood, D G; Buren, G Van; van der Kolk, N; van Leeuwen, M; Molen, A M Vander; Varma, R; Vasilevski, I M; Vasiliev, A N; Vernet, R; Vigdor, S E; Viyogi, Y P; Vokal, S; Voloshin, S A; Waggoner, W T; Wang, F; Wang, G; Wang, J S; Wang, X L; Wang, Y; Watson, J W; Webb, J C; Westfall, G D; Wetzler, A; Whitten, C; Wieman, H; Wissink, S W; Witt, R; Wood, J; Wu, J; Xu, N; Xu, Q H; Xu, Z; Yepes, P; Yoo, I-K; Yurevich, V I; Zhan, W; Zhang, H; Zhang, W M; Zhang, Y; Zhang, Z P; Zhao, Y; Zhong, C; Zoulkarneev, R; Zoulkarneeva, Y; Zubarev, A N; Zuo, J X
2006-09-29
We report the measurements of Sigma(1385) and Lambda(1520) production in p+p and Au+Au collisions at sqrt[s{NN}]=200 GeV from the STAR Collaboration. The yields and the p(T) spectra are presented and discussed in terms of chemical and thermal freeze-out conditions and compared to model predictions. Thermal and microscopic models do not adequately describe the yields of all the resonances produced in central Au+Au collisions. Our results indicate that there may be a time span between chemical and thermal freeze-out during which elastic hadronic interactions occur.
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42 CFR 405.410 - Conditions for properly opting-out of Medicare.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Conditions for properly opting-out of Medicare. 405.410 Section 405.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts...
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Financial and quality impacts of the Medicare physician group practice demonstration.
Pope, Gregory; Kautter, John; Leung, Musetta; Trisolini, Michael; Adamache, Walter; Smith, Kevin
2014-01-01
To examine the impact of the Medicare Physician Group Practice (PGP) demonstration on expenditure, utilization, and quality outcomes. Secondary data analysis of 2001-2010 Medicare claims for 1,776,387 person years assigned to the ten participating provider organizations and 1,579,080 person years in the corresponding local comparison groups. We used a pre-post comparison group observational design consisting of four pre-demonstration years (1/01-12/04) and five demonstration years (4/05-3/10). We employed a propensity-weighted difference-in-differences regression model to estimate demonstration effects, adjusting for demographics, health status, geographic area, and secular trends. The ten demonstration sites combined saved $171 (2.0%) per assigned beneficiary person year (p<0.001) during the five-year demonstration period. Medicare paid performance bonuses to the participating PGPs that averaged $102 per person year. The net savings to the Medicare program were $69 (0.8%) per person year. Demonstration savings were achieved primarily from the inpatient setting. The demonstration improved quality of care as measured by six of seven claims-based process quality indicators. The PGP demonstration, which used a payment model similar to the Medicare Accountable Care Organization (ACO) program, resulted in small reductions in Medicare expenditures and inpatient utilization, and improvements in process quality indicators. Judging from this demonstration experience, it is unlikely that Medicare ACOs will initially achieve large savings. Nevertheless, ACOs paid through shared savings may be an important first step toward greater efficiency and quality in the Medicare fee-for-service program.
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NASA Astrophysics Data System (ADS)
Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Becker, B.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Busza, W.; Carroll, A.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Harrington, A. S.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Khan, N.; Kulinich, P.; Kuo, C. M.; Lee, J. W.; Lin, W. T.; Manly, S.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Roland, C.; Roland, G.; Sagerer, J.; Sarin, P.; Sedykh, I.; Skulski, W.; Smith, C. E.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tonjes, M. B.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Veres, G. I.; Wolfs, F. L. H.; Wosiek, B.; Woźniak, K.; Wysłouch, B.; Zhang, J.
Transverse momentum spectra of charged hadrons with pT < 6 GeV/c have been measured near mid-rapidity (0.2 < ɛ < 1.4) by the PHOBOS experiment at RHIC in Au + Au and d + Au collisions at {√ {s{NN}} = {200 GeV}}. The spectra for different collision centralities are compared to {p + ¯ {p}} collisions at the same energy. The resulting nuclear modification factor for central Au + Au collisions shows evidence of strong suppression of charged hadrons in the high-pT region (>2 GeV/c). In contrast, the d + Au nuclear modification factor exhibits no suppression of the high-pT yields. These measurements suggest a large energy loss of the high-pT particles in the highly interacting medium created in the central Au + Au collisions. The lack of suppression in d + Au collisions suggests that it is unlikely that initial state effects can explain the suppression in the central Au + Au collisions. PACS: 25.75.-q
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Practice arrangement and medicare physician payment in otolaryngology.
Cracchiolo, Jennifer; Ridge, John A; Egleston, Brian; Lango, Miriam
2015-06-01
Medicare Part B physician payment indicates a cost to Medicare beneficiaries for a physician service and connotes physician clinical productivity. The objective of this study was to determine whether there was an association between practice arrangement and Medicare physician payment. Cross-sectional study. Medicare provider utilization and payment data. Otolaryngologists from 1 metropolitan area were included as part of a pilot study. A generalized linear model was used to determine the effect of practice-specific variables including patient volumes on physician payment. Of 67 otolaryngologists included, 23 (34%) provided services through an independent practice, while others were employed by 1 of 3 local academic centers. Median payment was $58,895 per physician for the year, although some physicians received substantially higher payments. Reimbursements to faculty at 1 academic department were higher than to those at other institutions or to independent practitioners. After adjustments were made for patient volumes, physician subspecialty, and gender, payments to each faculty at Hospital C were 2 times higher than to those at Hospital A (relative ratio [RR] 2.03; 95% CI, 1.27-3.27; P = .003); 2 times higher than to faculty at Hospital B (RR 2.04; 95% CI, 1.4-2.7; P = .0001); and 1.6 times higher than to independent practitioners (RR 1.6; 95% CI, 1.04-2.7; P = .03). Payments to physicians in the other groups were not significantly different. Differences in reimbursement corresponded to an emphasis on procedures over office visits but not Medicare case mix adjustments for patient discharges from associated institutions. Variation in the cost of academic otolaryngology care may be subject in part to institutional factors. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
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46 CFR 151.03-38 - Nondestructive testing.
Code of Federal Regulations, 2011 CFR
2011-10-01
... examination, radiographic examination, eddy current, and acoustic emission. [CGD 85-061, 54 FR 50965, Dec. 11... 46 Shipping 5 2011-10-01 2011-10-01 false Nondestructive testing. 151.03-38 Section 151.03-38... CARRYING BULK LIQUID HAZARDOUS MATERIAL CARGOES Definitions § 151.03-38 Nondestructive testing...
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46 CFR 151.03-38 - Nondestructive testing.
Code of Federal Regulations, 2012 CFR
2012-10-01
... examination, radiographic examination, eddy current, and acoustic emission. [CGD 85-061, 54 FR 50965, Dec. 11... 46 Shipping 5 2012-10-01 2012-10-01 false Nondestructive testing. 151.03-38 Section 151.03-38... CARRYING BULK LIQUID HAZARDOUS MATERIAL CARGOES Definitions § 151.03-38 Nondestructive testing...
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46 CFR 151.03-38 - Nondestructive testing.
Code of Federal Regulations, 2013 CFR
2013-10-01
... examination, radiographic examination, eddy current, and acoustic emission. [CGD 85-061, 54 FR 50965, Dec. 11... 46 Shipping 5 2013-10-01 2013-10-01 false Nondestructive testing. 151.03-38 Section 151.03-38... CARRYING BULK LIQUID HAZARDOUS MATERIAL CARGOES Definitions § 151.03-38 Nondestructive testing...
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46 CFR 151.03-38 - Nondestructive testing.
Code of Federal Regulations, 2014 CFR
2014-10-01
... examination, radiographic examination, eddy current, and acoustic emission. [CGD 85-061, 54 FR 50965, Dec. 11... 46 Shipping 5 2014-10-01 2014-10-01 false Nondestructive testing. 151.03-38 Section 151.03-38... CARRYING BULK LIQUID HAZARDOUS MATERIAL CARGOES Definitions § 151.03-38 Nondestructive testing...
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76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-03
... interest by November 15, 2011 using the LOI template provided on the Innovation Center Web site at http://www.innovation.cms.gov /. Application Submission Deadline: Applications must be received through an... practice redesign in primary care through payment reform. The Center for Medicare & Medicaid Innovation...
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What Incentives Are Created by Medicare Payments for Total Hip Arthroplasty?
Clement, R Carter; Soo, Adrianne E; Kheir, Michael M; Derman, Peter B; Flynn, David N; Levin, L Scott; Fleisher, Lee A
2016-09-01
Differences in profitability and contribution margin (CM) between various patient populations may make certain patients particularly attractive (or unattractive) to providers. This study seeks to identify patient characteristics associated with increased profit and CM among Medicare patients undergoing total hip arthroplasty (THA). The expected Medicare reimbursement for consecutive patients of Medicare-eligible age (65+ years) undergoing primary unilateral elective THA (n = 498) was calculated in accordance with Center for Medicare and Medicaid Services policy. Costs were derived from the hospital's cost accounting system. Profit and CM were calculated for each patient as reimbursement less total and variable costs, respectively. Patients were compared based on clinical and demographic factors by univariate and multivariate analyses. Medicare patients undergoing THA generated negative average profits but substantial positive CMs. Lower profit and CM were associated with higher American Society of Anesthesiologists Physical Status Classification (P < .01, P = .03), older age (P < .01), and longer length of stay (P < .01, P = .03). No association was found with gender, body mass index, or race. If our results are generalizable, Medicare patients requiring THA are currently financially attractive, but institutions have a long-term incentive to shift resources to more profitable patients and service lines, which may eventually restrict access to care for this population. THA providers have a financial incentive to favor Medicare patients with younger age, lower American Society of Anesthesiologists Physical Status Classification, and those who can be expected to require relatively short admissions. The Center for Medicare and Medicaid Services must strive to accurately match reimbursement rates to provider costs to avoid inequitable payments to providers and financial incentives discouraging treatment of high-risk patients or other patient subpopulations. Copyright
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-21
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2011-04-14
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... for receiving health services If you have other health insurance Contacting Social Security 1 1 3 7 8 ... 2048 What is Medicare? Medicare is our country’s health insurance program for people age 65 or older. People ...
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..., Department of Health and Human Services, Attention: CMS-1599-IFC, P.O. Box 8013, Baltimore, MD 21244-8013... for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1599-IFC... receive Supplemental Security Income (SSI) benefits and their Medicaid utilization. Under section 1886(r...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-31
...-crm-510.html . \\10\\ Department of Justice, ``Owners of Miami Home Health Companies Sentenced to Prison in $48 million Health Care Fraud Scheme.'' See http://www.justice.gov/opa/pr/2013/February/13-crm-243... Convicted in Medicare Fraud Scheme.'' See http://www.justice.gov/opa/pr/2013/March/13-crm-273.html . \\24...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-30
...-10-0015C; FR] RIN 0581-AD03 Softwood Lumber Research, Promotion, Consumer Education and Industry.... Pello, Marketing Specialist, Research and Promotion Division, Fruit and Vegetable Programs, AMS, USDA, P... Softwood Lumber Research, Promotion, Consumer Education and Industry Information Order (Order). The purpose...
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Baicker, Katherine; Shepard, Mark; Skinner, Jonathan
2013-05-01
The US Medicare program consumes an ever-rising share of the federal budget. Although this public spending can produce health and social benefits, raising taxes to finance it comes at the cost of slower economic growth. In this article we describe a model incorporating the benefits of public programs and the cost of tax financing. The model implies that the "one-size-fits-all" Medicare program, with everyone covered by the same insurance policy, will be increasingly difficult to sustain. We show that a Medicare program with guaranteed basic benefits and the option to purchase additional coverage could lead to more unequal health spending but slower growth in taxation, greater overall well-being, and more rapid growth of gross domestic product. Our framework highlights the key trade-offs between Medicare spending and economic prosperity.
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Epitaxial growth of a mono-crystalline metastable AuIn layer at the Au/InP(001) interface
NASA Astrophysics Data System (ADS)
Renda, M.; Morita, K.
1990-01-01
Thermal annealing of a gold layer deposited on the InP(001)-p(2×4) surface has been studied in-situ by means of LEED, AES and RBS techniques and by post analysis of RBS-channeling and glancing incidence X-ray diffraction. A clean LEED pattern of p(2×2) spots was observed for the specimen annealed for 10 min at 300°C. The composition ratio of Au/In in the epitaxial compound layer was found to be 49/51 by RBS and several at% of P was also detected by post sputter-AES analysis. It was also found that the epitaxial layer shows a clear channeling dip for an incident ion beam which is aligned along the <001> axis of InP substrate. The glancing incidence X-ray diffraction analysis indicates diffraction peaks from the pseudo-orthorombic phase of AuIn. From these experimental results, it is concluded that the epitaxial Au-compound layer is a mono-crystalline metastable phase of AuIn, of which every three atomic rows of Au or In in the [110] direction would be situated on every four atomic rows in the [010] direction of the In(001) face of the InP crystal.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-26
... stent facilities. Included in this notice is a list of the American College of Cardiology's National... 21244-1850, or you can call (410) 786-6962. Questions concerning Medicare-approved carotid stent... 20 of the CFR. Addendum VIII includes listings of Medicare-approved carotid stent facilities. All...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-24
...- approved carotid stent facilities. Included in this notice is a list of the American College of Cardiology... 21244-1850, or you can call (410) 786-6962. Questions concerning Medicare-approved carotid stent... listings of Medicare-approved carotid stent facilities. All facilities listed meet CMS standards for...
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Swing-bed services under the Medicare program, 1984-87
Silverman, Herbert A.
1990-01-01
Under Medicare, swing beds are beds that can be used by small rural hospitals to furnish both acute and post-acute care. The swing-bed program was instituted under the provisions of the Omnibus Reconciliation Act of 1980 (Public Law 96-499). Under Medicare, post-acute care in the hospital would be covered as services equivalent to skilled nursing facility level of care. Data show that the program has had a rapid rate of growth. By 1987, swing beds accounted for 9.7 percent of the admissions to skilled nursing facility services, 6.0 percent of the covered days of care, and 6.2 percent of the reimbursements. Over one-half of the swing-bed services are furnished in the North Central States. PMID:10113275
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-26
... forth in 42 CFR 414.402 will be used to determine what items will be included in the competitions. These..., regardless of the method of delivery. Non-Mail Order Item--Any item that a beneficiary or caregiver picks up... what Medicare pays for mail order supplies versus non-mail order supplies may encourage fraud and abuse...
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K(892)* resonance production in Au+Au and p+p collisions at {radical}s{sub NN} = 200 GeV at RHIC
DOE Office of Scientific and Technical Information (OSTI.GOV)
Adams, J.; Aggarwal, M.M.; Ahammed, Z.
2004-12-09
The short-lived K(892)* resonance provides an efficient tool to probe properties of the hot and dense medium produced in relativistic heavy-ion collisions. We report measurements of K* in {radical}s{sub NN} = 200 GeV Au+Au and p+p collisions reconstructed via its hadronic decay channels K(892)*{sup 0} {yields} K{pi} and K(892)*{sup +-} {yields} K{sub S}{sup 0}{pi}{sup +-} using the STAR detector at RHIC. The K*{sup 0} mass has been studied as function of p{sub T} in minimum bias p + p and central Au+Au collisions. The K* p{sub T} spectra for minimum bias p + p interactions and for Au+Au collisions inmore » different centralities are presented. The K*/K ratios for all centralities in Au+Au collisions are found to be significantly lower than the ratio in minimum bias p + p collisions, indicating the importance of hadronic interactions between chemical and kinetic freeze-outs. The nuclear modification factor of K* at intermediate p{sub T} is similar to that of K{sub S}{sup 0}, but different from {Lambda}. This establishes a baryon-meson effect over a mass effect in the particle production at intermediate p{sub T} (2 < p{sub T} {le} 4 GeV/c). A significant non-zero K*{sup 0} elliptic flow (v{sub 2}) is observed in Au+Au collisions and compared to the K{sub S}{sup 0} and {Lambda} v{sub 2}.« less
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NASA Technical Reports Server (NTRS)
Sako, H.; Ahle, L.; Akiba, Y.; Ashktorab, K.; Baker, M. D.; Beavis, D.; Britt, H. C.; Chang, J.; Chasman, C.; Chen, Z.;
1997-01-01
Antiproton production in heavy ion collisions reflects subtle interplay between initial production and absorption by nucleons. Because the AGS energies (10--20 A(center-dot)GeV/c) are close to the antiproton production threshold, antiproton may be sensitive to cooperative processes such as QGP and hadronic multi-step processes. On the other hand, antiproton has been proposed as a probe of baryon density due to large N(anti N) annihilation cross sections. Cascade models predict the maximum baryon density reaches about 10 times the normal nucleus density in central Au+Au collisions, where the strong antiproton absorption is expected. In this paper, the authors show systematic studies of antiproton production from p+A to Au+Au collisions.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-05
... furnished to Medicare beneficiaries). A dentist furnishes many services that are not covered by Medicare and, as a result, most dentists are not enrolled in Medicare. However, a dentist may order services for...
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Capitation among Medicare beneficiaries.
Bazos, D A; Fisher, E S
1999-01-01
The Medicare program has promoted capitation as a way to contain costs. About 15% of Medicare beneficiaries nationwide are currently under capitation, but tremendous regional variation exists. The proportion of Medicare beneficiaries who have enrolled in risk-contract plans in individual states and in the 25 largest metropolitan areas in the United States. Health Care Financing Administration data files. Medicare beneficiaries are most likely to be under capitation in Arizona (38%) and California (37%). Eight other states have capitation rates greater than 20%: Colorado, Florida, Rhode Island, Oregon, Washington, Pennsylvania, Massachusetts, and Nevada. Thirty states, largely in the Great Plains area and the southern United States, have capitation rates less than 10%. Four major metropolitan areas have market penetration rates greater than 40%: San Bernardino, California; San Diego, California; Phoenix, Arizona; and Miami, Florida. Little penetration exists outside of metropolitan areas. Capitation in Medicare is a regional and predominantly an urban phenomenon.
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Geographic variation in Medicare and the military healthcare system.
Adesoye, Taiwo; Kimsey, Linda G; Lipsitz, Stuart R; Nguyen, Louis L; Goodney, Philip; Olaiya, Samuel; Weissman, Joel S
2017-08-01
To compare geographic variation in healthcare spending and utilization between the Military Health System (MHS) and Medicare across hospital referral regions (HRRs). Retrospective analysis. Data on age-, sex-, and race-adjusted Medicare per capita expenditure and utilization measures by HRR were obtained from the Dartmouth Atlas for 2007 to 2010. Similarly, adjusted data from 2007 and 2010 were obtained from the MHS Data Repository and patients assigned to HRRs. We compared high- and low-spending regions, and computed coefficient of variation (CoV) and correlation coefficients for healthcare spending, hospital inpatient days, hip surgery, and back surgery between MHS and Medicare patients. We found significant variation in spending and utilization across HRRs in both the MHS and Medicare. CoV for spending was higher in the MHS compared with Medicare, (0.24 vs 0.15, respectively) and CoV for inpatient days was 0.36 in the MHS versus 0.19 in Medicare. The CoV for back surgery was also greater in the MHS compared with Medicare (0.47 vs 0.29, respectively). Per capita Medicare spending per HRR was significantly correlated to adjusted MHS spending (r = 0.3; P <.0001). Correlation in inpatient days (r = 0.29; P <.0001) and back surgery (r = 0.52; P <.0001) was also significant. Higher spending markets in both systems were not comparable; lower spending markets were located mostly in the Midwest. In comparing 2 systems with similar pricing schemes, differences in spending likely reflect variation in utilization and the influence of local provider culture.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-24
... Provider Organizations for a term of 6 years. DATES: This final notice is effective through July 10, 2018... financially affiliated with the entity being surveyed. A description of the organization's data management and... Health Care, Inc. for Medicare Advantage Health Maintenance Organizations and Local Preferred Provider...
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Baicker, Katherine; Shepard, Mark; Skinner, Jonathan
2013-01-01
The US Medicare program consumes an ever-rising share of the federal budget. Although this public spending can produce health and social benefits, raising taxes to finance it comes at the cost of slower economic growth. In this article we describe a model incorporating the benefits of public programs and the cost of tax financing. The model implies that the “one-size-fits-all” Medicare program, with everyone covered by the same insurance policy, will be increasingly difficult to sustain. We show that a Medicare program with guaranteed basic benefits and the option to purchase additional coverage could lead to more unequal health spending but slower growth in taxation, greater overall well-being, and more rapid growth of gross domestic product. Our framework highlights the key trade-offs between Medicare spending and economic prosperity. PMID:23650321
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Federal Register 2010, 2011, 2012, 2013, 2014
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.
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The Medicare Health Outcomes Survey program: overview, context, and near-term prospects.
Jones, Nathaniel; Jones, Stephanie L; Miller, Nancy A
2004-07-12
In 1996, the Centers for Medicare & Medicaid Services (CMS) initiated the Medicare Health Outcomes Survey (HOS). It is the first national survey to measure the quality of life and functional health status of Medicare beneficiaries enrolled in managed care. The program seeks to gather valid and reliable health status data in Medicare managed care for use in quality improvement activities, public reporting, plan accountability and improving health outcomes based on competition. The context that led to the development of the HOS was formed by the convergence of the following factors: 1) a recognized need to monitor the performance of managed care plans, 2) technical expertise and advancement in the areas of quality measurement and health outcomes assessment, 3) the existence of a tested functional health status assessment tool (SF-36)1, which was valid for an elderly population, 4) CMS leadership, and 5) political interest in quality improvement. Since 1998, there have been six baseline surveys and four follow up surveys. CMS, working with its partners, performs the following tasks as part of the HOS program: 1) Supports the technical/scientific development of the HOS measure, 2) Certifies survey vendors, 3) Collects Health Plan Employer Data and Information Set(HEDIS)2 HOS data, 4) Cleans, scores, and disseminates annual rounds of HOS data, public use files and reports to CMS, Quality Improvement Organizations (QIOs), Medicare+Choice Organizations (M+COs), and other stakeholders, 5) Trains M+COs and QIOs in the use of functional status measures and best practices for improving care, 6) Provides technical assistance to CMS, QIOs, M+COs and other data users, and 7) Conducts analyses using HOS data to support CMS and HHS priorities.CMS has recently sponsored an evaluation of the HOS program, which will provide the information necessary to enhance the future administration of the program. Information collected to date reveals that the HOS program is a valuable tool that
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Connected Au network in annealed Ni/Au thin films on p-GaN
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lee, S. P.; Jang, H. W.; Noh, D. Y.
2007-11-12
We report the formation of a connected Au network in annealed Ni/Au thin films on p-GaN, which was studied by scanning electron microscopy, transmission electron microscopy, and synchrotron x-ray diffraction. As the Ni was oxidized into NiO upon annealing at 530 deg. C in air, the Au layer was transformed to an interconnected network with an increased thickness. During annealing, Ni atoms diffuse out onto the Au through defects to form NiO, while Au atoms replace the Ni positions. The Au network grows downward until it reaches the p-GaN substrate, and NiO columns fill the space between the Au network.
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Half-life of {sup 221}Fr in Si and Au at 4 K and at millikelvin temperatures
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wauters, F.; Breitenfeldt, M.; De Leebeeck, V.
2010-12-15
The half-life of the {alpha}-decaying nucleus {sup 221}Fr was determined in different environments, that is, embedded in Si at 4 K, and embedded in Au at 4 K and about 20 mK. No differences in half-life for these different conditions were observed within 0.1%. Furthermore, we quote a value for the absolute half-life of {sup 221}Fr of t{sub 1/2}=286.1(10) s that is of comparable precision to the most precise value available in the literature.
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42 CFR 460.180 - Medicare payment to PACE organizations.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Medicare payment to PACE organizations. 460.180... FOR THE ELDERLY (PACE) Payment § 460.180 Medicare payment to PACE organizations. (a) Principle of payment. Under a PACE program agreement, CMS makes a prospective monthly payment to the PACE organization...
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Medicare Advantage: Issues, Insights, and Implications for the Future
Cotton, Paul; Newhouse, Joseph P.; Volpp, Kevin G.; Fendrick, A. Mark; Oesterle, Susan Lynne; Oungpasuk, Pat; Aggarwal, Ruchi; Wilensky, Gail; Sebelius, Kathleen
2016-01-01
Medicare Advantage: Issues, Insights, and Implications for the Future Paul Cotton, Joseph P. Newhouse, PhD, Kevin G. Volpp, MD, PhD, A. Mark Fendrick, MD, Susan Lynne Oesterle, Pat Oungpasuk, Ruchi Aggarwal, Gail Wilensky, PhD, and Kathleen Sebelius Editorial S-2 D.B. Nash, and A.Y. Schwartz The History, Impact, and Future of the Medicare Advantage Star Ratings System S-3 P. Cotton Medicare Advantage and Traditional Fee-For-Service Medicare S-4 J.P. Newhouse Behavioral Economics: Key to Effective Care Management Programs for Patients, Payers, and Providers S-5 K.G. Volpp Value-Based Insurance Design: A Promising Strategy for Medicare Advantage S-6 A.M. Fendrick, S.L. Oesterle, P. Oungpasuk, and R. Aggarwal Two Perspectives on the Future of Medicare Advantage S-7 G. Wilensky and K. Sebelius PMID:27834576
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Code of Federal Regulations, 2010 CFR
2010-10-01
..., home health services, and hospice care. [48 FR 56026, Dec. 16, 1983, as amended at 50 FR 33033, Aug. 16... 42 Public Health 2 2010-10-01 2010-10-01 false Scope. 406.2 Section 406.2 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-20
... on the Innovation Center Web site http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated... Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Mail Stop S3-13-05, 7500... and Medicaid Innovation (Innovation Center). The Pioneer ACO Model is an Innovation Center initiative...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-10
...This final rule updates and makes certain revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2012. We are also finalizing the interim final rule with comment period published on April 6, 2011, regarding the transition budget-neutrality adjustment under the ESRD PPS,. This final rule also sets forth requirements for the ESRD quality incentive program (QIP) for payment years (PYs) 2013 and 2014. In addition, this final rule revises the ambulance fee schedule regulations to conform to statutory changes. This final rule also revises the definition of durable medical equipment (DME) by adding a 3-year minimum lifetime requirement (MLR) that must be met by an item or device in order to be considered durable for the purpose of classifying the item under the Medicare benefit category for DME. Finally, this final rule implements certain provisions of section 154 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) related to the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) Competitive Acquisition Program and responds to comments received on an interim final rule published January 16, 2009, that implemented these provisions of MIPPA effective April 18, 2009. (See the Table of Contents for a listing of the specific issues addressed in this final rule.)
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75 FR 49029 - Medicare Program; End-Stage Renal Disease Prospective Payment System
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-12
...This final rule implements a case-mix adjusted bundled prospective payment system (PPS) for Medicare outpatient end-stage renal disease (ESRD) dialysis facilities beginning January 1, 2011 (ESRD PPS), in compliance with the statutory requirement of the Medicare Improvements for Patients and Providers Act (MIPPA), enacted July 15, 2008. This ESRD PPS also replaces the current basic case-mix adjusted composite payment system and the methodologies for the reimbursement of separately billable outpatient ESRD services.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-15
... list of topics that we have proposed to the Committee. The list of research topics to be discussed at... information about this topic, including panel ma- terials, is available at http://www.cms.gov/medicare...) of any items or services being discussed. The Committee will deliberate openly on the topics under...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-11
... April 15, 2011. Your comments should focus on issues specific to the list of topics that we have proposed to the Committee. The list of research topics to be discussed at the meeting will be available on... information about this topic, including panel materials, is available at http://www.cms.gov/medicare-coverage...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-24
...] Medicare Program; Town Hall Meeting on the Physician Compare Web Site, October 27, 2010 AGENCY: Centers for... establish a Physician Compare Web site by January 1, 2011. This notice announces a Town Hall meeting to discuss the Physician Compare Web site. The purpose of this Town Hall meeting is to solicit input from...
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Les facteurs associés à l'infection au cours de la polyarthrite rhumatoïde
Akasbi, Nessrine; Tahiri, Latifa; Houssaini, Ghita Sqalli; Harzy, Taoufik
2013-01-01
Les complications infectieuses sont redoutables au cours de la polyarthrite rhumatoïde (PR). Le but de notre étude est d'estimer leur fréquence et de déterminer les facteurs associés à l'infection chez ces patients. Il s'agit d'une étude rétrospective incluant les cas de PR établis recensés entre 2007 et 2011 au service de rhumatologie au CHU Hassan II de Fès au Maroc. Nous avons inclu 164 patients atteint de PR, l’âge moyen des patients était de 47,9 ans, avec une prédominance féminine (137 F/27H). La fréquence des infections dans notre série était de 26,2%, dominées par les infections urogénitales (22 cas), pleuro pulmonaires (11 cas) dont 2 cas de tuberculose pulmonaire et un cas d'infection H1N1, 3 cas d'infections cutanées et 4 cas d'arthrite septiques. Dans notre série 127 patients étaient sous corticothérapie orale, 147 patients étaient sous méthotrexate, 25 patients étaient sous rituximab et 8 patients étaient sous tocilizumab. Dans notre étude, les facteurs associés à la survenue d'infection étaient l’âge avancé (p= 0,02), une CRP élevée (p= 0,04) et une dose de corticothérapie - 7.5 mg/j (p= 0,03). Notre étude a mis en évidence certains facteurs associés à la survenue d'une infection au cours de la PR. En connaissant ces facteurs, il faut instaurer une surveillance particulière pour améliorer la qualité de prise en charge. PMID:25120853
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-25
...] Medicare Program; Request for Information To Aid in the Design and Development of a Survey Regarding..., well-designed Hospice Survey will allow us to understand: (1) Patient experiences throughout their... accordance with CAHPS[supreg] Survey Design Principles and implementation instructions will be based on those...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-19
... Vol. 76 Monday, No. 243 December 19, 2011 Part II Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 402 and 403 Medicare, Medicaid, Children's Health...; [[Page 78742
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Positron transport studies at the Au - (InP:Fe) interface
NASA Astrophysics Data System (ADS)
Au, H. L.; Lee, T. C.; Beling, C. D.; Fung, S.
1996-03-01
Positron mobility and lifetime measurements have been carried out on semi-insulating Fe-doped InP samples with Au contacts used for electric field application. The lifetime measurements, with electric fields directed towards the Au - InP:Fe interface, reveal no component associated with interfacial open-volume sites and thus give no evidence of any positron mobility. The mobility measurements, made using the Doppler-shifted annihilation radiation technique, however, reveal a temperature independent positron mobility of about 0953-8984/8/10/012/img1 in the range 150 - 300 K. These observations, together with results from I - V analysis, are discussed with reference to two possible band-bending schemes. The first, which requires an ionized shallow donor region adjacent to the Au - InP interface, seems less plausible on a number of grounds. In the second, however, an 0953-8984/8/10/012/img2 negative space charge produces an adverse diffusion barrier for positrons approaching the interface together with a non-uniform electric field in the samples capable of explaining the observed mobility results.
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1992-05-04
This final rule sets forth the procedures to be followed for collection of past-due amounts owed by individuals who breached contracts under certain scholarship and loan programs. The programs that would be affected are the National Health Service Corps Scholarship, the Physician Shortage Area Scholarship, and the Health Education Assistance Loan. These procedures would apply to those individuals who breached contracts under the scholarship and loan programs and who-- Accept Medicare assignment for services; Are employed by or affiliated with a provider, Health Maintenance Organization, or Competitive Medical Plan that receives Medicare payment for services; or Are members of a group practice that receives Medicare payment for services. This regulation implements section 1892 of the Social Security Act, as added by section 4052 of the Omnibus Budget Reconciliation Act of 1987.
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2010-04-23
This final rule will permit a waiver of a nurse aide training disapproval as it applies to skilled nursing facilities, in the Medicare program, and nursing facilities, in the Medicaid program, that are assessed a civil money penalty of at least $5,000 for noncompliance that is not related to quality of care. This is a statutory provision enacted by section 932 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173, enacted December 8, 2003).
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42 CFR 406.7 - Forms to apply for entitlement under Medicare Part A.
Code of Federal Regulations, 2010 CFR
2010-10-01
... supplementary medical insurance program.) CMS-43—Application for Health Insurance Benefits under Medicare for... 42 Public Health 2 2010-10-01 2010-10-01 false Forms to apply for entitlement under Medicare Part A. 406.7 Section 406.7 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...
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Kenney, G; Rajan, S
2000-01-01
Both the Medicare and Medicaid programs have experienced considerable growth in spending on home care in recent years. As policymakers adopt measures (such as those legislated in the Balanced Budget Act of 1997) to curb the rate of spending growth on home care services, it is important to understand interactions between the Medicare and Medicaid home care programs in serving the dually enrolled population. This study examines the potential effects of the Medicaid home care program on Medicare home health utilization using multivariate models. The study relied on data from the Health Care Financing Administration's Medicare Current Beneficiary Survey (MCBS), a longitudinal survey of Medicare enrollees. The primary MCBS file used was from Round 1 of the survey, which was fielded between September and December 1991. The unit of analysis was individuals. The authors used descriptive and multivariate methods to explore the relationship between Medicare coverage and state home care program characteristics. Included were variables that have been found to be significant determinants of Medicare home health utilization in other studies as well as variables to indicate the availability and generosity of Medicaid home care services in each state represented in the survey. The findings were consistent with those of previous studies, in that dual enrollees were disproportionate users of Medicare home health services, accounting for only 16% of enrollees but receiving 40% of all visits. In addition, lower levels of Medicare home health use were observed in states with relatively higher Medicaid spending on home health and personal care services, but this relationship appeared to be heavily dominated by the inclusion of enrollees living in New York State. When individuals from New York were excluded from the analysis, we found a negative but statistically significant relationship between Medicaid outlays on home health and personal care services and Medicare home health
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-27
... Education (APOE), December 18, 2012 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION... open to the public. DATES: Meeting Date: Tuesday, December 18, 2012, 8:30 a.m. to 4:00 p.m. Eastern... Yee-Melichar, Professor & Coordinator, San Francisco State University. The agenda for the December 18...
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Lateral spreading of Au contacts on InP
NASA Technical Reports Server (NTRS)
Fatemi, Navid S.; Weizer, Victor G.
1990-01-01
The contact spreading phenomenon observed when small area Au contacts on InP are annealed at temperatures above about 400 C was investigated. It was found that the rapid lateral expansion of the contact metallization which consumes large quantities of InP during growth is closely related to the third stage in the series of solid state reactions that occur between InP and Au, i.e., to the Au3In-to-Au9In4 transition. Detailed descriptions are presented of both the spreading process and the Au3In-to-Au9In4 transition along with arguments that the two processes are manifestations of the same basic phenomenon.
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Ryan, Andrew M; Damberg, Cheryl L
2013-06-01
The Medicare program has implemented pay-for-performance (P4P), or Value-Based Purchasing, for inpatient care and for Medicare Advantage plans, and plans to implement a program for physicians in 2015. In this paper, we review evidence on the effectiveness of P4P and identify design criteria deemed to be best practice in P4P. We then assess the extent to which Medicare's existing and planned Value-Based Purchasing programs align with these best practices. Of the seven identified best practices in P4P program design, the Hospital Value-Based Purchasing program is strongly aligned with two of the best practices, moderately aligned with three, weakly aligned with one, and has unclear alignment with one best practice. The Physician Value-Based Purchasing Modifier is strongly aligned with two of the best practices, moderately aligned with one, weakly aligned with three, and has unclear alignment with one of the best practices. The Medicare Advantage Quality Bonus Program is strongly aligned with four of the best practices, moderately aligned with two, and weakly aligned with one of the best practices. We identify enduring gaps in P4P literature as it relates to Medicare's plans for Value-Based Purchasing and discuss important issues in the future of these implementations in Medicare. Copyright © 2013 Elsevier Inc. All rights reserved.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-25
... September 30, 2011.) E. L. Hambrick, M.D., J.D., Chair, a CMS Medical Officer Ruth L. Bush, M.D., M.P.H... disability; medical or technical specialty; and type of hospital, hospital health system, or other Medicare... encompasses hospital payment systems; hospital medical care delivery systems; provider billing systems; APC...
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Health Insurance Knowledge Among Medicare Beneficiaries
McCormack, Lauren A; Garfinkel, Steven A; Hibbard, Judith H; Keller, Susan D; Kilpatrick, Kerry E; Kosiak, Beth
2002-01-01
Objective To assess the effect of new consumer information materials about the Medicare program on beneficiary knowledge of their health care coverage under the Medicare system. Data Source A telephone survey of 2,107 Medicare beneficiaries in the 10-county Kansas City metropolitan statistical area. Study Design Beneficiaries were randomly assigned to a control group and three treatment groups each receiving a different set of Medicare informational materials. The “handbook-only” group received the Health Care Financing Administration's new Medicare & You 1999 handbook. The “bulletin” group received an abbreviated version of the handbook, and the “handbook + CAHPS” group received the Medicare & You handbook plus the Consumer Assessment of Health Plans (CAHPS)® survey report comparing the quality of health care provided by Medicare HMOs. Beneficiaries interested in receiving information were oversampled. Data Collection Methods Data were collected during two separate telephone surveys of Medicare beneficiaries: one survey of new beneficiaries and another survey of experienced beneficiaries. The intervention materials were mailed to sample members in advance of the interviews. Knowledge for the treatment groups was measured shortly after beneficiaries received the intervention materials. Principal Findings Respondents' knowledge was measured using a psychometrically valid and reliable 15-item measure. Beneficiaries who received the intervention materials answered significantly more questions correctly than control group members. The effect on beneficiary knowledge of providing the information was modest for all intervention groups but varied for experienced beneficiaries only, depending on the intervention they received. Conclusions The findings suggest that all of the new materials had a positive effect on beneficiary knowledge about Medicare and the Medicare + Choice program. While the absolute gain in knowledge was modest, it was greater than
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An Economic History of Medicare Part C
Mcguire, Thomas G; Newhouse, Joseph P; Sinaiko, Anna D
2011-01-01
Context: Twenty-five years ago, private insurance plans were introduced into the Medicare program with the stated dual aims of (1) giving beneficiaries a choice of health insurance plans beyond the fee-for-service Medicare program and (2) transferring to the Medicare program the efficiencies and cost savings achieved by managed care in the private sector. Methods: In this article we review the economic history of Medicare Part C, known today as Medicare Advantage, focusing on the impact of major changes in the program's structure and of plan payment methods on trends in the availability of private plans, plan enrollment, and Medicare spending. Additionally, we compare the experience of Medicare Advantage and of employer-sponsored health insurance with managed care over the same time period. Findings: Beneficiaries' access to private plans has been inconsistent over the program's history, with higher plan payments resulting in greater choice and enrollment and vice versa. But Medicare Advantage generally has cost more than the traditional Medicare program, an overpayment that has increased in recent years. Conclusions: Major changes in Medicare Advantage's payment rules are needed in order to simultaneously encourage the participation of private plans, the provision of high-quality care, and to save Medicare money. PMID:21676024
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-25
...] Medicare Program; Request for Information To Aid in the Design and Development of a Survey Regarding... CAHPS[supreg] Survey Design Principles and implementation instructions will be based on those for CAHPS... 26, 2013. ADDRESSES: In responding to this solicitation, please reply via email to AmbSurgSurvey@cms...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-27
... (HOP Panel)--March 11 and March 12, 2013 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... Program; Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment (HOP Panel)--March 11...-annual meeting of the Advisory Panel on Hospital Outpatient Payment (HOP, the Panel) for 2013. We note...
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Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays.
Baker, Laurence C; Bundorf, M Kate; Devlin, Aileen M; Kessler, Daniel P
2016-08-01
There is ongoing debate about how prices paid to providers by Medicare Advantage plans compare to prices paid by fee-for-service Medicare. We used data from Medicare and the Health Care Cost Institute to identify the prices paid for hospital services by fee-for-service (FFS) Medicare, Medicare Advantage plans, and commercial insurers in 2009 and 2012. We calculated the average price per admission, and its trend over time, in each of the three types of insurance for fixed baskets of hospital admissions across metropolitan areas. After accounting for differences in hospital networks, geographic areas, and case-mix between Medicare Advantage and FFS Medicare, we found that Medicare Advantage plans paid 5.6 percent less for hospital services than FFS Medicare did. Without taking into account the narrower networks of Medicare Advantage, the program paid 8.0 percent less than FFS Medicare. We also found that the rates paid by commercial plans were much higher than those of either Medicare Advantage or FFS Medicare, and growing. At least some of this difference comes from the much higher prices that commercial plans pay for profitable service lines. Project HOPE—The People-to-People Health Foundation, Inc.
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Federal Register 2010, 2011, 2012, 2013, 2014
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.)
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Non Photonic e-D{sup 0} correlations in p+p and Au+Au collisions at {radical}(S{sub NN} = 200 GeV)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Geromitsos, Artemios
The sum of charm and beauty in Au+Au collisions at 200 GeV measured through non-photonic electrons, show similar suppression at high p{sub T} as light hadrons, in contrast to expectations based on the dead cone effect. To understand this observation, it is important to separate the charm and beauty components. Non-photonic electron-D{sup 0} and electron-hadron azimuthal angular correlations are used to disentangle the contributions from charm and beauty decays. The beauty contribution in p+p. collisions at 200 GeV is found to be comparable to charm at p{sub T}{approx}5.5 GeV, indicating that beauty may contribute significantly to the non photonic electronsmore » from heavy flavour decays in Au+Au data at high p{sub T}. Furthermore, we are employing microvertexing techniques, not used for the analysis of p+p collisions, in Au+Au collisions at 200 GeV. We present our analysis status of D{sub 0} meson reconstruction.« less
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Dalal, Anand A; Liu, Fang; Riedel, Aylin A
2011-01-01
Background Few estimates of health care costs related to chronic obstructive pulmonary disease (COPD) are available regarding commercially insured patients in the United States. The aims of this retrospective observational analysis of administrative data were to describe and compare health care resource use and costs related to COPD in the United States for patients with commercial insurance or Medicare Advantage with Part D benefits, and to assess cost trends over time. Methods Patient-level and visit-level health care costs in the calendar years 2006, 2007, 2008, and 2009 were assessed for patients with evidence of COPD. Generalized linear models adjusting for sex, age category, and geographic region were used to investigate cost trends over time for patients with Medicare or commercial insurance. Results Medical costs, which ranged from an annual mean of US$2382 (Medicare 2007) to US$3339 (commercial 2009) per patient, comprised the majority of total costs in all years for patients with either type of insurance. COPD-related costs were less for Medicare than commercial cohorts. In the multivariate analysis, total costs increased by approximately 6% per year for commercial insurance patients (cost ratio 1.06; 95% confidence interval [CI] 1.04–1.07; P < 0.001) and 5% per year for Medicare patients (cost ratio 1.05; 95% CI 1.03–1.07; P < 0.001). Costs for outpatient and emergency department visits increased significantly over time in both populations. Standard admission costs increased significantly for Medicare patients (cost ratio 1.03; 95% CI 1.00–1.05; P = 0.03), but not commercial patients, and costs for intensive care unit visits remained stable for both populations. Conclusion COPD imposed a substantial economic burden on patients and the health care system, with costs increasing significantly in both the Medicare and commercial populations. PMID:22069365
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Dalal, Anand A; Liu, Fang; Riedel, Aylin A
2011-01-01
Few estimates of health care costs related to chronic obstructive pulmonary disease (COPD) are available regarding commercially insured patients in the United States. The aims of this retrospective observational analysis of administrative data were to describe and compare health care resource use and costs related to COPD in the United States for patients with commercial insurance or Medicare Advantage with Part D benefits, and to assess cost trends over time. Patient-level and visit-level health care costs in the calendar years 2006, 2007, 2008, and 2009 were assessed for patients with evidence of COPD. Generalized linear models adjusting for sex, age category, and geographic region were used to investigate cost trends over time for patients with Medicare or commercial insurance. Medical costs, which ranged from an annual mean of US$2382 (Medicare 2007) to US$3339 (commercial 2009) per patient, comprised the majority of total costs in all years for patients with either type of insurance. COPD-related costs were less for Medicare than commercial cohorts. In the multivariate analysis, total costs increased by approximately 6% per year for commercial insurance patients (cost ratio 1.06; 95% confidence interval [CI] 1.04-1.07; P < 0.001) and 5% per year for Medicare patients (cost ratio 1.05; 95% CI 1.03-1.07; P < 0.001). Costs for outpatient and emergency department visits increased significantly over time in both populations. Standard admission costs increased significantly for Medicare patients (cost ratio 1.03; 95% CI 1.00-1.05; P = 0.03), but not commercial patients, and costs for intensive care unit visits remained stable for both populations. COPD imposed a substantial economic burden on patients and the health care system, with costs increasing significantly in both the Medicare and commercial populations.
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Adams, J; Adler, C; Aggarwal, M M; Ahammed, Z; Amonett, J; Anderson, B D; Anderson, M; Arkhipkin, D; Averichev, G S; Badyal, S K; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellwied, R; Berger, J; Bezverkhny, B I; Bhardwaj, S; Bhaskar, P; Bhati, A K; Bichsel, H; Billmeier, A; Bland, L C; Blyth, C O; Bonner, B E; Botje, M; Boucham, A; Brandin, A; Bravar, A; Cadman, R V; Cai, X Z; Caines, H; Calderón de la Barca Sánchez, M; Carroll, J; Castillo, J; Castro, M; Cebra, D; Chaloupka, P; Chattopadhyay, S; Chen, H F; Chen, Y; Chernenko, S P; Cherney, M; Chikanian, A; Choi, B; Christie, W; Coffin, J P; Cormier, T M; Cramer, J G; Crawford, H J; Das, D; Das, S; Derevschikov, A A; Didenko, L; Dietel, T; Dong, X; Draper, J E; Du, F; Dubey, A K; Dunin, V B; Dunlop, J C; Dutta Majumdar, M R; Eckardt, V; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Fachini, P; Faine, V; Faivre, J; Fatemi, R; Filimonov, K; Filip, P; Finch, E; Fisyak, Y; Flierl, D; Foley, K J; Fu, J; Gagliardi, C A; Ganti, M S; Gagunashvili, N; Gans, J; Gaudichet, L; Germain, M; Geurts, F; Ghazikhanian, V; Ghosh, P; Gonzalez, J E; Grachov, O; Grigoriev, V; Gronstal, S; Grosnick, D; Guedon, M; Guertin, S M; Gupta, A; Gushin, E; Gutierrez, T D; Hallman, T J; Hardtke, D; Harris, J W; Heinz, M; Henry, T W; Heppelmann, S; Herston, T; Hippolyte, B; Hirsch, A; Hjort, E; Hoffmann, G W; Horsley, M; Huang, H Z; Huang, S L; Humanic, T J; Igo, G; Ishihara, A; Jacobs, P; Jacobs, W W; Janik, M; Johnson, I; Jones, P G; Judd, E G; Kabana, S; Kaneta, M; Kaplan, M; Keane, D; Kiryluk, J; Kisiel, A; Klay, J; Klein, S R; Klyachko, A; Koetke, D D; Kollegger, T; Konstantinov, A S; Kopytine, M; Kotchenda, L; Kovalenko, A D; Kramer, M; Kravtsov, P; Krueger, K; Kuhn, C; Kulikov, A I; Kumar, A; Kunde, G J; Kunz, C L; Kutuev, R Kh; Kuznetsov, A A; Lamont, M A C; Landgraf, J M; Lange, S; Lansdell, C P; Lasiuk, B; Laue, F; Lauret, J; Lebedev, A; Lednický, R; Leontiev, V M; LeVine, M J; Li, C; Li, Q; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, L; Liu, Z; Liu, Q J; Ljubicic, T; Llope, W J; Long, H; Longacre, R S; Lopez-Noriega, M; Love, W A; Ludlam, T; Lynn, D; Ma, J; Ma, Y G; Magestro, D; Mahajan, S; Mangotra, L K; Mahapatra, D P; Majka, R; Manweiler, R; Margetis, S; Markert, C; Martin, L; Marx, J; Matis, H S; Matulenko, Yu A; McShane, T S; Meissner, F; Melnick, Yu; Meschanin, A; Messer, M; Miller, M L; Milosevich, Z; Minaev, N G; Mironov, C; Mishra, D; Mitchell, J; Mohanty, B; Molnar, L; Moore, C F; Mora-Corral, M J; Morozov, V; de Moura, M M; Munhoz, M G; Nandi, B K; Nayak, S K; Nayak, T K; Nelson, J M; Nevski, P; Nikitin, V A; Nogach, L V; Norman, B; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Paic, G; Pandey, S U; Pal, S K; Panebratsev, Y; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Perevoztchikov, V; Peryt, W; Petrov, V A; Phatak, S C; Picha, R; Planinic, M; Pluta, J; Porile, N; Porter, J; Poskanzer, A M; Potekhin, M; Potrebenikova, E; Potukuchi, B V K S; Prindle, D; Pruneau, C; Putschke, J; Rai, G; Rakness, G; Raniwala, R; Raniwala, S; Ravel, O; Ray, R L; Razin, S V; Reichhold, D; Reid, J G; Renault, G; Retiere, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevski, O V; Romero, J L; Rose, A; Roy, C; Ruan, L J; Rykov, V; Sahoo, R; Sakrejda, I; Salur, S; Sandweiss, J; Savin, I; Schambach, J; Scharenberg, R P; Schmitz, N; Schroeder, L S; Schweda, K; Seger, J; Seliverstov, D; Seyboth, P; Shahaliev, E; Shao, M; Sharma, M; Shestermanov, K E; Shimanskii, S S; Singaraju, R N; Simon, F; Skoro, G; Smirnov, N; Snellings, R; Sood, G; Sorensen, P; Sowinski, J; Spinka, H M; Srivastava, B; Stanislaus, S; Stock, R; Stolpovsky, A; Strikhanov, M; Stringfellow, B; Struck, C; Suaide, A A P; Sugarbaker, E; Suire, C; Sumbera, M; Surrow, B; Symons, T J M; Szanto de Toledo, A; Szarwas, P; Tai, A; Takahashi, J; Tang, A H; Thein, D; Thomas, J H; Tikhomirov, V; Tokarev, M; Tonjes, M B; Trainor, T A; Trentalange, S; Tribble, R E; Trivedi, M D; Trofimov, V; Tsai, O; Ullrich, T; Underwood, D G; Van Buren, G; VanderMolen, A M; Vasiliev, A N; Vasiliev, M; Vigdor, S E; Viyogi, Y P; Voloshin, S A; Waggoner, W; Wang, F; Wang, G; Wang, X L; Wang, Z M; Ward, H; Watson, J W; Wells, R; Westfall, G D; Whitten, C; Wieman, H; Willson, R; Wissink, S W; Witt, R; Wood, J; Wu, J; Xu, N; Xu, Z; Xu, Z Z; Yakutin, A E; Yamamoto, E; Yang, J; Yepes, P; Yurevich, V I; Zanevski, Y V; Zborovský, I; Zhang, H; Zhang, H Y; Zhang, W M; Zhang, Z P; Zołnierczuk, P A; Zoulkarneev, R; Zoulkarneeva, J; Zubarev, A N
2003-08-15
We report measurements of single-particle inclusive spectra and two-particle azimuthal distributions of charged hadrons at high transverse momentum (high p(T)) in minimum bias and central d+Au collisions at sqrt[s(NN)]=200 GeV. The inclusive yield is enhanced in d+Au collisions relative to binary-scaled p+p collisions, while the two-particle azimuthal distributions are very similar to those observed in p+p collisions. These results demonstrate that the strong suppression of the inclusive yield and back-to-back correlations at high p(T) previously observed in central Au+Au collisions are due to final-state interactions with the dense medium generated in such collisions.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-03
...] Medicare Program; Request for Information To Aid in the Design and Development of a Survey Regarding... from emergency room to inpatient care). Having a rigorous, well-designed emergency department survey... this solicitation, please reply via email to CMS ED_Survey@cms.hhs.gov or by postal mail at Centers for...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-08
...] RIN 0938-AQ27 Medicare Program; Changes to the End-Stage Renal Disease Prospective Payment System for... through Federal Digital System (FDsys), a service of the U.S. Government Printing Office. This database... Internet on the CMS Web site. The Addenda to the End-Stage Renal Disease (ESRD) Prospective Payment System...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-12
...This document corrects technical errors that appeared in the final rule with comment period published in the Federal Register on November 16, 2012, entitled ``Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013.''
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Wennberg, John E; Fisher, Elliott S; Skinner, Jonathan S; Bronner, Kristen K
2007-01-01
The care of Americans with severe chronic illnesses is disorganized, unnecessarily costly, and undisciplined by sound clinical science. The federal government should invest in a crash program to improve the scientific basis of managing chronic illness, and the Centers for Medicare and Medicaid Services (CMS) should extend its pay-for-performance (P4P) agenda to ensure that within ten years all Americans with severe chronic illnesses have access to accountable health care organizations providing evidence-based prospective care. This paper recommends a strategy for achieving this goal.
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Jennifer, Taylor; Michael, Schoenbaum; Katon Wayne, J; Pincus Harold, A; Diane, Hogan; Jürgen, Unützer
2013-01-01
Objective To examine case-finding strategies for depression in the context of a disease management program for chronically ill Medicare recipients. Study Design Observational analysis of telephone/mail surveys and claims data collected for the Medicare Health Support (MHS) program. Methods This study examines data from 14,902 participants with diabetes and/or congestive heart failure in the MHS program administered by Green Ribbon Health.. Depression screening was performed by administering a 2-item screener (PHQ-2) by telephone or mail. Additional information about depression was drawn from ICD-9 depression diagnoses from claims and self-reported use of antidepressant medications. We compared screener positive rates for depression on the PHQ-2 administered by telephone or mail, examined variations in screener positives by care manager, and compared rates of positive screens to antidepressant use and claims diagnoses of depression. Results Nearly 14 % of participants received an ICD-9 diagnosis of depression in the year prior to program enrollment; 7% reported taking antidepressants, and 5 % screened positive on the PHQ-2. Substantial variation in positive depression screens by care manager was found that could not be explained by case mix, prior depression diagnoses or current depression treatment. After adjusting for demographic and clinical differences, the PHQ2 positive rate was 6.5% by phone and 14.1% by mail screen (p<0.001). Conclusion A combined depression screening approach with mail screening (using the PHQ-2) augmented by information about antidepressant use and claims diagnoses of depression may be the most cost-effective method to identify depression in a large sample of medically ill Medicare recipients. PMID:18690765
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Tuberculose chez le personnel de santé du secteur public au Burundi: fréquence et facteurs de risque
Mukuku, Olivier; Ruhindiza, Bienvenu Mukuku; Mupepe, Alexis Kumba; Sawadogo, Michel
2013-01-01
Introduction Le but de cette étude était de déterminer la fréquence de la tuberculose (TB) chez le personnel de santé du secteur public en charge des patients tuberculeux et d’évaluer les facteurs de risque de contracter la tuberculose chez ce personnel au Burundi. Méthodes Il s’agit d’une étude transversale à visée analytique réalisée auprès de 300 travailleurs prestant dans 30 centres de dépistage et de traitement de la TB (CDT) au Burundi du 16 octobre au 15 novembre 2012. Les paramètres sociodémographiques et professionnels ainsi que l’antécédent de vaccination BCG de travailleurs ayant été touché par la TB ont été analysé et comparé à ceux de travailleurs qui ne l’ont pas été. Le seuil de signification a été fixé à p < 0,05. Résultats La fréquence de la TB chez le personnel de santé est de 15%. Le risque de souffrir de la TB est de près de 4 fois chez les travailleurs âgés d’au moins 50 ans (OR=3,73; 1,53-9,08), chez ceux qui n’ont jamais reçu de vaccin de BCG (OR=3,73; 1,24-11,03), chez ceux qui n’ont pas de cicatrice vaccinale de BCG (OR=3,80; 1,67-8,62) et chez ceux qui travaillent depuis au moins 6 ans dans un CDT (OR=3,79; 1,44-9,96); ce risque est de 9 fois chez ceux qui sont mariés (OR=9,42; 1,26-70,23), de 8 fois chez ceux qui n’aèrent pas leurs salles de travail (OR=8,20; 1,48-48,23) et de 6 fois chez ceux qui ont comme profession nettoyeur ou aide-soignant (OR=6,12; 2,92-12,82). Par contre, aucune corrélation statistiquement significative n’a été observée entre le fait de souffrir de la TB et le sexe mais aussi le nombre d’heures de contact d’un travailleur avec un patient tuberculeux (p>0,05). Conclusion L’âge, l’antécédent de vaccination de BCG ainsi que la majorité de paramètres professionnels sont en association avec la maladie TB des travailleurs de CDT. D’où, la maîtrise de certains facteurs de risque s’avère important pour faire face au fardeau de la TB parmi
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-27
... sources and types of other data that these organizations might match to Medicare claims; challenges in... and Affordable Care Act, Availability of Medicare Data for Performance Measurement DATE: September 20... 1874 of the Social Security Act: Availability of Medicare Data for Performance Measurement. The purpose...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-09
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1587-N2... Submission of Applications AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice of... hospitals to apply to the Centers for Medicare & Medicaid Services (CMS) to receive St. Vincent's Medical...
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76 FR 26341 - Medicaid Program; Methods for Assuring Access to Covered Medicaid Services
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-06
... Medicare & Medicaid Services 42 CFR Part 447 Medicare Program; Methods for Assuring Access to Covered... Services 42 CFR Part 447 [CMS 2328-P] RIN 0938-AQ54 Medicaid Program; Methods for Assuring Access to... design the procedures for enrolling providers of such care, and to set the methods for establishing...
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Chollet, D J
1999-05-01
Despite the enactment of significant changes to the Medicare program in 1997, Medicare's Hospital Insurance trust fund is projected to be exhausted just as the baby boom enters retirement. To address Medicare's financial difficulties, a number of reform proposals have been offered, including several to individualize Medicare financing and benefits. These proposals would attempt to increase Medicare revenues and reduce Medicare expenditures by having individuals bear risk--investment market risk before retirement and insurance market risk after retirement. Many fundamental aspects of these proposals have yet to be worked out, including how to guarantee a baseline level of saving for health insurance after retirement, how retirees might finance unanticipated health insurance price increases after retirement, the potential implications for Medicaid of inadequate individual saving, and whether the administrative cost of making the system fair and adequate ultimately would eliminate any rate-of-return advantages from allowing workers to invest their Medicare contributions in corporate stocks and bonds.
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State Regulatory Enforcement and Nursing Home Termination from the Medicare and Medicaid Programs
Li, Yue; Harrington, Charlene; Spector, William D; Mukamel, Dana B
2010-01-01
Objectives Nursing homes certified by the Medicare and/or Medicaid program are subject to federally mandated and state-enforced quality and safety standards. We examined the relationship between state quality enforcement and nursing home terminations from the two programs. Study Design Using data from a survey of state licensure and certification agencies and other secondary databases, we performed bivariate and multivariate analyses on the strength of state quality regulation in 2005, and nursing home voluntary terminations (decisions made by the facility) or involuntary terminations (imposed by the state) in 2006–2007. Principal Findings Involuntary terminations were rarely imposed by state regulators, while voluntary terminations were relatively more common (2.16 percent in 2006–2007) and varied considerably across states. After controlling for facility, market, and state covariates, nursing homes in states implementing stronger quality enforcement were more likely to voluntarily terminate from the Medicare and Medicaid programs (odds ratio=1.53, p=.018). Conclusions Although involuntary nursing home terminations occurred rarely in most states, nursing homes in states with stronger quality regulations tend to voluntarily exit the publicly financed market. Because of the consequences of voluntary terminations on patient care and access, state regulators need to consider the effects of increased enforcement on both enhanced quality and the costs of termination. PMID:20819106
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NASA Technical Reports Server (NTRS)
Weizer, Victor G.; Fatemi, Navid S.
1991-01-01
The introduction of a very small amount of Ga into Au contact metallization on InP is shown to have a significant effect on both the metallurgical and electrical behavior of that contact system. Ga atoms in the interstices of the Au lattice are shown to be effective in preventing the solid state reactions that normally take place between Au and InP during contact sintering. In addition to suppressing the metallurgical interaction, the presence of small amounts of Ga is shown to cause an order of magnitude reduction in the specific contact resistivity. Evidence is presented that the reactions of GaP and GaAs with Au contacts are also drastically affected by the presence of Ga. The sintering behavior of the Au-GaP and the Au-GaAs systems (as contrasted with that of the Au-InP system) is explained as due to the presence of interstitial Ga in the contact metallization. Finally the large, two-to-three order of magnitude drop in the contact resistance that occurs in the Au-InP system upon sintering at 400 degrees Centigrade is shown to be a result of the formation of an Au (sub 2) P (sub 3) layer at the metal-semiconductor interface. Contact resistivities in the 10 (sup -6) ohm square centimeter range are obtained for as-deposited Au on InP when a thin (20 Angstrom) layer of Au (sub 2) P (sub 3) is introduced between the InP and the Au contacts.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-29
...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 finalizes the calendar year (CY) 2010 interim relative value units (RVUs) and issues interim RVUs for new and revised procedure codes for CY 2011. It also addresses, implements, or discusses certain provisions of both the Affordable Care Act (ACA) and the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). In addition, this final rule with comment period discusses payments under the Ambulance Fee Schedule (AFS), the Ambulatory Surgical Center (ASC) payment system, and the Clinical Laboratory Fee Schedule (CLFS), payments to end-stage renal disease (ESRD) facilities, and payments for Part B drugs. Finally, this final rule with comment period also includes a discussion regarding the Chiropractic Services Demonstration program, the Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (CBP DMEPOS), and provider and supplier enrollment issues associated with air ambulances.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-01
... 0938-AQ15 Medicare Program; Part A Premiums for CY 2012 for the Uninsured Aged and for Certain Disabled...'') and by certain disabled individuals who have exhausted other entitlement. The monthly Part A premium... monthly premium for certain disabled individuals who have exhausted other entitlement. These are...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-21
... 0938-AR15 Medicare Program; Part A Premiums for CY 2013 for the Uninsured Aged and for Certain Disabled...'') and by certain disabled individuals who have exhausted other entitlement. The monthly Part A premium... monthly premium for certain disabled individuals who have exhausted other entitlement. These are...
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Identified hadron transverse momentum spectra in Au+Au collisions at sNN=62.4 GeV
NASA Astrophysics Data System (ADS)
Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Busza, W.; Carroll, A.; Chai, Z.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Halliwell, C.; Hamblen, J.; Hauer, M.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Khan, N.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Reed, C.; Roland, C.; Roland, G.; Sagerer, J.; Seals, H.; Sedykh, I.; Smith, C. E.; Stankiewicz, M. A.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tonjes, M. B.; Trzupek, A.; Vale, C.; Nieuwenhuizen, G. J. Van; Vaurynovich, S. S.; Verdier, R.; Veres, G. I.; Wenger, E.; Wolfs, F. L. H.; Wosiek, B.; Woźniak, K.; Wysłouch, B.
2007-02-01
Transverse momentum spectra of pions, kaons, protons, and antiprotons from Au+Au collisions at sNN = 62.4 GeV have been measured by the PHOBOS experiment at the Relativistic Heavy Ion Collider at Brookhaven National Laboratory. The identification of particles relies on three different methods: low momentum particles stopping in the first detector layers; the specific energy loss (dE/dx) in the silicon spectrometer, and time-of-flight measurement. These methods cover the transverse momentum ranges 0.03 0.2, 0.2 1.0, and 0.5 3.0 GeV/c, respectively. Baryons are found to have substantially harder transverse momentum spectra than mesons. The pT region in which the proton to pion ratio reaches unity in central Au+Au collisions at sNN = 62.4 GeV fits into a smooth trend as a function of collision energy. At low transverse mass, the spectra of various species exhibit a significant deviation from transverse mass scaling. The observed particle yields at very low pT are comparable to extrapolations from higher pT for kaons, protons and antiprotons. By comparing our results to Au+Au collisions at sNN = 200 GeV, we conclude that the net proton yield at midrapidity is proportional to the number of participant nucleons in the collision.
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Medicare+Choice: what lies ahead?
Layne, R Jeffrey
2002-03-01
Health plans have continued to exit the Medicare+Choice program in recent years, despite efforts of Congress and the Centers for Medicare and Medicaid Services (CMS) to reform the program. Congress and CMS therefore stand poised to make additional, substantial reforms to the program. CMS has proposed to consolidate its oversight of the program, extend the due date for Medicare+Choice plans to file their adjusted community rate proposals, revise risk-adjustment processes, streamline the marketing review process, enhance quality-improvement requirements, institute results based performance assessment audits, coordinate policy changes to coincide with contracting cycles, expand its fall advertising campaign for the program, provide better employer-based Medicare options for beneficiaries, and take steps to minimize beneficiary costs. Congressional leaders have proposed various legislative remedies to improve the program, including creation of an entirely new pricing structure for the program based on a competitive bidding process.
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Medicare privatization and the erosion of retirement security.
Polivka, Larry; Kwak, Jung
2008-01-01
This paper describes initiatives to privatize the Medicare program over the last 10 years and the implications of these initiatives for the future of retirement security. Our analysis focuses on the privatization provisions of the Medicare Modernization Act, which is largely designed to benefit the corporate health care sector without containing costs or significantly reducing the threat of rising health care costs to the economic security of current and future retirees. In fact, as designed, the Medicare Modernization Act is likely to increase the threat to retirement security in the years ahead. We conclude with a series of policy alternatives to the neoliberal agenda for the privatization of Medicare.
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Adams, J; Adler, C; Aggarwal, M M; Ahammed, Z; Amonett, J; Anderson, B D; Arkhipkin, D; Averichev, G S; Badyal, S K; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellwied, R; Berger, J; Bezverkhny, B I; Bhardwaj, S; Bhati, A K; Bichsel, H; Billmeier, A; Bland, L C; Blyth, C O; Bonner, B E; Botje, M; Boucham, A; Brandin, A; Bravar, A; Cadman, R V; Cai, X Z; Caines, H; Calderón de la Barca Sánchez, M; Carroll, J; Castillo, J; Cebra, D; Chaloupka, P; Chattopadhyay, S; Chen, H F; Chen, Y; Chernenko, S P; Cherney, M; Chikanian, A; Christie, W; Coffin, J P; Cormier, T M; Cramer, J G; Crawford, H J; Das, D; Das, S; Derevschikov, A A; Didenko, L; Dietel, T; Dong, W J; Dong, X; Draper, J E; Du, F; Dubey, A K; Dunin, V B; Dunlop, J C; Dutta Majumdar, M R; Eckardt, V; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Estienne, M; Fachini, P; Faine, V; Faivre, J; Fatemi, R; Filimonov, K; Filip, P; Finch, E; Fisyak, Y; Flierl, D; Foley, K J; Fu, J; Gagliardi, C A; Gagunashvili, N; Gans, J; Ganti, M S; Gaudichet, L; Geurts, F; Ghazikhanian, V; Ghosh, P; Gonzalez, J E; Grachov, O; Grebenyuk, O; Gronstal, S; Grosnick, D; Guertin, S M; Gupta, A; Gutierrez, T D; Hallman, T J; Hamed, A; Hardtke, D; Harris, J W; Heinz, M; Henry, T W; Heppelmann, S; Hippolyte, B; Hirsch, A; Hjort, E; Hoffmann, G W; Horsley, M; Huang, H Z; Huang, S L; Hughes, E; Humanic, T J; Igo, G; Ishihara, A; Jacobs, P; Jacobs, W W; Janik, M; Jiang, H; Johnson, I; Jones, P G; Judd, E G; Kabana, S; Kaplan, M; Keane, D; Khodyrev, V Yu; Kiryluk, J; Kisiel, A; Klay, J; Klein, S R; Klyachko, A; Koetke, D D; Kollegger, T; Kopytine, M; Kotchenda, L; Kovalenko, A D; Kramer, M; Kravtsov, P; Kravtsov, V I; Krueger, K; Kuhn, C; Kulikov, A I; Kumar, A; Kunde, G J; Kunz, C L; Kutuev, R Kh; Kuznetsov, A A; Lamont, M A C; Landgraf, J M; Lange, S; Lasiuk, B; Laue, F; Lauret, J; Lebedev, A; Lednický, R; LeVine, M J; Li, C; Li, Q; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, L; Liu, Z; Liu, Q J; Ljubicic, T; Llope, W J; Long, H; Longacre, R S; Lopez-Noriega, M; Love, W A; Ludlam, T; Lynn, D; Ma, J; Ma, Y G; Magestro, D; Mahajan, S; Mangotra, L K; Mahapatra, D P; Majka, R; Manweiler, R; Margetis, S; Markert, C; Martin, L; Marx, J; Matis, H S; Matulenko, Yu A; McClain, C J; McShane, T S; Meissner, F; Melnick, Yu; Meschanin, A; Miller, M L; Milosevich, Z; Minaev, N G; Mironov, C; Mischke, A; Mishra, D; Mitchell, J; Mohanty, B; Molnar, L; Moore, C F; Mora-Corral, M J; Morozov, D A; Morozov, V; De Moura, M M; Munhoz, M G; Nandi, B K; Nayak, S K; Nayak, T K; Nelson, J M; Netrakanti, P K; Nikitin, V A; Nogach, L V; Norman, B; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Paic, G; Pal, S K; Panebratsev, Y; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Peitzmann, T; Perevoztchikov, V; Perkins, C; Peryt, W; Petrov, V A; Phatak, S C; Picha, R; Planinic, M; Pluta, J; Porile, N; Porter, J; Poskanzer, A M; Potekhin, M; Potrebenikova, E; Potukuchi, B V K S; Prindle, D; Pruneau, C; Putschke, J; Rai, G; Rakness, G; Raniwala, R; Raniwala, S; Ravel, O; Ray, R L; Razin, S V; Reichhold, D; Reid, J G; Renault, G; Retiere, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevski, O V; Romero, J L; Rose, A; Roy, C; Ruan, L J; Sahoo, R; Sakrejda, I; Salur, S; Sandweiss, J; Savin, I; Schambach, J; Scharenberg, R P; Schmitz, N; Schroeder, L S; Schweda, K; Seger, J; Seyboth, P; Shahaliev, E; Shao, M; Shao, W; Sharma, M; Shestermanov, K E; Shimanskii, S S; Singaraju, R N; Simon, F; Skoro, G; Smirnov, N; Snellings, R; Sood, G; Sorensen, P; Sowinski, J; Speltz, J; Spinka, H M; Srivastava, B; Stanislaus, T D S; Stock, R; Stolpovsky, A; Strikhanov, M; Stringfellow, B; Struck, C; Suaide, A A P; Sugarbaker, E; Suire, C; Sumbera, M; Surrow, B; Symons, T J M; Szanto de Toledo, A; Szarwas, P; Tai, A; Takahashi, J; Tang, A H; Thein, D; Thomas, J H; Timoshenko, S; Tokarev, M; Tonjes, M B; Trainor, T A; Trentalange, S; Tribble, R E; Tsai, O; Ullrich, T; Underwood, D G; Van Buren, G; VanderMolen, A M; Varma, R; Vasilevski, I; Vasiliev, A N; Vernet, R; Vigdor, S E; Viyogi, Y P; Voloshin, S A; Vznuzdaev, M; Waggoner, W; Wang, F; Wang, G; Wang, G; Wang, X L; Wang, Y; Wang, Z M; Ward, H; Watson, J W; Webb, J C; Wells, R; Westfall, G D; Whitten, C; Wieman, H; Willson, R; Wissink, S W; Witt, R; Wood, J; Wu, J; Xu, N; Xu, Z; Xu, Z Z; Yamamoto, E; Yepes, P; Yurevich, V I; Yuting, B; Zanevski, Y V; Zhang, H; Zhang, W M; Zhang, Z P; Zhaomin, Z P; Zizong, Z P; Zołnierczuk, P A; Zoulkarneev, R; Zoulkarneeva, J; Zubarev, A N
2004-03-05
We report results on rho(770)(0)-->pi(+)pi(-) production at midrapidity in p+p and peripheral Au+Au collisions at sqrt[s(NN)]=200 GeV. This is the first direct measurement of rho(770)(0)-->pi(+)pi(-) in heavy-ion collisions. The measured rho(0) peak in the invariant mass distribution is shifted by approximately 40 MeV/c(2) in minimum bias p+p interactions and approximately 70 MeV/c(2) in peripheral Au+Au collisions. The rho(0) mass shift is dependent on transverse momentum and multiplicity. The modification of the rho(0) meson mass, width, and shape due to phase space and dynamical effects are discussed.
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46 CFR 26.03-10 - Signaling light.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 1 2010-10-01 2010-10-01 false Signaling light. 26.03-10 Section 26.03-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS OPERATIONS Special Operating Requirements § 26.03-10 Signaling light. All vessels of over 150 gross tons, when engaged on an international...
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46 CFR 26.03-10 - Signaling light.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 46 Shipping 1 2013-10-01 2013-10-01 false Signaling light. 26.03-10 Section 26.03-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS OPERATIONS Special Operating Requirements § 26.03-10 Signaling light. All vessels of over 150 gross tons, when engaged on an international...
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46 CFR 26.03-10 - Signaling light.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 1 2011-10-01 2011-10-01 false Signaling light. 26.03-10 Section 26.03-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS OPERATIONS Special Operating Requirements § 26.03-10 Signaling light. All vessels of over 150 gross tons, when engaged on an international...
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46 CFR 26.03-10 - Signaling light.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 46 Shipping 1 2012-10-01 2012-10-01 false Signaling light. 26.03-10 Section 26.03-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS OPERATIONS Special Operating Requirements § 26.03-10 Signaling light. All vessels of over 150 gross tons, when engaged on an international...
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46 CFR 26.03-10 - Signaling light.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 46 Shipping 1 2014-10-01 2014-10-01 false Signaling light. 26.03-10 Section 26.03-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS OPERATIONS Special Operating Requirements § 26.03-10 Signaling light. All vessels of over 150 gross tons, when engaged on an international...
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High-temperature stability of Au/Pd/Cu and Au/Pd(P)/Cu surface finishes
NASA Astrophysics Data System (ADS)
Ho, C. E.; Hsieh, W. Z.; Lee, P. T.; Huang, Y. H.; Kuo, T. T.
2018-03-01
Thermal reliability of Au/Pd/Cu and Au/Pd(4-6 wt.% P)/Cu trilayers in the isothermal annealing at 180 °C were investigated by X-ray photoelectron spectroscopy (XPS), time-of-flight secondary ion mass spectrometry (TOF-SIMS), and transmission electron microscopy (TEM). The pure Pd film possessed a nanocrystalline structure with numerous grain boundaries, thereby facilitating the interdiffusion between Au and Cu. Out-diffusion of Cu through Pd and Au grain boundaries yielded a significant amount of Cu oxides (CuO and Cu2O) over the Au surface and gave rise to void formation in the Cu film. By contrast, the Pd(P) film was amorphous and served as a good diffusion barrier against Cu diffusion. The results of this study indicated that amorphous Pd(P) possessed better oxidation resistance and thermal reliability than crystalline Pd.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-30
... 0938-AR57 Medicare Program; Part A Premiums for CY 2014 for the Uninsured Aged and for Certain Disabled...'') and by certain disabled individuals who have exhausted other entitlement. The monthly Part A premium... payment of a monthly premium for certain disabled individuals who have exhausted other entitlement. These...
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76 FR 12308 - Modernizing the FCC Form 477 Data Program; Correction
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-07
... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Parts 1, 20, and 43 [WCB: WC Docket Nos. 07-38, 09-190, 10-132, 11-10; FCC 11-14] Modernizing the FCC Form 477 Data Program; Correction AGENCY: Federal..., Deputy Manager. [FR Doc. 2011-5095 Filed 3-4-11; 8:45 am] BILLING CODE 6712-01-P ...
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Dorn, Stan; Shang, Baoping
2012-02-01
Fewer than one-third of eligible Medicare beneficiaries enroll in Medicare savings programs, which pay premiums and, in some cases, eliminate out-of-pocket cost sharing for poor and near-poor enrollees. Many beneficiaries don't participate in savings programs because they must complete a cumbersome application process, including a burdensome asset test. We demonstrate that a streamlined alternative to the asset test-allowing seniors to qualify for Medicare savings programs by providing evidence of limited assets or showing a lack of investment income-would permit 78 percent of currently eligible seniors to bypass the asset test entirely. This simplified approach would increase the number of beneficiaries who qualify for Medicare savings programs from the current 3.6 million seniors to 4.6 million. Such an alternative would keep benefits targeted to people with low assets, eliminate costly administrative expenses and obstacles to enrollment associated with the asset test, and avoid the much larger influx of seniors that would occur if the asset test were eliminated entirely.
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How much do persons with Alzheimer's disease cost Medicare?
Taylor, D H; Sloan, F A
2000-06-01
Medicare claims are increasingly being used to identify persons with chronic diseases such as Alzheimer's disease (AD) for the purpose of determining the cost to Medicare of caring for such persons. Past work has been limited by the use of only 1 or 2 years of claims data to identify cases, leading to worries that this might lead to an undercount of prevalent cases and bias cost findings. To analyze the average total cost to the Medicare program in 1994 of persons with a claims-based diagnosis of AD, using a 12-year period of claims history to identify prevalent cases, and to investigate the effect on cost of time since diagnosis. A cross-sectional design with a 12-year retrospective period to identify persons with AD. Medical care practices, hospitals, and other providers of services to Medicare beneficiaries in the US in 1994. Respondents to the screener (n = 10,858) and community (5429) and institutional (n = 1341) questionnaire of the 1994 National Long Term Care Survey, with and without a claims-based diagnosis of AD. Average total cost to Medicare in 1994, measured as the actual amount Medicare paid for inpatient, outpatient, home health, skilled nursing facility, hospice, and Part B services, including payments to physicians, and other items such as durable medical equipment. We also measured disability in a variety of ways, including cognition, activity limitations, and residence in a nursing home. The average total cost to Medicare of persons with a claims-based diagnosis of AD was $6021 versus $2310 (P < .001) for persons without a diagnosis. When adjusting for patient characteristics, the ratio of cost between persons with AD and those without was reduced to about 1.6 to 1. Time since diagnosis was an important predictor of average total cost in 1994, with each additional year since diagnosis resulting in a $248 (P = .04) decrease in total cost (about 10% of the total sample mean cost of $2426). There was mixed evidence that persons with a diagnosis of
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75 FR 14454 - National Protection and Programs Directorate; National Infrastructure Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-25
..., National Infrastructure Advisory Council. [FR Doc. 2010-6633 Filed 3-24-10; 8:45 am] BILLING CODE 9110-9P-P ... Directorate; National Infrastructure Advisory Council AGENCY: National Protection and Programs Directorate... Infrastructure Advisory Council (NIAC) will meet on Tuesday, April 13, 2010, at the National Press Club's...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-06
...) March 10-11, 2014 AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human... Advisory Panel on Hospital Outpatient Payment (the Panel) for 2014. The purpose of the Panel is to advise... therapeutic services supervision issues. DATES: Meeting Dates: The first semi-annual meeting in 2014 is...
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Interface observation in Au/Ni/p-GaN studied by HREM and energy-filtering TEM.
Lim, Sung-Hwan; Ra, Tae-Yeub; Kim, Won-Yong
2003-01-01
The contact resistance of Au/Ni/p-GaN ohmic contacts for different annealing conditions was measured. This was then correlated with microstructure, including phase distribution, observed by high-resolution electron microscopy combined with energy-filtering imaging. A contact resistance of 2.22 x 10(-4) ohms cm2 for Au/Ni contacts to p-GaN after annealing at 500 degrees C for 5 min in air ambient was obtained. NiO layers were identified at the interface and upper area of annealed Ni/Au/p-GaN for air ambient. In addition, an Au layer was found at the interface of p-GaN due to a reversal reaction during annealing. Identification of the observed phases is discussed, along with possible formation mechanisms for the ohmic contacts in the Au/Ni/p-GaN system.
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Payment policy and inefficient benefits in the Medicare+Choice program.
Pizer, Steven D; Frakt, Austin B; Feldman, Roger
2003-06-01
We investigated whether constraints on premium rebates by health plans in the Medicare+Choice program result in inefficient benefits. Since relationships between revenue and benefits could be confounded by unobserved variation in the cost of coverage, we took advantage of natural experiment that occurred following passage of the Benefits Improvement and Protection Act of 2000. Our findings indicate that benefits in zero premium plans were more sensitive to changes in payment rates than were benefits in plans that charged nonzero premiums. These results strongly suggest that current Medicare policy induces plans to offer benefits that are not valued by enrollees at or above their cost.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-18
... Administration. ACTION: Final rule. SUMMARY: This final rule adopts, without change, the interim final rule with... incorporated changes to the Medicare prescription drug coverage low-income subsidy (Extra Help) program made by..., 2011. We also revised our regulations to incorporate changes made by the Medicare Improvements for...
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Changes in Post-acute Care in the Medicare Shared Savings Program
McWilliams, J. Michael; Gilstrap, Lauren G.; Stevenson, David G.; Chernew, Michael E.; Huskamp, Haiden A.; Grabowski, David C.
2017-01-01
Importance Post-acute care is thought to be a major source of wasteful spending. The extent to which accountable care organizations (ACOs) can limit post-acute spending has implications for the importance and design of other payment models that include post-acute care. Objective To assess changes in post-acute spending and utilization associated with provider participation as ACOs in the Medicare Shared Savings Program (MSSP) and the pathways by which they occurred. Design and Setting Using fee-for-service Medicare claims from 2009–2014, we conducted difference-in-difference comparisons of beneficiaries served by ACOs with beneficiaries served by local non-ACO providers (control group) before vs. after entry into the MSSP. We estimated differential changes separately for cohorts of ACOs entering the MSSP in 2012, 2013, and 2014. Participants Random 20% sample of beneficiaries with 25,544,650 patient-years, 8,395,426 hospital admissions, and 1,595,352 SNF stays from 2009–2014. Exposure Patient attribution to an ACO in the MSSP. Main Outcomes and Measures Post-acute spending, discharge to a facility, length of SNF stays, readmissions, use of highly-rated SNFs, and mortality, adjusted for patient characteristics. Results For the 2012 cohort of ACOs, MSSP participation was associated with an overall reduction in post-acute spending (differential change in 2014 for ACOs vs. control group: −$106/beneficiary or −9.0%; P=0.003) that was driven by differential reductions in inpatient utilization, discharges to facilities rather than home (−0.6 percentage points or −2.7%; P=0.03), and length of SNF stays (−0.60 days/stay or −2.2%; P=0.002). Reductions in SNF use and length of stay were due largely to within-hospital or within-SNF changes in care specifically for ACO patients. MSSP participation was associated with smaller significant reductions in SNF spending in 2014 for the 2013 ACO cohort but not in the 2013 or 2014 cohort’s first year of participation
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... health plans include all Medicare Advantage Plans, Medicare Cost Plans, and Demonstration/Pilot Programs. PACE plans can be offered by public or private entities and provide Part D and other benefits in addition to Part A and Part B ...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-24
... commonly found in other medical facilities, for example, cooking, anesthesia, paint shops, or piped-in... Part A and Part B claims appeals. In 2003, the Medicare Prescription Drug, Improvement, and... BIPA. The Food and Drug Administration's (FDA) categorization of a product as a category A device is...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-02
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 489... & Medicaid Services (CMS), HHS. ACTION: Request for comments. SUMMARY: This request for comments addresses... comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and...
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Solar wind helium ions - Observations of the Helios solar probes between 0.3 and 1 AU
NASA Technical Reports Server (NTRS)
Marsch, E.; Rosenbauer, H.; Schwenn, R.; Muehlhaeuser, K.-H.; Neubauer, F. M.
1982-01-01
A Helios solar probe survey of solar wind helium ion velocity distributions and derived parameters between 0.3 and 1 AU is presented. Distributions in high-speed wind are found to generally have small total anisotropies, with some indication that, in the core part, the temperatures are greater parallel rather than perpendicular to the magnetic field. The anisotropy tends to increase with heliocentric radial distance, and the average dependence of helium ion temperatures on radial distance from the sun is described by a power law. Differential ion speeds with values of more than 150 km/sec are observed near perihelion, or 0.3 AU. The role of Coulomb collisions in limiting differential ion speeds and the ion temperature ratio is investigated, and it is found that collisions play a distinct role in low-speed wind, by limiting both differential ion velocity and temperature.
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42 CFR 403.322 - Termination of agreements for Medicare recognition of State systems.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Termination of agreements for Medicare recognition of State systems. 403.322 Section 403.322 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Recognition of State...
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Healy, Peter C; Loughrey, Bradley T; Bowmaker, Graham A; Hanna, John V
2008-07-28
(197)Au Mössbauer spectra for the d(10) gold(i) phosphine complexes, [Au(dppey)(2)]X (X = PF(6), I; dppey = (cis-bis(diphenylphosphino)ethylene), and the single crystal X-ray structure and solid state (31)P CPMAS NMR spectrum of [Au(dppey)(2)]I are reported here. In [Au(dppey)(2)]I the AuP(4) coordination geometry is distorted from the approximately D(2) symmetry observed for the PF(6)(-) complex with Au-P bond lengths 2.380(2)-2.426(2) A and inter-ligand P-Au-P angles 110.63(5)-137.71(8) degrees . Quadrupole splitting parameters derived from the Mössbauer spectra are consistent with the increased distortion of the AuP(4) coordination sphere with values of 1.22 and 1.46 mm s(-1) for the PF(6)(-) and I(-) complexes respectively. In the solid state (31)P CP MAS NMR spectrum of [Au(dppey)(2)]I, signals for each of the four crystallographically independent phosphorus nuclei are observed, with the magnitude of the (197)Au quadrupole coupling being sufficiently large to produce a collapse of (1)J(Au-P) splitting from quartets to doublets. The results highlight the important role played by the counter anion in the determination of the structural and spectroscopic properties of these sterically crowded d(10) complexes.
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NASA Astrophysics Data System (ADS)
Hanneson, C.; Johnson, C.; Al Asad, M.
2017-12-01
Magnetometer data from the MErcury Surface, Space ENvironment, GEochemistry and Ranging (MESSENGER), Advanced Composition Explorer (ACE) and Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft were used to characterize the variation of the interplanetary magnetic field (IMF) with heliocentric distance from 0.3 to 1.7 AU. MESSENGER and ACE data form a set of simultaneous observations that spans eight years, from March 2007 until April 2015, with ACE observations continuing until the present. MAVEN data have been collected since November 2014. Furthermore, for the period 2008-2015, MESSENGER and ACE observations were taken over the same range of heliocentric distances: 0.31-0.47 AU and 0.94-1.00 AU respectively. The IMF varies with the solar sunspot cycle, and so data taken simultaneously at different heliocentric distances allow solar-cycle effects to be decoupled from the radial evolution of the IMF. The data were averaged temporally by taking 1-hour means, and median values were then computed in 0.01-AU bins. For the time interval spanned by all observations, the median value of the magnitude of the IMF decreases steadily from 30.1 nT at 0.3 AU to 4.3 nT at 1.0 AU and 2.5 nT at 1.6 AU. The magnitude of the IMF was found to decay with heliocentric distance according to an inverse power law with an exponent equal to the adiabatic index for an ideal monatomic gas, 5/3, within 95% confidence limits. The magnitude of the radial component decays with distance as an inverse square law within 95% confidence limits. We also consider temporal variations of the heliocentric-dependence of the IMF over the current solar cycle by computing power law fits to the simultaneous MESSENGER and ACE observations using a moving window. Our study complements the recent study of Gruesbeck et al. (2017) that used Juno data to consider the variation in IMF properties over the heliocentric distance range 1 to 6 AU.
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1996-09-19
This rule establishes requirements and procedures for advance payments to suppliers of Medicare Part B services. An advance payment will be made only if the carrier is unable to process a claim timely; the supplier requests advance payment; we determine that payment of interest is insufficient to compensate the supplier for loss of the use of the funds; and, we expressly approve the advance payment in writing. These rules are necessary to address deficiencies noted by the General Accounting Office in its report analyzing current procedures for making advance payments. The intent of this rule is to ensure more efficient and effective administration of this aspect of the Medicare program.
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77 FR 38837 - Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-29
... weights, price-measurement proxies, and productivity adjustment. This meeting is open to the public in... productivity adjustment. For more information on the Panel, see the October 7, 2011 Federal Register (76 FR... recommendations regarding the MEI's inputs, input weights, price- measurement proxies, and the productivity...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-28
...This notice announces the annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on or after January 1, 2013. The calendar year 2013 AIC threshold amounts are $140 for ALJ hearings and $1,400 for judicial review.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-27
...This notice announces the annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on or after January 1, 2014. The calendar year 2014 AIC threshold amounts are $140 for ALJ hearings and $1,430 for judicial review.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-23
...This notice announces the annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on or after January 1, 2012. The calendar year 2012 AIC threshold amounts are $130 for ALJ hearings and $1,350 for judicial review.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-24
...This notice announces the annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on or after January 1, 2011. The 2011 AIC threshold amounts are $130 for ALJ hearings and $1,300 for judicial review.
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Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Suspension, offset, and recoupment of Medicare payments to providers and suppliers of services. 405.371 Section 405.371 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR...
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Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 2 2011-10-01 2011-10-01 false Suspension, offset, and recoupment of Medicare payments to providers and suppliers of services. 405.371 Section 405.371 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR...
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Statistical uncertainty in the Medicare shared savings program.
DeLia, Derek; Hoover, Donald; Cantor, Joel C
2012-01-01
Analyze statistical risks facing CMS and Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP). We calculate the probability that shared savings formulas lead to inappropriate payment, payment denial, and/or financial penalties, assuming that ACOs generate real savings in Medicare spending ranging from 0-10%. We also calculate expected payments from CMS to ACOs under these scenarios. The probability of an incorrect outcome is heavily dependent on ACO enrollment size. For example, in the MSSP two-sided model, an ACO with 5,000 enrollees that keeps spending constant faces a 0.24 probability of being inappropriately rewarded for savings and a 0.26 probability of paying an undeserved penalty for increased spending. For an ACO with 50,000 enrollees, both of these probabilities of incorrect outcomes are equal to 0.02. The probability of inappropriate payment denial declines as real ACO savings increase. Still, for ACOs with 5,000 patients, the probability of denial is at least 0.15 even when true savings are 5-7%. Depending on ACO size and the real ACO savings rate, expected ACO payments vary from $115,000 to $35.3 million. Our analysis indicates there may be greater statistical uncertainty in the MSSP than previously recognized. CMS and ACOs will have to consider this uncertainty in their financial, administrative, and care management planning. We also suggest analytic strategies that can be used to refine ACO payment formulas in the longer term to ensure that the MSSP (and other ACO initiatives that will be influenced by it) work as efficiently as possible.
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NASA Astrophysics Data System (ADS)
Wang, Yaping; STAR Collaboration
2017-08-01
In these proceedings, we present recent results on electrons from semi-leptonic decays of open heavy-flavor hadrons (eHF) with the STAR detector at the Relativistic Heavy Ion Collider. We report the updated measurements of eHF production in p+p collisions at √{ s } = 200 GeV with significantly improved precision and wider kinematic coverage than previous measurements. With this new p+p reference, we obtain the nuclear modification factor (RAA) for eHF in Au+Au collisions at √{sNN } = 200 GeV using 2010 data. The RAA shows significant suppression at high pT in most central Au+Au collisions, while the suppression reduces gradually towards more peripheral collisions. We compare eHFRAA in central Au+Au collisions to that in central U+U collisions at √{sNN } = 193 GeV and find that they are consistent within uncertainties. We also show the results of B-hadron contribution to eHF extracted from azimuthal correlations between eHF and charged hadrons in p+p collisions. Finally we report the measurements of eHF from open bottom hadron decays and discuss the prospect of measuring eHF from open bottom and charm hadron decays separately utilizing the Heavy Flavor Tracker in Au+Au collisions.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-09
..., Financings which Constitute Conflicts of Interest of the Small Business Administration (``SBA'') Rules and... Business Holdings, Inc., 30775 Barrington, Suite 100, Madison Heights, MI 48071 (``Dorsey''). The financing... SMALL BUSINESS ADMINISTRATION Solutions Capital I, L.P., License No. 03/03-0247; Notice Seeking...
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Xu, Peng; Burgess, James F; Cabral, Howard; Soria-Saucedo, Rene; Kazis, Lewis E
2015-03-03
The Centers for Medicare & Medicaid Services (CMS) publishes star ratings on Medicare Advantage (MA) contracts to measure plan quality of care with implications for reimbursement and bonuses. To investigate whether MA contract characteristics are associated with quality of care through the Medicare plan star ratings. Retrospective study of MA star ratings in 2010. Unadjusted and adjusted multivariable linear regression models assessed the relationship between 5-star rating summary scores and plan characteristics. CMS MA contracts nationally. 409 (71%) of a total of 575 MA contracts, covering 10.56 million Medicare beneficiaries (90% of the MA population) in the United States in 2010. The MA quality ratings summary score (stars range from 1 to 5) is a quality measure based on 36 indicators related to processes of care, health outcomes, access to care, and beneficiary satisfaction. Nonprofit, larger, and older MA contracts were more likely to receive higher star ratings. Star ratings ranged from 2 to 5. Nonprofit contracts received an average 0.55 (95% CI, 0.42 to 0.67) higher star ratings than for-profit contracts (P < 0.001) after controls were set for contract characteristics. The study focused on persons aged 65 years or older covered by MA. In 2010, nonprofit MA contracts received significantly higher star ratings than for-profit contracts. When comparing health plans in the future, the CMS should give increasing attention to for-profit plans with lower quality ratings and consider developing programs to assist newer and smaller plans in improving their care for Medicare beneficiaries. None.
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Chiral magnetic effect search in p+Au, d+Au and Au+Au collisions at RHIC
NASA Astrophysics Data System (ADS)
Zhao, Jie
2018-01-01
Metastable domains of fluctuating topological charges can change the chirality of quarks and induce local parity violation in quantum chromodynamics. This can lead to observable charge separation along the direction of the strong magnetic field produced by spectator protons in relativistic heavy-ion collisions, a phenomenon called the chiral magnetic effect (CME). A major background source for CME measurements using the charge-dependent azimuthal correlator (Δϒ) is the intrinsic particle correlations (such as resonance decays) coupled with the azimuthal elliptical anisotropy (v2). In heavy-ion collisions, the magnetic field direction and event plane angle are correlated, thus the CME and the v2-induced background are entangled. In this report, we present two studies from STAR to shed further lights on the background issue. (1) The Δϒ should be all background in small system p+Au and d+Au collisions, because the event plane angles are dominated by geometry fluctuations uncorrelated to the magnetic field direction. However, significant Δϒ is observed, comparable to the peripheral Au+Au data, suggesting a background dominance in the latter, and likely also in the mid-central Au+Au collisions where the multiplicity and v2 scaled correlator is similar. (2) A new approach is devised to study Δϒ as a function of the particle pair invariant mass (minv) to identify the resonance backgrounds and hence to extract the possible CME signal. Signal is consistent with zero within uncertainties at high minv. Signal at low minv, extracted from a two-component model assuming smooth mass dependence, is consistent with zero within uncertainties.
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Han, Seung Cheol; Kim, Jae-Kwan; Kim, Jun Young; Lee, Dong Min; Yoon, Jae-Sik; Kim, Jong-Kyu; Schubert, E F; Lee, Ji-Myon
2013-08-01
The electrical properties of Ni-based ohmic contacts to N-face p-type GaN were investigated. The specific contact resistance of N-face p-GaN exhibits a linear decrease from 1.01 omega cm2 to 9.05 x 10(-3) omega cm2 for the as-deposited and the annealed Ni/Au contacts, respectively, with increasing annealing temperature. However, the specific contact resistance could be decreased down to 1.03 x 10(-4) omega cm2 by means of surface treatment using an alcohol-based (NH4)2S solution. The depth profile data measured from the intensity of O1s peak in the X-ray photoemission spectra showed that the alcohol-based (NH4)2S treatment was effective in removing the surface oxide layer of GaN.
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The Impact of Hospital Pay-for-Performance on Hospital and Medicare Costs
Kruse, Gregory B; Polsky, Daniel; Stuart, Elizabeth A; Werner, Rachel M
2012-01-01
Objective To evaluate the effects of Medicare's hospital pay-for-performance demonstration project on hospital revenues, costs, and margins and on Medicare costs. Data Sources/Study Setting All health care utilization for Medicare beneficiaries hospitalized for acute myocardial infarction (AMI; ICD-9-CM code 410.x1) in fiscal years 2002–2005 from Medicare claims, containing 420,211 admissions with AMI. Study Design We test for changes in hospital costs and revenues and Medicare payments among 260 hospitals participating in the Medicare hospital pay-for-performance demonstration project and a group of 780 propensity-score-matched comparison hospitals. Effects were estimated using a difference-in-difference model with hospital fixed effects, testing for changes in costs among pay-for-performance hospitals above and beyond changes in comparison hospitals. Principal Findings We found no significant effect of pay-for-performance on hospital financials (revenues, costs, and margins) or Medicare payments (index hospitalization and 1 year after admission) for AMI patients. Conclusions Pay-for-performance in the CMS hospital demonstration project had minimal impact on hospital financials and Medicare payments to providers. As P4P extends to all hospitals under the Affordable Care Act, these results provide some estimates of the impact of P4P and emphasize our need for a better understanding of the financial implications of P4P on providers and payers if we want to create sustainable and effective programs to improve health care value. PMID:23088391
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The impact of hospital pay-for-performance on hospital and Medicare costs.
Kruse, Gregory B; Polsky, Daniel; Stuart, Elizabeth A; Werner, Rachel M
2012-12-01
To evaluate the effects of Medicare's hospital pay-for-performance demonstration project on hospital revenues, costs, and margins and on Medicare costs. All health care utilization for Medicare beneficiaries hospitalized for acute myocardial infarction (AMI; ICD-9-CM code 410.x1) in fiscal years 2002-2005 from Medicare claims, containing 420,211 admissions with AMI. We test for changes in hospital costs and revenues and Medicare payments among 260 hospitals participating in the Medicare hospital pay-for-performance demonstration project and a group of 780 propensity-score-matched comparison hospitals. Effects were estimated using a difference-in-difference model with hospital fixed effects, testing for changes in costs among pay-for-performance hospitals above and beyond changes in comparison hospitals. We found no significant effect of pay-for-performance on hospital financials (revenues, costs, and margins) or Medicare payments (index hospitalization and 1 year after admission) for AMI patients. Pay-for-performance in the CMS hospital demonstration project had minimal impact on hospital financials and Medicare payments to providers. As P4P extends to all hospitals under the Affordable Care Act, these results provide some estimates of the impact of P4P and emphasize our need for a better understanding of the financial implications of P4P on providers and payers if we want to create sustainable and effective programs to improve health care value. © Health Research and Educational Trust.
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76 FR 627 - Medicare Program; End-Stage Renal Disease Quality Incentive Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-05
... FR 49215- 49232). We received and reviewed many helpful comments regarding the design of the QIP that... three measures. We stated that in designing the scoring methodology for the first year, we wanted to...
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NASA Astrophysics Data System (ADS)
Kim, Dae-Hyun; Park, Jae-Seong; Kang, Daesung; Seong, Tae-Yeon
2017-08-01
We developed NiZn/(Ta/)Ni ohmic contacts to replace expensive AuBe/Au contacts commonly used in high-efficiency AlGaInP-based light-emitting diodes (LEDs), and compared the electrical properties of the two contact types. Unlike the AuBe/Au (130 nm/100 nm) contact, the NiZn/Ta/Ni (130 nm/20 nm/100 nm) contact shows improved electrical properties after being annealed at 500°C, with a contact resistivity of 5.2 × 10-6 Ω cm2. LEDs with the NiZn/Ta/Ni contact exhibited a 4.4% higher output power (at 250 mW) than LEDs with the AuBe/Au contact. In contrast to the trend for the AuBe/Au contact, the Ga 2 p core level for the NiZn/Ta/Ni contact shifted toward lower binding energies after being annealed at 500°C. Auger electron spectroscopy (AES) depth profiles showed that annealing the AuBe/Au samples caused the outdiffusion of both Be and P atoms into the metal contact, whereas in the NiZn/Ta/Ni samples, Zn atoms indiffused into the GaP layer. The annealing-induced electrical degradation and ohmic contact formation mechanisms are described and discussed on the basis of the results of x-ray photoemission spectroscopy and AES.
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Gu, Qian; Koenig, Lane; Faerberg, Jennifer; Steinberg, Caroline Rossi; Vaz, Christopher; Wheatley, Mary P
2014-06-01
To explore the impact of the Hospital Readmissions Reduction Program (HRRP) on hospitals serving vulnerable populations. Medicare inpatient claims to calculate condition-specific readmission rates. Medicare cost reports and other sources to determine a hospital's share of duals, profit margin, and characteristics. Regression analyses and projections were used to estimate risk-adjusted readmission rates and financial penalties under the HRRP. Findings were compared across groups of hospitals, determined based on their share of duals, to assess differential impacts of the HRRP. Both patient dual-eligible status and a hospital's dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations. Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations. © Health Research and Educational Trust.
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Gu, Qian; Koenig, Lane; Faerberg, Jennifer; Steinberg, Caroline Rossi; Vaz, Christopher; Wheatley, Mary P
2014-01-01
Objective To explore the impact of the Hospital Readmissions Reduction Program (HRRP) on hospitals serving vulnerable populations. Data Sources/Study Setting Medicare inpatient claims to calculate condition-specific readmission rates. Medicare cost reports and other sources to determine a hospital's share of duals, profit margin, and characteristics. Study Design Regression analyses and projections were used to estimate risk-adjusted readmission rates and financial penalties under the HRRP. Findings were compared across groups of hospitals, determined based on their share of duals, to assess differential impacts of the HRRP. Principal Findings Both patient dual-eligible status and a hospital's dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations. Conclusions Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations. PMID:24417309
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Chiral Magnetic Effect Search in p(d)+Au, Au+Au Collisions at RHIC
NASA Astrophysics Data System (ADS)
Zhao, Jie
The chiral magnetic effect (CME) refers to charge separation along a strong magnetic field of single-handed quarks, caused by interactions with topological gluon fields from QCD vacuum fluctuations. A major background of CME measurements in heavy-ion collisions comes from resonance decays coupled with elliptical flow anisotropy. These proceedings present two new studies from STAR to shed further light on the background issue: (1) small system p+Au and d+Au collisions where the CME signal is not expected, and (2) pair invariant mass dependence where resonance peaks can be identified.
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Medicare contracting risk/Medicare risk contracting: a life-cycle view from twelve markets.
Hurley, Robert E; Grossman, Joy M; Strunk, Bradley C
2003-02-01
To examine the evolution of the Medicare HMO program from 1996 to 2001 in 12 nationally representative urban markets by exploring how the separate and confluent influences of government policy initiatives and health plans' strategic aims and operational experience affected the availability of HMOs to Medicare beneficiaries. Qualitative data gathered from 12 nationally representative urban communities with more than 200,000 residents each, in tandem with quantitative information from the Centers for Medicare and Medicaid Services and other sources. Detailed interview protocols, developed as part of the multiyear, multimethod Community Tracking Study of the Center for Studying Health System Change, were used to conduct three rounds of interviews (1996, 1998, and 2000-2001) with health plans and providers in 12 nationally representative urban communities. A special focus during the third round of interviews was on gathering information related to Medicare HMOs' experience in the previous four years. This information was used to build on previous research to develop a longitudinal perspective on health plans' experience in Medicare's HMO program. From 1996 to 2001, the activities and expectations of health plans in local markets underwent a rapid and dramatic transition from enthusiasm for the Medicare HMO product, to abrupt reconsideration of interest corresponding to changes in the Balanced Budget Act of 1997, on to significant retrenchment and disillusionment. Policy developments were important in their own right, but they also interacted with shifts in the strategic aims and operational experiences of health plans that reflect responses to insurance underwriting cycle pressures and pushback from providers. The Medicare HMO program went through a substantial reversal of fortune during the study period, raising doubts about whether its downward course can be altered. Market-level analysis reveals that virtually all momentum for the program has been lost and that
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-17
...-Approved Lung JoAnna Baldwin, MS.. (410) 786-7205 Volume Reduction Surgery Facilities. XIV Medicare-Approved Kate Tillman, RN, (410) 786-9252 Bariatric Surgery MAS. Facilities. XV Fluorodeoxyglucose Stuart...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-04
...-Approved Lung JoAnna Baldwin, (410) 786-7205 Volume Reduction Surgery MS. Facilities. XIV Medicare-Approved Kate Tillman, RN, (410) 786-9252 Bariatric Surgery Facilities. MAS. XV Fluorodeoxyglucose Positron...
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Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R; Van Nostrand, Joan F; Eggert, Gerald M
2010-01-01
To examine the impact of an experimental consumer-choice voucher benefit on the selection of independent and agency personal assistance services (PAS) providers among rural and urban Medicare beneficiaries with disabilities. The Medicare Primary and Consumer-Directed Care Demonstration enrolled 1,605 Medicare beneficiaries in 19 counties in New York State, West Virginia, and Ohio. A total of 839 participants were randomly assigned to receive a voucher benefit (up to $250 per month with a 20% copayment) that could be used toward PAS provided by either independent or agency workers. A bivariate probit model was used to estimate the probabilities of choosing either type of PAS provider while controlling for potential confounders. The voucher was associated with a 32.4% (P < .01) increase in the probability of choosing agency providers and a 12.5% (P= .03) increase in the likelihood of choosing independent workers. When the analysis was stratified by rural/urban status, rural voucher recipients had 36.8% higher probability of using independent workers compared to rural controls. Urban voucher recipients had 37.1% higher probability of using agency providers compared to urban controls. This study provided evidence that rural and urban Medicare beneficiaries with disabilities may have very different responses to a consumer-choice PAS voucher program. Offering a consumer-choice voucher option to rural populations holds the potential to significantly improve their access to PAS. © 2010 National Rural Health Association.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-28
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 482... Critical Access Hospital Conditions of Participation To Ensure Visitation Rights for All Patients AGENCY...) to ensure the visitation rights of all patients. Medicare- and Medicaid- participating hospitals and...
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Dijet imbalance measurements in Au +Au and p p collisions at √{sN N}=200 GeV at STAR
NASA Astrophysics Data System (ADS)
Adamczyk, L.; Adkins, J. K.; Agakishiev, G.; Aggarwal, M. M.; Ahammed, Z.; Alekseev, I.; Anderson, D. M.; Aoyama, R.; Aparin, A.; Arkhipkin, D.; Aschenauer, E. C.; Ashraf, M. U.; Attri, A.; Averichev, G. S.; Bai, X.; Bairathi, V.; Bellwied, R.; Bhasin, A.; Bhati, A. K.; Bhattarai, P.; Bielcik, J.; Bielcikova, J.; Bland, L. C.; Bordyuzhin, I. G.; Bouchet, J.; Brandenburg, J. D.; Brandin, A. V.; Brown, D.; Bunzarov, I.; Butterworth, J.; Caines, H.; Calderón de la Barca Sánchez, M.; Campbell, J. M.; Cebra, D.; Chakaberia, I.; Chaloupka, P.; Chang, Z.; Chatterjee, A.; Chattopadhyay, S.; Chen, J. H.; Chen, X.; Cheng, J.; Cherney, M.; Christie, W.; Contin, G.; Crawford, H. J.; Das, S.; De Silva, L. C.; Debbe, R. R.; Dedovich, T. G.; Deng, J.; Derevschikov, A. A.; Didenko, L.; Dilks, C.; Dong, X.; Drachenberg, J. L.; Draper, J. E.; Du, C. M.; Dunkelberger, L. E.; Dunlop, J. C.; Efimov, L. G.; Elsey, N.; Engelage, J.; Eppley, G.; Esha, R.; Esumi, S.; Evdokimov, O.; Ewigleben, J.; Eyser, O.; Fatemi, R.; Fazio, S.; Federic, P.; Fedorisin, J.; Feng, Z.; Filip, P.; Finch, E.; Fisyak, Y.; Flores, C. E.; Fulek, L.; Gagliardi, C. A.; Garand, D.; Geurts, F.; Gibson, A.; Girard, M.; Greiner, L.; Grosnick, D.; Gunarathne, D. S.; Guo, Y.; Gupta, A.; Gupta, S.; Guryn, W.; Hamad, A. I.; Hamed, A.; Haque, R.; Harris, J. W.; He, L.; Heppelmann, S.; Heppelmann, S.; Hirsch, A.; Hoffmann, G. W.; Horvat, S.; Huang, X.; Huang, B.; Huang, H. Z.; Huang, T.; Huck, P.; Humanic, T. J.; Igo, G.; Jacobs, W. W.; Jentsch, A.; Jia, J.; Jiang, K.; Jowzaee, S.; Judd, E. G.; Kabana, S.; Kalinkin, D.; Kang, K.; Kauder, K.; Ke, H. W.; Keane, D.; Kechechyan, A.; Khan, Z.; Kikoła, D. P.; Kisel, I.; Kisiel, A.; Kochenda, L.; Koetke, D. D.; Kosarzewski, L. K.; Kraishan, A. F.; Kravtsov, P.; Krueger, K.; Kumar, L.; Lamont, M. A. C.; Landgraf, J. M.; Landry, K. D.; Lauret, J.; Lebedev, A.; Lednicky, R.; Lee, J. H.; Li, W.; Li, X.; Li, X.; Li, Y.; Li, C.; Lin, T.; Lisa, M. A.; Liu, Y.; Liu, F.; Ljubicic, T.; Llope, W. J.; Lomnitz, M.; Longacre, R. S.; Luo, X.; Luo, S.; Ma, G. L.; Ma, L.; Ma, R.; Ma, Y. G.; Magdy, N.; Majka, R.; Manion, A.; Margetis, S.; Markert, C.; Matis, H. S.; McDonald, D.; McKinzie, S.; Meehan, K.; Mei, J. C.; Miller, Z. W.; Minaev, N. G.; Mioduszewski, S.; Mishra, D.; Mohanty, B.; Mondal, M. M.; Morozov, D. A.; Mustafa, M. K.; Nasim, Md.; Nayak, T. K.; Nigmatkulov, G.; Niida, T.; Nogach, L. V.; Nonaka, T.; Novak, J.; Nurushev, S. B.; Odyniec, G.; Ogawa, A.; Oh, K.; Okorokov, V. A.; Olvitt, D.; Page, B. S.; Pak, R.; Pan, Y. X.; Pandit, Y.; Panebratsev, Y.; Pawlik, B.; Pei, H.; Perkins, C.; Pile, P.; Pluta, J.; Poniatowska, K.; Porter, J.; Posik, M.; Poskanzer, A. M.; Pruthi, N. K.; Przybycien, M.; Putschke, J.; Qiu, H.; Quintero, A.; Ramachandran, S.; Ray, R. L.; Reed, R.; Rehbein, M. J.; Ritter, H. G.; Roberts, J. B.; Rogachevskiy, O. V.; Romero, J. L.; Roth, J. D.; Ruan, L.; Rusnak, J.; Rusnakova, O.; Sahoo, N. R.; Sahu, P. K.; Sakrejda, I.; Salur, S.; Sandweiss, J.; Schambach, J.; Scharenberg, R. P.; Schmah, A. M.; Schmidke, W. B.; Schmitz, N.; Seger, J.; Seyboth, P.; Shah, N.; Shahaliev, E.; Shanmuganathan, P. V.; Shao, M.; Sharma, M. K.; Sharma, A.; Sharma, B.; Shen, W. Q.; Shi, S. S.; Shi, Z.; Shou, Q. Y.; Sichtermann, E. P.; Sikora, R.; Simko, M.; Singha, S.; Skoby, M. J.; Smirnov, D.; Smirnov, N.; Solyst, W.; Song, L.; Sorensen, P.; Spinka, H. M.; Srivastava, B.; Stanislaus, T. D. S.; Stepanov, M.; Stock, R.; Strikhanov, M.; Stringfellow, B.; Sugiura, T.; Sumbera, M.; Summa, B.; Sun, X. M.; Sun, Z.; Sun, Y.; Surrow, B.; Svirida, D. N.; Tang, Z.; Tang, A. H.; Tarnowsky, T.; Tawfik, A.; Thäder, J.; Thomas, J. H.; Timmins, A. R.; Tlusty, D.; Todoroki, T.; Tokarev, M.; Trentalange, S.; Tribble, R. E.; Tribedy, P.; Tripathy, S. K.; Tsai, O. D.; Ullrich, T.; Underwood, D. G.; Upsal, I.; Van Buren, G.; van Nieuwenhuizen, G.; Vasiliev, A. N.; Vertesi, R.; Videbæk, F.; Vokal, S.; Voloshin, S. A.; Vossen, A.; Wang, F.; Wang, J. S.; Wang, G.; Wang, Y.; Wang, Y.; Webb, G.; Webb, J. C.; Wen, L.; Westfall, G. D.; Wieman, H.; Wissink, S. W.; Witt, R.; Wu, Y.; Xiao, Z. G.; Xie, G.; Xie, W.; Xin, K.; Xu, Q. H.; Xu, H.; Xu, Y. F.; Xu, Z.; Xu, J.; Xu, N.; Yang, S.; Yang, Q.; Yang, Y.; Yang, C.; Yang, Y.; Yang, Y.; Ye, Z.; Ye, Z.; Yi, L.; Yip, K.; Yoo, I.-K.; Yu, N.; Zbroszczyk, H.; Zha, W.; Zhang, X. P.; Zhang, J.; Zhang, J.; Zhang, Z.; Zhang, S.; Zhang, J. B.; Zhang, Y.; Zhang, S.; Zhao, J.; Zhong, C.; Zhou, L.; Zhu, X.; Zoulkarneeva, Y.; Zyzak, M.; STAR Collaboration
2017-08-01
We report the first dijet transverse momentum asymmetry measurements from Au +Au and p p collisions at RHIC. The two highest-energy back-to-back jets reconstructed from fragments with transverse momenta above 2 GeV /c display a significantly higher momentum imbalance in heavy-ion collisions than in the p p reference. When reexamined with correlated soft particles included, we observe that these dijets then exhibit a unique new feature—momentum balance is restored to that observed in p p for a jet resolution parameter of R =0.4 , while rebalancing is not attained with a smaller value of R =0.2 .
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-31
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1459-N... Slots AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This notice announces the closure of two teaching hospitals and the initiation of an application process where hospitals...
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2014-11-06
This final rule will update and make revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2015. This rule also finalizes requirements for the ESRD quality incentive program (QIP), including for payment years (PYs) 2017 and 2018. This rule will also make a technical correction to remove outdated terms and definitions. In addition, this final rule sets forth the methodology for adjusting Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment amounts using information from the Medicare DMEPOS Competitive Bidding Program (CBP); makes alternative payment rules for certain DME under the Medicare DMEPOS CBP; clarifies the statutory Medicare hearing aid coverage exclusion and specifies devices not subject to the hearing aid exclusion; will not update the definition of minimal self-adjustment; clarifies the Change of Ownership (CHOW) and provides for an exception to the current requirements; revises the appeal provisions for termination of a CBP contract, including the beneficiary notification requirement under the Medicare DMEPOS CBP, and makes a technical change to the regulation related to the conditions for awarding contracts for furnishing infusion drugs under the Medicare DMEPOS CBP.
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Statistical Uncertainty in the Medicare Shared Savings Program
DeLia, Derek; Hoover, Donald; Cantor, Joel C.
2012-01-01
Objective Analyze statistical risks facing CMS and Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP). Methods We calculate the probability that shared savings formulas lead to inappropriate payment, payment denial, and/or financial penalties, assuming that ACOs generate real savings in Medicare spending ranging from 0–10%. We also calculate expected payments from CMS to ACOs under these scenarios. Results The probability of an incorrect outcome is heavily dependent on ACO enrollment size. For example, in the MSSP two-sided model, an ACO with 5,000 enrollees that keeps spending constant faces a 0.24 probability of being inappropriately rewarded for savings and a 0.26 probability of paying an undeserved penalty for increased spending. For an ACO with 50,000 enrollees, both of these probabilities of incorrect outcomes are equal to 0.02. The probability of inappropriate payment denial declines as real ACO savings increase. Still, for ACOs with 5,000 patients, the probability of denial is at least 0.15 even when true savings are 5–7%. Depending on ACO size and the real ACO savings rate, expected ACO payments vary from $115,000 to $35.3 million. Discussion Our analysis indicates there may be greater statistical uncertainty in the MSSP than previously recognized. CMS and ACOs will have to consider this uncertainty in their financial, administrative, and care management planning. We also suggest analytic strategies that can be used to refine ACO payment formulas in the longer term to ensure that the MSSP (and other ACO initiatives that will be influenced by it) work as efficiently as possible. PMID:24800155
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77 FR 72268 - Rules Relating to Additional Medicare Tax
Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-05
... social security tax, and Hospital Insurance (HI) tax, also referred to as Medicare tax. The Medicare... finances different benefits. Tier 1 RRTA tax provides equivalent social security and Medicare benefits... social security and Medicare taxes on the self-employment income of every individual at the same combined...
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Genetic Predisposition to Obesity and Medicare Expenditures.
Wehby, George L; Domingue, Benjamin W; Ullrich, Fred; Wolinsky, Fredric D
2017-12-12
The relationship between obesity and health expenditures is not well understood. We examined the relationship between genetic predisposition to obesity measured by a polygenic risk score for body mass index (BMI) and Medicare expenditures. Biennial interview data from the Health and Retirement Survey for a nationally representative sample of older adults enrolled in fee-for-service Medicare were obtained from 1991 through 2010 and linked to Medicare claims for the same period and to Genome-Wide Association Study (GWAS) data. The study included 6,628 Medicare beneficiaries who provided 68,627 complete person-year observations during the study period. Outcomes were total and service-specific Medicare expenditures and indicators for expenditures exceeding the 75th and 90th percentiles. The BMI polygenic risk score was derived from GWAS data. Regression models were used to examine how the BMI polygenic risk score was related to health expenditures adjusting for demographic factors and GWAS-derived ancestry. Greater genetic predisposition to obesity was associated with higher Medicare expenditures. Specifically, a 1 SD increase in the BMI polygenic risk score was associated with a $805 (p < .001) increase in annual Medicare expenditures per person in 2010 dollars (~15% increase), a $370 (p < .001) increase in inpatient expenses, and a $246 (p < .001) increase in outpatient services. A 1 SD increase in the polygenic risk score was also related to increased likelihood of expenditures exceeding the 75th percentile by 18% (95% CI: 10%-28%) and the 90th percentile by 27% (95% CI: 15%-40%). Greater genetic predisposition to obesity is associated with higher Medicare expenditures. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Medication adherence and Medicare expenditure among beneficiaries with heart failure.
Lopert, Ruth; Shoemaker, J Samantha; Davidoff, Amy; Shaffer, Thomas; Abdulhalim, Abdulla M; Lloyd, Jennifer; Stuart, Bruce
2012-09-01
To (1) measure utilization of and adherence to heart failure medications and (2) assess whether better adherence is associated with lower Medicare spending. Pooled cross-sectional design using six 3-year cohorts of Medicare beneficiaries with congestive heart failure (CHF) from 1997 through 2005 (N = 2204). Adherence to treatment was measured using average daily pill counts. Bivariate and multivariate methods were used to examine the relationship between medication adherence and Medicare spending. Multivariate analyses included extensive variables to control for confounding, including healthy adherer bias. Approximately 58% of the cohort were taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), 72% a diuretic, 37% a beta-blocker, and 34% a cardiac glycoside. Unadjusted results showed that a 10% increase in average daily pill count for ACE inhibitors or ARBs, beta-blockers, diuretics, or cardiac glycosides was associated with reductions in Medicare spending of $508 (not significant [NS]), $608 (NS), $250 (NS), and $1244 (P <.05), respectively. Estimated adjusted marginal effects of a 10% increase in daily pill counts for beta-blockers and cardiac glycosides were reductions in cumulative 3-year Medicare spending of $510 to $561 and $750 to $923, respectively (P <.05). Higher levels of medication adherence among Medicare beneficiaries with CHF were associated with lower cumulative Medicare spending over 3 years, with savings generally exceeding the costs of the drugs in question.
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Schwartz, Aaron L; Chernew, Michael E; Landon, Bruce E; McWilliams, J Michael
2015-11-01
Wasteful practices are widespread in the US health care system. It is unclear if payment models intended to improve health care efficiency, such as the Medicare accountable care organization (ACO) programs, discourage the provision of low-value services. To assess whether the first year of the Medicare Pioneer ACO program was associated with a reduction in use of low-value services. In a difference-in-differences analysis, we compared use of low-value services between Medicare fee-for-service beneficiaries attributed to health care provider groups that entered the Pioneer program (ACO group) and beneficiaries attributed to other health care providers (control group) before (2009-2011) vs after (2012) Pioneer ACO contracts began. Data analysis was conducted from December 1, 2014, to June 27, 2015. Comparisons were adjusted for beneficiaries' sociodemographic and clinical characteristics as well as for geography. We decomposed estimates according to service characteristics (clinical category, price, and sensitivity to patient preferences) and compared estimates between subgroups of ACOs with higher vs lower baseline use of low-value services. Use of, and spending on, 31 services in instances that provide minimal clinical benefit, measured as annual service counts per 100 beneficiaries and price-standardized annual service spending per 100 beneficiaries. During the precontract period, trends in the use of low-value services were similar for the ACO and control groups. The first year of ACO contracts was associated with a differential reduction (95% CI) of 0.8 low-value services per 100 beneficiaries for the ACO group (-1.2 to -0.4; P < .001), corresponding to a 1.9% differential reduction in service quantity (-2.9% to -0.9%) and a 4.5% differential reduction in spending on low-value services (-7.5% to -1.4%; P = .004). Differential reductions were similar for services less sensitive vs more sensitive to patient preferences and for higher- vs lower-priced services
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Evaluation of Student Outcomes after Participating in a Medicare Outreach Program
ERIC Educational Resources Information Center
Hollingsworth, Joshua C.; Teeter, Benjamin S.; Westrick, Salisa C.
2015-01-01
This article describes the development of a service-learning project and analysis of student pharmacists' participation therein. Using a mixed-methods approach, this study analyzed student pharmacists' knowledge and attitudes after volunteering in the inaugural Medicare Outreach Program, a collaboration between the School of Pharmacy and State…
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42 CFR 424.535 - Revocation of enrollment in the Medicare program.
Code of Federal Regulations, 2014 CFR
2014-10-01
... the Medicare program. (a) Reasons for revocation. CMS may revoke a currently enrolled provider or... the following reasons: (1) Noncompliance. The provider or supplier is determined not to be in...— (A) Felony crimes against persons, such as murder, rape, assault, and other similar crimes for which...
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Adler, C; Ahammed, Z; Allgower, C; Amonett, J; Anderson, B D; Anderson, M; Averichev, G S; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellwied, R; Berger, J; Bichsel, H; Billmeier, A; Bland, L C; Blyth, C O; Bonner, B E; Boucham, A; Brandin, A; Bravar, A; Cadman, R V; Caines, H; Calderón de la Barca Sánchez, M; Cardenas, A; Carroll, J; Castillo, J; Castro, M; Cebra, D; Chaloupka, P; Chattopadhyay, S; Chen, Y; Chernenko, S P; Cherney, M; Chikanian, A; Choi, B; Christie, W; Coffin, J P; Cormier, T M; Corral, M M; Cramer, J G; Crawford, H J; Derevschikov, A A; Didenko, L; Dietel, T; Draper, J E; Dunin, V B; Dunlop, J C; Eckardt, V; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Fachini, P; Faine, V; Faivre, J; Fatemi, R; Filimonov, K; Finch, E; Fisyak, Y; Flierl, D; Foley, K J; Fu, J; Gagliardi, C A; Gagunashvili, N; Gans, J; Gaudichet, L; Germain, M; Geurts, F; Ghazikhanian, V; Grachov, O; Grigoriev, V; Guedon, M; Gushin, E; Hallman, T J; Hardtke, D; Harris, J W; Henry, T W; Heppelmann, S; Herston, T; Hippolyte, B; Hirsch, A; Hjort, E; Hoffmann, G W; Horsley, M; Huang, H Z; Humanic, T J; Igo, G; Ishihara, A; Ivanshin, Yu I; Jacobs, P; Jacobs, W W; Janik, M; Johnson, I; Jones, P G; Judd, E G; Kaneta, M; Kaplan, M; Keane, D; Kiryluk, J; Kisiel, A; Klay, J; Klein, S R; Klyachko, A; Kollegger, T; Konstantinov, A S; Kopytine, M; Kotchenda, L; Kovalenko, A D; Kramer, M; Kravtsov, P; Krueger, K; Kuhn, C; Kulikov, A I; Kunde, G J; Kunz, C L; Kutuev, R Kh; Kuznetsov, A A; Lakehal-Ayat, L; Lamont, M A C; Landgraf, J M; Lange, S; Lansdell, C P; Lasiuk, B; Laue, F; Lauret, J; Lebedev, A; Lednický, R; Leontiev, V M; LeVine, M J; Li, Q; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, L; Liu, Z; Liu, Q J; Ljubicic, T; Llope, W J; LoCurto, G; Long, H; Longacre, R S; Lopez-Noriega, M; Love, W A; Ludlam, T; Lynn, D; Ma, J; Magestro, D; Majka, R; Margetis, S; Markert, C; Martin, L; Marx, J; Matis, H S; Matulenko, Yu A; McShane, T S; Meissner, F; Melnick, Yu; Meschanin, A; Messer, M; Miller, M L; Milosevich, Z; Minaev, N G; Mitchell, J; Moore, C F; Morozov, V; de Moura, M M; Munhoz, M G; Nelson, J M; Nevski, P; Nikitin, V A; Nogach, L V; Norman, B; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Paic, G; Pandey, S U; Panebratsev, Y; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Perevoztchikov, V; Peryt, W; Petrov, V A; Planinic, M; Pluta, J; Porile, N; Porter, J; Poskanzer, A M; Potrebenikova, E; Prindle, D; Pruneau, C; Putschke, J; Rai, G; Rakness, G; Ravel, O; Ray, R L; Razin, S V; Reichhold, D; Reid, J G; Renault, G; Retiere, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevski, O V; Romero, J L; Rose, A; Roy, C; Rykov, V; Sakrejda, I; Salur, S; Sandweiss, J; Savin, I; Schambach, J; Scharenberg, R P; Schmitz, N; Schroeder, L S; Schüttauf, A; Schweda, K; Seger, J; Seliverstov, D; Seyboth, P; Shahaliev, E; Shestermanov, K E; Shimanskii, S S; Simon, F; Skoro, G; Smirnov, N; Snellings, R; Sorensen, P; Sowinski, J; Spinka, H M; Srivastava, B; Stephenson, E J; Stock, R; Stolpovsky, A; Strikhanov, M; Stringfellow, B; Struck, C; Suaide, A A P; Sugarbaker, E; Suire, C; Sumbera, M; Surrow, B; Symons, T J M; Szanto de Toledo, A; Szarwas, P; Tai, A; Takahashi, J; Tang, A H; Thein, D; Thomas, J H; Thompson, M; Tikhomirov, V; Tokarev, M; Tonjes, M B; Trainor, T A; Trentalange, S; Tribble, R E; Trofimov, V; Tsai, O; Ullrich, T; Underwood, D G; Van Buren, G; VanderMolen, A M; Vasilevski, I M; Vasiliev, A N; Vigdor, S E; Voloshin, S A; Wang, F; Ward, H; Watson, J W; Wells, R; Westfall, G D; Whitten, C; Wieman, H; Willson, R; Wissink, S W; Witt, R; Wood, J; Xu, N; Xu, Z; Yakutin, A E; Yamamoto, E; Yang, J; Yepes, P; Yurevich, V I; Zanevski, Y V; Zborovský, I; Zhang, H; Zhang, W M; Zoulkarneev, R; Zubarev, A N
2003-02-28
Azimuthal correlations for large transverse momentum charged hadrons have been measured over a wide pseudorapidity range and full azimuth in Au+Au and p+p collisions at sqrt[s(NN)]=200 GeV. The small-angle correlations observed in p+p collisions and at all centralities of Au+Au collisions are characteristic of hard-scattering processes previously observed in high-energy collisions. A strong back-to-back correlation exists for p+p and peripheral Au+Au. In contrast, the back-to-back correlations are reduced considerably in the most central Au+Au collisions, indicating substantial interaction as the hard-scattered partons or their fragmentation products traverse the medium.
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Measurement of Υ (1 S +2 S +3 S ) production in p +p and Au + Au collisions at √{sNN}=200 GeV
NASA Astrophysics Data System (ADS)
Adare, A.; Afanasiev, S.; Aidala, C.; Ajitanand, N. N.; Akiba, Y.; Akimoto, R.; Al-Bataineh, H.; Al-Ta'Ani, H.; Alexander, J.; Angerami, A.; Aoki, K.; Apadula, N.; Aphecetche, L.; Aramaki, Y.; Asai, J.; Asano, H.; Aschenauer, E. C.; Atomssa, E. T.; Averbeck, R.; Awes, T. C.; Azmoun, B.; Babintsev, V.; Bai, M.; Baksay, G.; Baksay, L.; Baldisseri, A.; Bannier, B.; Barish, K. N.; Barnes, P. D.; Bassalleck, B.; Basye, A. T.; Bathe, S.; Batsouli, S.; Baublis, V.; Baumann, C.; Baumgart, S.; Bazilevsky, A.; Belikov, S.; Belmont, R.; Bennett, R.; Berdnikov, A.; Berdnikov, Y.; Bickley, A. A.; Bing, X.; Blau, D. S.; Boissevain, J. G.; Bok, J. S.; Borel, H.; Boyle, K.; Brooks, M. L.; Buesching, H.; Bumazhnov, V.; Bunce, G.; Butsyk, S.; Camacho, C. M.; Campbell, S.; Castera, P.; Chang, B. S.; Chang, W. C.; Charvet, J.-L.; Chen, C.-H.; Chernichenko, S.; Chi, C. Y.; Chiu, M.; Choi, I. J.; Choi, J. B.; Choi, S.; Choudhury, R. K.; Christiansen, P.; Chujo, T.; Chung, P.; Churyn, A.; Chvala, O.; Cianciolo, V.; Citron, Z.; Cole, B. A.; Connors, M.; Constantin, P.; Csanád, M.; Csörgő, T.; Dahms, T.; Dairaku, S.; Das, K.; Datta, A.; Daugherity, M. S.; David, G.; Denisov, A.; D'Enterria, D.; Deshpande, A.; Desmond, E. J.; Dharmawardane, K. V.; Dietzsch, O.; Ding, L.; Dion, A.; Donadelli, M.; Drapier, O.; Drees, A.; Drees, K. A.; Dubey, A. K.; Durham, J. M.; Durum, A.; Dutta, D.; Dzhordzhadze, V.; D'Orazio, L.; Edwards, S.; Efremenko, Y. V.; Ellinghaus, F.; Engelmore, T.; Enokizono, A.; En'yo, H.; Esumi, S.; Eyser, K. O.; Fadem, B.; Fields, D. E.; Finger, M.; Finger, M.; Fleuret, F.; Fokin, S. L.; Fraenkel, Z.; Frantz, J. E.; Franz, A.; Frawley, A. D.; Fujiwara, K.; Fukao, Y.; Fusayasu, T.; Gainey, K.; Gal, C.; Garishvili, A.; Garishvili, I.; Glenn, A.; Gong, H.; Gong, X.; Gonin, M.; Gosset, J.; Goto, Y.; Granier de Cassagnac, R.; Grau, N.; Greene, S. V.; Grosse Perdekamp, M.; Gunji, T.; Guo, L.; Gustafsson, H.-Å.; Hachiya, T.; Hadj Henni, A.; Haggerty, J. S.; Hahn, K. I.; Hamagaki, H.; Han, R.; Hanks, J.; Hartouni, E. P.; Haruna, K.; Hashimoto, K.; Haslum, E.; Hayano, R.; He, X.; Heffner, M.; Hemmick, T. K.; Hester, T.; Hill, J. C.; Hohlmann, M.; Hollis, R. S.; Holzmann, W.; Homma, K.; Hong, B.; Horaguchi, T.; Hori, Y.; Hornback, D.; Huang, S.; Ichihara, T.; Ichimiya, R.; Iinuma, H.; Ikeda, Y.; Imai, K.; Imrek, J.; Inaba, M.; Iordanova, A.; Isenhower, D.; Ishihara, M.; Isobe, T.; Issah, M.; Isupov, A.; Ivanischev, D.; Ivanishchev, D.; Jacak, B. V.; Javani, M.; Jia, J.; Jiang, X.; Jin, J.; Johnson, B. M.; Joo, K. S.; Jouan, D.; Jumper, D. S.; Kajihara, F.; Kametani, S.; Kamihara, N.; Kamin, J.; Kaneti, S.; Kang, B. H.; Kang, J. H.; Kang, J. S.; Kapustinsky, J.; Karatsu, K.; Kasai, M.; Kawall, D.; Kazantsev, A. V.; Kempel, T.; Khanzadeev, A.; Kijima, K. M.; Kikuchi, J.; Kim, B. I.; Kim, C.; Kim, D. H.; Kim, D. J.; Kim, E.; Kim, E.-J.; Kim, H. J.; Kim, K.-B.; Kim, S. H.; Kim, Y.-J.; Kim, Y. K.; Kinney, E.; Kiriluk, K.; Kiss, Á.; Kistenev, E.; Klatsky, J.; Klay, J.; Klein-Boesing, C.; Kleinjan, D.; Kline, P.; Kochenda, L.; Komatsu, Y.; Komkov, B.; Konno, M.; Koster, J.; Kotchetkov, D.; Kotov, D.; Kozlov, A.; Král, A.; Kravitz, A.; Krizek, F.; Kunde, G. J.; Kurita, K.; Kurosawa, M.; Kweon, M. J.; Kwon, Y.; Kyle, G. S.; Lacey, R.; Lai, Y. S.; Lajoie, J. G.; Layton, D.; Lebedev, A.; Lee, B.; Lee, D. M.; Lee, J.; Lee, K. B.; Lee, K. S.; Lee, S. H.; Lee, S. R.; Lee, T.; Leitch, M. J.; Leite, M. A. L.; Leitgab, M.; Lenzi, B.; Lewis, B.; Li, X.; Liebing, P.; Lim, S. H.; Linden Levy, L. A.; Liška, T.; Litvinenko, A.; Liu, H.; Liu, M. X.; Love, B.; Lynch, D.; Maguire, C. F.; Makdisi, Y. I.; Makek, M.; Malakhov, A.; Malik, M. D.; Manion, A.; Manko, V. I.; Mannel, E.; Mao, Y.; Mašek, L.; Masui, H.; Masumoto, S.; Matathias, F.; McCumber, M.; McGaughey, P. L.; McGlinchey, D.; McKinney, C.; Means, N.; Mendoza, M.; Meredith, B.; Miake, Y.; Mibe, T.; Mignerey, A. C.; Mikeš, P.; Miki, K.; Milov, A.; Mishra, D. K.; Mishra, M.; Mitchell, J. T.; Miyachi, Y.; Miyasaka, S.; Mohanty, A. K.; Moon, H. J.; Morino, Y.; Morreale, A.; Morrison, D. P.; Motschwiller, S.; Moukhanova, T. V.; Mukhopadhyay, D.; Murakami, T.; Murata, J.; Nagae, T.; Nagamiya, S.; Nagle, J. L.; Naglis, M.; Nagy, M. I.; Nakagawa, I.; Nakamiya, Y.; Nakamura, K. R.; Nakamura, T.; Nakano, K.; Nattrass, C.; Nederlof, A.; Newby, J.; Nguyen, M.; Nihashi, M.; Niida, T.; Nouicer, R.; Novitzky, N.; Nyanin, A. S.; O'Brien, E.; Oda, S. X.; Ogilvie, C. A.; Oka, M.; Okada, K.; Onuki, Y.; Oskarsson, A.; Ouchida, M.; Ozawa, K.; Pak, R.; Palounek, A. P. T.; Pantuev, V.; Papavassiliou, V.; Park, B. H.; Park, I. H.; Park, J.; Park, S. K.; Park, W. J.; Pate, S. F.; Patel, L.; Pei, H.; Peng, J.-C.; Pereira, H.; Peresedov, V.; Peressounko, D. Yu.; Petti, R.; Pinkenburg, C.; Pisani, R. P.; Proissl, M.; Purschke, M. L.; Purwar, A. K.; Qu, H.; Rak, J.; Rakotozafindrabe, A.; Ravinovich, I.; Read, K. F.; Rembeczki, S.; Reygers, K.; Reynolds, D.; Riabov, V.; Riabov, Y.; Richardson, E.; Riveli, N.; Roach, D.; Roche, G.; Rolnick, S. D.; Rosati, M.; Rosendahl, S. S. E.; Rosnet, P.; Rukoyatkin, P.; Ružička, P.; Rykov, V. L.; Sahlmueller, B.; Saito, N.; Sakaguchi, T.; Sakai, S.; Sakashita, K.; Samsonov, V.; Sano, M.; Sarsour, M.; Sato, T.; Sawada, S.; Sedgwick, K.; Seele, J.; Seidl, R.; Semenov, A. Yu.; Semenov, V.; Sen, A.; Seto, R.; Sharma, D.; Shein, I.; Shibata, T.-A.; Shigaki, K.; Shimomura, M.; Shoji, K.; Shukla, P.; Sickles, A.; Silva, C. L.; Silvermyr, D.; Silvestre, C.; Sim, K. S.; Singh, B. K.; Singh, C. P.; Singh, V.; Slunečka, M.; Soldatov, A.; Soltz, R. A.; Sondheim, W. E.; Sorensen, S. P.; Soumya, M.; Sourikova, I. V.; Staley, F.; Stankus, P. W.; Stenlund, E.; Stepanov, M.; Ster, A.; Stoll, S. P.; Sugitate, T.; Suire, C.; Sukhanov, A.; Sun, J.; Sziklai, J.; Takagui, E. M.; Takahara, A.; Taketani, A.; Tanabe, R.; Tanaka, Y.; Taneja, S.; Tanida, K.; Tannenbaum, M. J.; Tarafdar, S.; Taranenko, A.; Tarján, P.; Tennant, E.; Themann, H.; Thomas, T. L.; Todoroki, T.; Togawa, M.; Toia, A.; Tomášek, L.; Tomášek, M.; Tomita, Y.; Torii, H.; Towell, R. S.; Tram, V.-N.; Tserruya, I.; Tsuchimoto, Y.; Tsuji, T.; Vale, C.; Valle, H.; van Hecke, H. W.; Vargyas, M.; Vazquez-Zambrano, E.; Veicht, A.; Velkovska, J.; Vértesi, R.; Vinogradov, A. A.; Virius, M.; Vossen, A.; Vrba, V.; Vznuzdaev, E.; Wang, X. R.; Watanabe, D.; Watanabe, K.; Watanabe, Y.; Watanabe, Y. S.; Wei, F.; Wei, R.; Wessels, J.; Whitaker, S.; White, S. N.; Winter, D.; Wolin, S.; Woody, C. L.; Wysocki, M.; Xie, W.; Yamaguchi, Y. L.; Yamaura, K.; Yang, R.; Yanovich, A.; Ying, J.; Yokkaichi, S.; You, Z.; Young, G. R.; Younus, I.; Yushmanov, I. E.; Zajc, W. A.; Zaudtke, O.; Zelenski, A.; Zhang, C.; Zhou, S.; Zolin, L.; Phenix Collaboration
2015-02-01
Measurements of bottomonium production in heavy-ion and p +p collisions at the Relativistic Heavy Ion Collider (RHIC) are presented. The inclusive yield of the three Υ states, Υ (1 S +2 S +3 S ) , was measured in the PHENIX experiment via electron-positron decay pairs at midrapidity for Au +Au and p +p collisions at √{sNN}=200 GeV. The Υ (1 S +2 S +3 S ) →e+e- differential cross section at midrapidity was found to be Beed σ /d y =108 ±38 (stat) ±15 (syst) ±11 (luminosity) pb in p +p collisions. The nuclear modification factor in the 30% most central Au +Au collisions indicates a suppression of the total Υ state yield relative to the extrapolation from p +p collision data. The suppression is consistent with measurements made by STAR at RHIC and at higher energies by the CMS experiment at the Large Hadron Collider.
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Peikes, Deborah; Chen, Arnold; Schore, Jennifer; Brown, Randall
2009-02-11
Medicare expenditures of patients with chronic illnesses might be reduced through improvements in care, patient adherence, and communication. To determine whether care coordination programs reduced hospitalizations and Medicare expenditures and improved quality of care for chronically ill Medicare beneficiaries. Eligible fee-for-service Medicare patients (primarily with congestive heart failure, coronary artery disease, and diabetes) who volunteered to participate between April 2002 and June 2005 in 15 care coordination programs (each received a negotiated monthly fee per patient from Medicare) were randomly assigned to treatment or control (usual care) status. Hospitalizations, costs, and some quality-of-care outcomes were measured with claims data for 18 309 patients (n = 178 to 2657 per program) from patients' enrollment through June 2006. A patient survey 7 to 12 months after enrollment provided additional quality-of-care measures. Nurses provided patient education and monitoring (mostly via telephone) to improve adherence and ability to communicate with physicians. Patients were contacted twice per month on average; frequency varied widely. Hospitalizations, monthly Medicare expenditures, patient-reported and care process indicators. Thirteen of the 15 programs showed no significant (P<.05) differences in hospitalizations; however, Mercy had 0.168 fewer hospitalizations per person per year (90% confidence interval [CI], -0.283 to -0.054; 17% less than the control group mean, P=.02) and Charlestown had 0.118 more hospitalizations per person per year (90% CI, 0.025-0.210; 19% more than the control group mean, P=.04). None of the 15 programs generated net savings. Treatment group members in 3 programs (Health Quality Partners [HQP], Georgetown, Mercy) had monthly Medicare expenditures less than the control group by 9% to 14% (-$84; 90% CI, -$171 to $4; P=.12; -$358; 90% CI, -$934 to $218; P=.31; and -$112; 90% CI, -$231 to $8; P=.12; respectively). Savings offset
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-08
...-7205 Ventricular Assist Device (Destination Therapy) Facilities. XIII Medicare-Approved Lung JoAnna...-Approved Ventricular Assist Device (Destination Therapy) Facilities, Addendum XIII: Lung Volume Reduction...-Approved Ventricular Assist Device (Destination Therapy) Facilities (January Through March 2011) Addendum...
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Cancer du sein au Cameroun, profil histo-épidémiologique: à propos de 3044 cas
Engbang, Jean Paul Ndamba; Essome, Henri; Koh, Valère Mve; Simo, Godefroy; Essam, Jean Daniel Sime; Mouelle, Albert Sone; Essame, Jean Louis Oyono
2015-01-01
Décrire les caractéristiques épidémiologiques et histo-pathologiques des tumeurs malignes du sein au Cameroun. Il s'agissait d'une étude rétrospective descriptive portant sur les tumeurs malignes du sein, colligées, dans les registres des différents laboratoires d'Anatomie Pathologique publiques et privés repartis dans cinq régions (centre, littoral, Ouest, Nord-ouest, Sud-ouest), pendant une période de 10 ans (2004-2013). Les paramètres étudiés étaient la fréquence, l’âge, le sexe, la localisation, le type et le grade histologique, et les récepteurs hormonaux. Un total de 3044 cas de cancers du sein a été recensé, soit une fréquence annuelle de 304,4 cas en moyenne. Le sexe féminin était le plus représenté avec 2971 cas (97,60%) et les hommes avec 73 cas (2,40%), soit un sexe ratio (H/F) de 0,02. L’âge moyen des patients était de 46±15,87 ans, avec des extrêmes de 13 et 95 ans. Selon la localisation, le sein gauche était atteint dans 1244 cas (52%) et le sein droit dans 1115 cas (47%). Au plan histologique, on retrouvait essentiellement des carcinomes avec 96,50% des cas, des sarcomes 1,39%, des lymphomes 1,07% et la maladie de Paget du mamelon, 1,03%. Les tumeurs épithéliales étaient infiltrantes dans 2049 cas (84,46%), avec une prédominance du carcinome canalaire infiltrant (1870 cas) et non infiltrantes dans 377 cas (15,54%). Le grade histo-pronostic de SBR avait révélé une prédominance du grade II dans 66% des cas. Les cancers du sein restent une pathologie fréquente au Cameroun et atteignent principalement la population féminine en âge de procréer. Ils sont caractérisés par la prédominance du carcinome canalaire infiltrant. PMID:26523182
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76 FR 60050 - Medicaid Program: Money Follows the Person Rebalancing Demonstration Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-28
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Medicaid Program: Money Follows the Person Rebalancing Demonstration Program AGENCY: Centers for Medicare & Medicaid..., particularly given the complexity and vulnerability of the populations being served in MFP and the Congress...
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Prospective payment and the Medicare hospice benefit.
Bloom, B S; Amenta, M O
1993-01-01
The objective of this study was to determine the effects of very high cost patients on hospice financial status. Ten Pennsylvania hospices dually certified by Medicare were randomly selected and agreed to participate. Patient age, sex, diagnosis, length of stay and payer were fairly uniform across hospices. Payments varied by diagnosis and payer. High cost patients were irregularly found in hospices; low cost patients were commonly and regularly distributed. Every hospice had at least one high cost patient. In one, the uncompensated payment for the 6.6 percent of patients defined as high cost ($7,300 and above) would have been 14.7 percent of total annual revenues. In another, uncompensated payments for high cost patients (9.8 percent) would have accounted for 17.2 percent of revenue. In 96.3 percent of the instances patients utilized less than the Medicare Hospice Benefit maximum allowable cost ($7,300); and, 98.8 percent of the time patients stayed less than the maximum allowable length of time of 210 days. A logistic regression model found long length of stay (p < 0.0001), Medicare hospice benefit as primary payer (p < 0.0001), any hospitalization during hospice stay (p < 0.003) and cerebrovascular disease diagnosis (p < 0.02) to be significantly related to high cost. Between the time the study was planned and completed, Medicare instituted a reinsurance program allowing unused funds below the maximum allowable limit from one patient to be used for patients who exhausted their benefits. Thus, no study hospice was adversely affected by high cost patients. However, it should serve as an object lesson to Medicare in using prospective payment.(ABSTRACT TRUNCATED AT 250 WORDS)
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75 FR 69037 - Medicaid Program; Recovery Audit Contractors
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-10
... [CMS-6034-P] RIN 0938-AQ19 Medicaid Program; Recovery Audit Contractors AGENCY: Centers for Medicare... Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs... RACs coordinate with other contractors and entities auditing Medicaid providers and with State and...
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Medicare Contracting Risk/Medicare Risk Contracting: A Life-Cycle View from Twelve Markets
Hurley, Robert E; Grossman, Joy M; Strunk, Bradley C
2003-01-01
Objective To examine the evolution of the Medicare HMO program from 1996 to 2001 in 12 nationally representative urban markets by exploring how the separate and confluent influences of government policy initiatives and health plans' strategic aims and operational experience affected the availability of HMOs to Medicare beneficiaries. Data Source Qualitative data gathered from 12 nationally representative urban communities with more than 200,000 residents each, in tandem with quantitative information from the Centers for Medicare and Medicaid Services and other sources. Study Design Detailed interview protocols, developed as part of the multiyear, multimethod Community Tracking Study of the Center for Studying Health System Change, were used to conduct three rounds of interviews (1996, 1998, and 2000–2001) with health plans and providers in 12 nationally representative urban communities. A special focus during the third round of interviews was on gathering information related to Medicare HMOs' experience in the previous four years. This information was used to build on previous research to develop a longitudinal perspective on health plans' experience in Medicare's HMO program. Principal Findings From 1996 to 2001, the activities and expectations of health plans in local markets underwent a rapid and dramatic transition from enthusiasm for the Medicare HMO product, to abrupt reconsideration of interest corresponding to changes in the Balanced Budget Act of 1997, on to significant retrenchment and disillusionment. Policy developments were important in their own right, but they also interacted with shifts in the strategic aims and operational experiences of health plans that reflect responses to insurance underwriting cycle pressures and pushback from providers. Conclusion The Medicare HMO program went through a substantial reversal of fortune during the study period, raising doubts about whether its downward course can be altered. Market-level analysis reveals that
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Financial Performance of Rural Medicare ACOs.
Nattinger, Matthew C; Mueller, Keith; Ullrich, Fred; Zhu, Xi
2018-12-01
The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan. Of the ACOs reporting performance data, we identified 97 ACOs with a measurable rural presence. We found that successful rural ACO financial performance is associated with the ACO's organizational type (eg, physician-based) and that 8 of the 11 rural ACOs participating in the Advanced Payment Program (APP) garnered savings for Medicare. Unlike previous work, we did not find an association between ACO size or experience and rural ACO financial performance. Our findings suggest that rural ACO financial success is likely associated with factors unique to rural environments. Given the emphasis CMS has placed on rural ACO development, further research to identify these factors is warranted. © 2016 National Rural Health Association.
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Ratios of charged antiparticles to particles near midrapidity in Au+Au collisions at (sNN)=200 GeV
NASA Astrophysics Data System (ADS)
Back, B. B.; Baker, M. D.; Barton, D. S.; Betts, R. R.; Ballintijn, M.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Decowski, M. P.; Garcia, E.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Michałowski, J.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Skulski, W.; Steadman, S. G.; Steinberg, P.; Stephans, G. S.; Stodulski, M.; Sukhanov, A.; Tang, J.-L.; Teng, R.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Wadsworth, B.; Wolfs, F. L.; Wosiek, B.; Woźniak, K.; Wuosmaa, A. H.; Wysłouch, B.
2003-02-01
The ratios of charged antiparticles to particles have been obtained for pions, kaons, and protons near midrapidity in central Au+Au collisions at (sNN)=200 GeV. Ratios of <π->/<π+>=1.025±0.006(stat.)±0.018(syst.),
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The financial status of Medicare.
Foster, R S
1998-01-01
Medicare is the largest health care program in the country, providing medical care to 38 million aged and disabled Americans. Concerns over rapid cost increases and the imminent insolvency of the Medicare Hospital Insurance trust fund led to enactment of sweeping Medicare legislation as part of the Balanced Budget Act of 1997. Preliminary estimates indicate that this legislation will result in program savings of $150 billion in the first five years and will postpone the depletion of the Hospital Insurance fund from the year 2001 until about 2010. While the Balanced Budget Act significantly reduces Hospital Insurance expenditure in the long range, serious deficits are still expected when the "baby boom" generation reaches retirement. The Medicare Supplementary Medical Insurance trust fund is automatically in financial balance, but policy makers remain concerned about continuing rapid cost increases. A new National Bipartisan Commission on the Future of Medicare will attempt to determine effective solutions to these long-range problems.
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NASA Astrophysics Data System (ADS)
Brandenburg, James D.; STAR Collaboration
2017-11-01
In this contribution we report e+e1 spectra with various invariant mass and pT differentials in Au+Au collisions at √{sNN} = 200GeV and U+U collisions at √{sNN} = 193GeV. The structure of the t (- t ≈ pT2) distributions of these mass regions will be shown and compared with the same distributions in ultra-peripheral collisions. Additionally, this contribution discusses first measurements of μ+μ- invariant mass spectra from STAR's recently installed Muon Telescope Detector (MTD) in p+p and Au+Au collisions at √{sNN} = 200GeV.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-31
... Registry (NOPR) Sites. Addendum XIII: Medicare-approved Ventricular Assist Device (Destination Therapy... Therapy) Facilities (October Through December 2010) On October 1, 2003, we issued our decision memorandum on ventricular assist devices (VADs) for the clinical indication of destination therapy. We...
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42 CFR 424.530 - Denial of enrollment in the Medicare program.
Code of Federal Regulations, 2011 CFR
2011-10-01
.... (a) Reasons for denial. CMS may deny a provider's or supplier's enrollment in the Medicare program for the following reasons: (1) Compliance. The provider or supplier at any time is found not to be in... severity of the underlying offense. (i) Offenses include— (A) Felony crimes against persons, such as murder...
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42 CFR 424.530 - Denial of enrollment in the Medicare program.
Code of Federal Regulations, 2013 CFR
2013-10-01
.... (a) Reasons for denial. CMS may deny a provider's or supplier's enrollment in the Medicare program for the following reasons: (1) Compliance. The provider or supplier at any time is found not to be in... severity of the underlying offense. (i) Offenses include— (A) Felony crimes against persons, such as murder...
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42 CFR 424.530 - Denial of enrollment in the Medicare program.
Code of Federal Regulations, 2012 CFR
2012-10-01
.... (a) Reasons for denial. CMS may deny a provider's or supplier's enrollment in the Medicare program for the following reasons: (1) Compliance. The provider or supplier at any time is found not to be in... severity of the underlying offense. (i) Offenses include— (A) Felony crimes against persons, such as murder...
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42 CFR 424.530 - Denial of enrollment in the Medicare program.
Code of Federal Regulations, 2014 CFR
2014-10-01
.... (a) Reasons for denial. CMS may deny a provider's or supplier's enrollment in the Medicare program for the following reasons: (1) Compliance. The provider or supplier at any time is found not to be in... severity of the underlying offense. (i) Offenses include— (A) Felony crimes against persons, such as murder...
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30 CFR 902.10 - State regulatory program approval.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 30 Mineral Resources 3 2010-07-01 2010-07-01 false State regulatory program approval. 902.10 Section 902.10 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE..., Technical Library, 1999 Broadway, Suite 3320, Denver, Colorado 80202-5733. [60 FR 33724, June 29, 1995, as...
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Hallam, K; Gardner, J
1999-11-08
Most Americans know Medicare as the health insurance program that covers the elderly. But to providers it's much more that. The program pays for medical education, finances capital projects and subsidizes care for the indigent. Should Medicare continue making those add-on payments? Is that the program's mission? The debate is intensifying.
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2014-06-17
This document announces changes to the payment adjustment for low-volume hospitals and to the Medicare-dependent hospital (MDH) program under the hospital inpatient prospective payment systems (IPPS) for the second half of FY 2014 (April 1, 2014 through September 30, 2014) in accordance with sections 105 and 106, respectively, of the Protecting Access to Medicare Act of 2014 (PAMA).
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The impact of health reform on the Medicare Advantage program: realigning payment with performance.
Biles, Brian; Casillas, Giselle; Arnold, Grace; Guterman, Stuart
2012-10-01
The Affordable Care Act enacts a new payment system for private health plans available to Medicare beneficiaries through the Medicare Advantage (MA) program. The system, which is being phased in through 2017, aims to (1) reduce the excess payments received by private plans relative to per capita spending in traditional Medicare, and (2) reward plans that earn high performance ratings. Using 2009 data, this issue brief presents analysis of the distributional impact on MA plan payments of these new policies as if they had been fully implemented in that year. We find that, when the polices [sic] are in place, they will bring overall MA plan payments nationwide down from 114 percent to 102 percent of what spending would have been for the same enrollees if they had been enrolled in traditional Medicare. While payments will vary across the nation, high-performing MA plans stand to benefit from this new arrangement.
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State Policies Influence Medicare Telemedicine Utilization.
Neufeld, Jonathan D; Doarn, Charles R; Aly, Reem
2016-01-01
Medicare policy regarding telemedicine reimbursement has changed little since 2000. Many individual states, however, have added telemedicine reimbursement for either Medicaid and/or commercial payers over the same period. Because telemedicine programs must serve patients from all or most payers, it is likely that these state-level policy changes have significant impacts on telemedicine program viability and utilization of services from all payers, not just those services and payers affected directly by state policy. This report explores the impact of two significant state-level policy changes-one expanding Medicaid telemedicine coverage and the other introducing telemedicine parity for commercial payers-on Medicare utilization in the affected states. Medicare claims data from 2011-2013 were examined for states in the Great Lakes region. All valid claims for live interactive telemedicine professional fees were extracted and linked to their states of origin. Allowed encounters and expenditures were calculated in total and on a per 1,000 members per year basis to standardize against changes in the Medicare population by state and year. Medicare telemedicine encounters and professional fee expenditures grew sharply following changes in state Medicaid and commercial payer policy in the examined states. Medicare utilization in Illinois grew by 173% in 2012 (over 2011) following Medicaid coverage expansion, and Medicare utilization in Michigan grew by 118% in 2013 (over 2012) following adoption of telemedicine parity for commercial payers. By contrast, annual Medicare telemedicine utilization growth in surrounding states (in which there were no significant policy changes during these years) varied somewhat but showed no discernible pattern. Although Medicare telemedicine policy has changed little since its inception, changes in state policies with regard to telemedicine reimbursement appear to have significant impacts on the practical viability of telemedicine programs
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Ultra-relativistic Au+Au and d+Au collisions:
NASA Astrophysics Data System (ADS)
Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Chai, Z.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Hauer, M.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Seals, H.; Sedykh, I.; Skulski, W.; Smith, C. E.; Stankiewicz, M. A.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tang, J.-L.; Tonjes, M. B.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Vaurynovich, S. S.; Verdier, R.; Veres, G. I.; Wenger, E.; Wolfs, F. L. H.; Wosiek, B.; Woźniak, K.; Wuosmaa, A. H.; Wysłouch, B.
In this talk I will review PHOBOS data on charged particle multiplicities, obtained in Au+Au and d+Au collisions at RHIC. The general features of the Au+Au pseudorapidity distributions results will be discussed and compared to those of /line{p}p collisions. The total charged particle multiplicity, scaled by the number of participant pairs, is observed to be about 40% higher in Au+Au collisions than in /line{p}p and d+Au systems, but, surprisingly at the same level of e+e- collisions. Limiting fragmentation scaling is seen to be obeyed in Au+Au collisions.
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Medicare prescription drug discount cards.
Bryant, Natasha
2004-01-01
With the passage of the Medicare Prescription Drug Improvement and Modernization Act of 2003 came the creation of a Part D drug benefit through Medicare. Until that benefit is implemented, Medicare has established a drug discount card program to help your clients save money on their outpatient prescription drug expenses. In this brief, we discuss the Medicare-approved discount cards--who is eligible, how they work, how your clients can best make important decisions about them, and what help is out there for people with low incomes.
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Adare, A.; Afanasiev, S.; Aidala, C.; ...
2015-02-24
Measurements of bottomonium production in heavy-ion and p+p collisions at the Relativistic Heavy Ion Collider (RHIC) are presented. The inclusive yield of the three Υ states, Υ(1S + 2S + 3S), was measured in the PHENIX experiment via electron-positron decay pairs at midrapidity for Au+Au and p+p collisions at \\(\\sqrt{s_{\\mathrm{NN}}}=200\\) GeV. The Υ(1S + 2S + 3S) → e⁺e⁻ differential cross section at midrapidity was found to be B eedσ/dy = 108 ± 38 (stat) ± 15 (syst) ± 11 (luminosity) pb in p+p collisions. The nuclear modification factor in the 30% most central Au+Au collisions indicates a suppression ofmore » the total Υ state yield relative to the extrapolation from p+p collision data. Thus, the suppression is consistent with measurements at higher energies by the CMS experiment at the Large Hadron Collider.« less
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Adare, A.; Aidala, C.; Ajitanand, N. N.; ...
2018-06-11
Here, we present measurements of the transverse-momentum dependence of elliptic flow v 2 for identified pions and (anti)protons at midrapidity (|η| < 0.35), in 0%–5% central p+Au and 3He+Au collisions at √ s NN = 200 GeV. When taken together with previously published measurements in d + Au collisions at √ s NN = 200 GeV, the results cover a broad range of small-collision-system multiplicities and intrinsic initial geometries. We observe a clear mass-dependent splitting of v 2(p T) in d + Au and 3He + Au collisions, just as in large nucleus-nucleus (A + A) collisions, and a smallermore » splitting in p + Au collisions. Both hydrodynamic and transport model calculations successfully describe the data at low p T (< 1.5GeV/c), but fail to describe various features at higher p T. In all systems, the v 2 values follow an approximate quark-number scaling as a function of the hadron transverse kinetic energy per constituent quark (KE T/n q), which was also seen previously in A + A collisions.« less
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Adare, A.; Aidala, C.; Ajitanand, N. N.
Here, we present measurements of the transverse-momentum dependence of elliptic flow v 2 for identified pions and (anti)protons at midrapidity (|η| < 0.35), in 0%–5% central p+Au and 3He+Au collisions at √ s NN = 200 GeV. When taken together with previously published measurements in d + Au collisions at √ s NN = 200 GeV, the results cover a broad range of small-collision-system multiplicities and intrinsic initial geometries. We observe a clear mass-dependent splitting of v 2(p T) in d + Au and 3He + Au collisions, just as in large nucleus-nucleus (A + A) collisions, and a smallermore » splitting in p + Au collisions. Both hydrodynamic and transport model calculations successfully describe the data at low p T (< 1.5GeV/c), but fail to describe various features at higher p T. In all systems, the v 2 values follow an approximate quark-number scaling as a function of the hadron transverse kinetic energy per constituent quark (KE T/n q), which was also seen previously in A + A collisions.« less
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Menz, Hylton B
2009-10-30
In 2004, as an extension of the Enhanced Primary Care (EPC) program, the Australian Government introduced a policy of providing Medicare rebates for allied health services provided to patients with chronic or complex health conditions. The objective of this study was to evaluate the utilisation of podiatry services provided under this scheme between 2004 and 2008. Data pertaining to the Medicare item 10962 for the calendar years 2004-2008 were extracted from the Australian Medicare Benefits Schedule (MBS) database and cross-tabulated by sex and age. Descriptive analyses were undertaken to assess sex and age differences in the number of consultations provided and to assess for temporal trends over the five-year assessment period. The total cost to Medicare over this period was also determined. During the 2004-2008 period, a total of 1,338,044 EPC consultations were provided by podiatrists in Australia. Females exhibited higher utilisation than males (63 versus 37%), and those aged over 65 years accounted for 75% of consultations. There was a marked increase in the number of consultations provided from 2004 to 2008, and the total cost of providing EPC podiatry services during this period was $62.9 M. Podiatry services have been extensively utilised under the EPC program by primary care patients, particularly older women, and the number of services provided has increased dramatically between 2004 and 2008. Further research is required to determine whether the EPC program enhances clinical outcomes compared to standard practice.
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NASA Astrophysics Data System (ADS)
Adare, A.; Aidala, C.; Ajitanand, N. N.; Akiba, Y.; Alfred, M.; Andrieux, V.; Apadula, N.; Asano, H.; Azmoun, B.; Babintsev, V.; Bagoly, A.; Bai, M.; Bandara, N. S.; Bannier, B.; Barish, K. N.; Bathe, S.; Bazilevsky, A.; Beaumier, M.; Beckman, S.; Belmont, R.; Berdnikov, A.; Berdnikov, Y.; Blau, D. S.; Boer, M.; Bok, J. S.; Boyle, K.; Brooks, M. L.; Bryslawskyj, J.; Bumazhnov, V.; Campbell, S.; Canoa Roman, V.; Cervantes, R.; Chen, C.-H.; Chi, C. Y.; Chiu, M.; Choi, I. J.; Choi, J. B.; Chujo, T.; Citron, Z.; Connors, M.; Cronin, N.; Csanád, M.; Csörgő, T.; Danley, T. W.; Datta, A.; Daugherity, M. S.; David, G.; Deblasio, K.; Dehmelt, K.; Denisov, A.; Deshpande, A.; Desmond, E. J.; Dion, A.; Diss, P. B.; Dixit, D.; Do, J. H.; Drees, A.; Drees, K. A.; Durham, J. M.; Durum, A.; Enokizono, A.; En'yo, H.; Esumi, S.; Fadem, B.; Fan, W.; Feege, N.; Fields, D. E.; Finger, M.; Finger, M.; Fokin, S. L.; Frantz, J. E.; Franz, A.; Frawley, A. D.; Fukuda, Y.; Gal, C.; Gallus, P.; Garg, P.; Ge, H.; Giordano, F.; Glenn, A.; Goto, Y.; Grau, N.; Greene, S. V.; Grosse Perdekamp, M.; Gunji, T.; Guragain, H.; Hachiya, T.; Haggerty, J. S.; Hahn, K. I.; Hamagaki, H.; Hamilton, H. F.; Han, S. Y.; Hanks, J.; Hasegawa, S.; Haseler, T. O. S.; Hashimoto, K.; He, X.; Hemmick, T. K.; Hill, J. C.; Hill, K.; Hodges, A.; Hollis, R. S.; Homma, K.; Hong, B.; Hoshino, T.; Hotvedt, N.; Huang, J.; Huang, S.; Imai, K.; Imrek, J.; Inaba, M.; Iordanova, A.; Isenhower, D.; Ivanishchev, D.; Jacak, B. V.; Jezghani, M.; Ji, Z.; Jia, J.; Jiang, X.; Johnson, B. M.; Jorjadze, V.; Jouan, D.; Jumper, D. S.; Kanda, S.; Kang, J. H.; Kapukchyan, D.; Karthas, S.; Kawall, D.; Kazantsev, A. V.; Key, J. A.; Khachatryan, V.; Khanzadeev, A.; Kim, C.; Kim, D. J.; Kim, E.-J.; Kim, G. W.; Kim, M.; Kim, M. H.; Kimelman, B.; Kincses, D.; Kistenev, E.; Kitamura, R.; Klatsky, J.; Kleinjan, D.; Kline, P.; Koblesky, T.; Komkov, B.; Kotov, D.; Kudo, S.; Kurgyis, B.; Kurita, K.; Kurosawa, M.; Kwon, Y.; Lacey, R.; Lajoie, J. G.; Lebedev, A.; Lee, S.; Lee, S. H.; Leitch, M. J.; Leung, Y. H.; Lewis, N. A.; Li, X.; Li, X.; Lim, S. H.; Liu, M. X.; Loggins, V.-R.; Lökös, S.; Lovasz, K.; Lynch, D.; Majoros, T.; Makdisi, Y. I.; Makek, M.; Manion, A.; Manko, V. I.; Mannel, E.; Masuda, H.; McCumber, M.; McGaughey, P. L.; McGlinchey, D.; McKinney, C.; Meles, A.; Mendoza, M.; Metzger, W. J.; Mignerey, A. C.; Mihalik, D. E.; Milov, A.; Mishra, D. K.; Mitchell, J. T.; Mitsuka, G.; Miyasaka, S.; Mizuno, S.; Mohanty, A. K.; Montuenga, P.; Moon, T.; Morrison, D. P.; Morrow, S. I.; Moukhanova, T. V.; Murakami, T.; Murata, J.; Mwai, A.; Nagai, K.; Nagashima, K.; Nagashima, T.; Nagle, J. L.; Nagy, M. I.; Nakagawa, I.; Nakagomi, H.; Nakano, K.; Nattrass, C.; Netrakanti, P. K.; Niida, T.; Nishimura, S.; Nouicer, R.; Novák, T.; Novitzky, N.; Nyanin, A. S.; O'Brien, E.; Ogilvie, C. A.; Orjuela Koop, J. D.; Osborn, J. D.; Oskarsson, A.; Ottino, G. J.; Ozawa, K.; Pak, R.; Pantuev, V.; Papavassiliou, V.; Park, J. S.; Park, S.; Pate, S. F.; Patel, M.; Peng, J.-C.; Peng, W.; Perepelitsa, D. V.; Perera, G. D. N.; Peressounko, D. Yu.; Perezlara, C. E.; Perry, J.; Petti, R.; Phipps, M.; Pinkenburg, C.; Pinson, R.; Pisani, R. P.; Pun, A.; Purschke, M. L.; Radzevich, P. V.; Rak, J.; Ramson, B. J.; Ravinovich, I.; Read, K. F.; Reynolds, D.; Riabov, V.; Riabov, Y.; Richford, D.; Rinn, T.; Rolnick, S. D.; Rosati, M.; Rowan, Z.; Rubin, J. G.; Runchey, J.; Safonov, A. S.; Sahlmueller, B.; Saito, N.; Sakaguchi, T.; Sako, H.; Samsonov, V.; Sarsour, M.; Sato, K.; Sato, S.; Schaefer, B.; Schmoll, B. K.; Sedgwick, K.; Seidl, R.; Sen, A.; Seto, R.; Sett, P.; Sexton, A.; Sharma, D.; Shein, I.; Shibata, T.-A.; Shigaki, K.; Shimomura, M.; Shioya, T.; Shukla, P.; Sickles, A.; Silva, C. L.; Silvermyr, D.; Singh, B. K.; Singh, C. P.; Singh, V.; Skoby, M. J.; Slunečka, M.; Snowball, M.; Soltz, R. A.; Sondheim, W. E.; Sorensen, S. P.; Sourikova, I. V.; Stankus, P. W.; Stepanov, M.; Stoll, S. P.; Sugitate, T.; Sukhanov, A.; Sumita, T.; Sun, J.; Sziklai, J.; Takeda, A.; Taketani, A.; Tanida, K.; Tannenbaum, M. J.; Tarafdar, S.; Taranenko, A.; Tarnai, G.; Tieulent, R.; Timilsina, A.; Todoroki, T.; Tomášek, M.; Towell, C. L.; Towell, R.; Towell, R. S.; Tserruya, I.; Ueda, Y.; Ujvari, B.; van Hecke, H. W.; Vazquez-Carson, S.; Velkovska, J.; Virius, M.; Vrba, V.; Vukman, N.; Wang, X. R.; Wang, Z.; Watanabe, Y.; Watanabe, Y. S.; Wei, F.; White, A. S.; Wong, C. P.; Woody, C. L.; Wysocki, M.; Xia, B.; Xu, C.; Xu, Q.; Xue, L.; Yalcin, S.; Yamaguchi, Y. L.; Yamamoto, H.; Yanovich, A.; Yin, P.; Yoo, J. H.; Yoon, I.; Yu, H.; Yushmanov, I. E.; Zajc, W. A.; Zelenski, A.; Zharko, S.; Zhou, S.; Zou, L.; Phenix Collaboration
2018-06-01
We present measurements of the transverse-momentum dependence of elliptic flow v2 for identified pions and (anti)protons at midrapidity (|η |<0.35 ), in 0%-5% central p +Au and 3He+Au collisions at √{sNN}=200 GeV. When taken together with previously published measurements in d +Au collisions at √{sNN}=200 GeV, the results cover a broad range of small-collision-system multiplicities and intrinsic initial geometries. We observe a clear mass-dependent splitting of v2(pT) in d +Au and 3He+Au collisions, just as in large nucleus-nucleus (A +A ) collisions, and a smaller splitting in p +Au collisions. Both hydrodynamic and transport model calculations successfully describe the data at low pT (<1.5 GeV /c ), but fail to describe various features at higher pT. In all systems, the v2 values follow an approximate quark-number scaling as a function of the hadron transverse kinetic energy per constituent quark (K ET/nq ), which was also seen previously in A +A collisions.
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42 CFR 422.108 - Medicare secondary payer (MSP) procedures.
Code of Federal Regulations, 2010 CFR
2010-10-01
... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422...; (2) Identify the amounts payable by those payers; and (3) Coordinate its benefits to Medicare enrollees with the benefits of the primary payers, including reporting, on an ongoing basis, information...
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Comment on “the ground-state structures of Au10-, Au8Ni and Au9Ni clusters”
NASA Astrophysics Data System (ADS)
Zheng, Ben-Xia; Die, Dong; Li, Qian-Qian; Dai, Ming-Liang; Li, Zhi-Qin; Yang, Ji-Xian
2017-09-01
The lowest energy structures of Aun+1- and AunNi (n = 2-9) clusters have been researched using the CALYPSO structure searching method in conjunction with the density functional theory. It is found that the most stable structures of Au10-, Au8Ni and Au9Ni clusters reported by Tang et al. [C. M. Tang, X. X. Chen and X. D. Yang, Int. J. Mod. Phys. B 28, 1450138 (2014)] are low-lying isomers. The correct ground states and vibrational spectra are given in this paper.
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Mammography Use Among Medicare Beneficiaries After Elimination of Cost Sharing.
Sabatino, Susan A; Thompson, Trevor D; Guy, Gery P; de Moor, Janet S; Tangka, Florence K
2016-04-01
We examined mammography use before and after Medicare eliminated cost sharing for screening mammography in January 2011. Using National Health Interview Survey data, we examined changes in mammography use between 2010 and 2013 among Medicare beneficiaries aged 65-74 years. Logistic regression and predictive margins were used to examine changes in use after adjusting for covariates. In 2013, 74.7% of women reported a mammogram within 2 years, a 3.5 percentage point increase (95% confidence interval, -0.3, 7.2) compared with 2010. Increases occurred among women aged 65-69 years, unmarried women, and women with usual sources of care and 2-5 physician visits in the prior year. After adjustment, mammography use increased in 2013 versus 2010 (74.8% vs. 71.3%, P=0.039). Interactions between year and income, insurance, race, or ethnicity were not significant. There was a modest increase in mammography use from 2010 to 2013 among Medicare beneficiaries aged 65-74 years, possibly consistent with an effect of eliminating Medicare cost sharing during this time. Findings suggest that eliminating cost sharing might increase use of recommended screening services.
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78 FR 71468 - Rules Relating to Additional Medicare Tax
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-29
... Rules Relating to Additional Medicare Tax AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... Insurance Tax on income above threshold amounts (``Additional Medicare Tax''), as added by the Affordable... to the implementation of Additional Medicare Tax, including the requirement to withhold Additional...
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The effect of metal surface passivation on the Au-InP interaction
NASA Technical Reports Server (NTRS)
Fatemi, Navid S.; Weizer, Victor G.
1989-01-01
The effect of SiO2 encapsulation on reaction rates in the Au-InP system was studied. Scanning electron microscopy and x-ray photoelectron spectroscopy were used to investigate surface and/or interface morphologies and in-depth compositional profiles. It was found that the rate of dissolution of InP into Au and subsequent phase transformations are largely dependent on the condition of the free surface of the metalization. SiO2 capping of Au is reported for the first time to suppress the Au-InP reaction rate. The Au-InP interaction is shown to be quite similar to the Au-GaAs interaction despite differences in behavior of the group-V elements.
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Magnetic fields and flows between 1 AU and 0.3 AU during the primary mission of HELIOS 1
NASA Technical Reports Server (NTRS)
Burlaga, L. F.; Ness, N. F.; Mariani, F.; Bavassano, B.; Villante, U.; Rosenbauer, H.; Schwenn, R.; Harvey, J.
1978-01-01
The recurrent flow and field patterns observed by HELIOS 1, and the relation between these patterns and coronal holes are discussed. Four types of recurrent patterns were observed: a large recurrent stream, a recurrent slow (quiet) flow, a rapidly evolving flow, and a recurrent compound stream. There recurrent streams were not stationary, for although the sources recurred at approximately the same longitudes on successive rotations, the shapes and latitudinal patterns changed from one rotation to the next. A type of magnetic field and plasma structure characterized by a low ion temperature and a high magnetic field intensity is described as well as the structures of stream boundaries between the sun at approximately 0.3 AU.
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Adams, J; Adler, C; Aggarwal, M M; Ahammed, Z; Amonett, J; Anderson, B D; Anderson, M; Arkhipkin, D; Averichev, G S; Badyal, S K; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellwied, R; Berger, J; Bezverkhny, B I; Bhardwaj, S; Bhaskar, P; Bhati, A K; Bichsel, H; Billmeier, A; Bland, L C; Blyth, C O; Bonner, B E; Botje, M; Boucham, A; Brandin, A; Bravar, A; Cadman, R V; Cai, X Z; Caines, H; Calderón de la Barca Sánchez, M; Carroll, J; Castillo, J; Castro, M; Cebra, D; Chaloupka, P; Chattopadhyay, S; Chen, H F; Chen, Y; Chernenko, S P; Cherney, M; Chikanian, A; Choi, B; Christie, W; Coffin, J P; Cormier, T M; Cramer, J G; Crawford, H J; Das, D; Das, S; Derevschikov, A A; Didenko, L; Dietel, T; Dong, X; Draper, J E; Drees, K A; Du, F; Dubey, A K; Dunin, V B; Dunlop, J C; Dutta Majumdar, M R; Eckardt, V; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Fachini, P; Faine, V; Faivre, J; Fatemi, R; Filimonov, K; Filip, P; Finch, E; Fisyak, Y; Flierl, D; Foley, K J; Fu, J; Gagliardi, C A; Ganti, M S; Gagunashvili, N; Gans, J; Gaudichet, L; Germain, M; Geurts, F; Ghazikhanian, V; Ghosh, P; Gonzalez, J E; Grachov, O; Grigoriev, V; Gronstal, S; Grosnick, D; Guedon, M; Guertin, S M; Gupta, A; Gushin, E; Gutierrez, T D; Hallman, T J; Hardtke, D; Harris, J W; Heinz, M; Henry, T W; Heppelmann, S; Herston, T; Hippolyte, B; Hirsch, A; Hjort, E; Hoffmann, G W; Horsley, M; Huang, H Z; Huang, S L; Humanic, T J; Igo, G; Ishihara, A; Jacobs, P; Jacobs, W W; Janik, M; Johnson, I; Jones, P G; Judd, E G; Kabana, S; Kaneta, M; Kaplan, M; Keane, D; Kiryluk, J; Kisiel, A; Klay, J; Klein, S R; Klyachko, A; Kollegger, T; Konstantinov, A S; Kopytine, M; Kotchenda, L; Kovalenko, A D; Kramer, M; Kravtsov, P; Krueger, K; Kuhn, C; Kulikov, A I; Kumar, A; Kunde, G J; Kunz, C L; Kutuev, R Kh; Kuznetsov, A A; Lamont, M A C; Landgraf, J M; Lange, S; Lansdell, C P; Lasiuk, B; Laue, F; Lauret, J; Lebedev, A; Lednický, R; Leontiev, V M; LeVine, M J; Li, C; Li, Q; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, L; Liu, Z; Liu, Q J; Ljubicic, T; Llope, W J; Long, H; Longacre, R S; Lopez-Noriega, M; Love, W A; Ludlam, T; Lynn, D; Ma, J; Ma, Y G; Magestro, D; Mahajan, S; Mangotra, L K; Mahapatra, D P; Majka, R; Manweiler, R; Margetis, S; Markert, C; Martin, L; Marx, J; Matis, H S; Matulenko, Yu A; McShane, T S; Meissner, F; Melnick, Yu; Meschanin, A; Messer, M; Miller, M L; Milosevich, Z; Minaev, N G; Mironov, C; Mishra, D; Mitchell, J; Mohanty, B; Molnar, L; Moore, C F; Mora-Corral, M J; Morozov, V; de Moura, M M; Munhoz, M G; Nandi, B K; Nayak, S K; Nayak, T K; Nelson, J M; Nevski, P; Nikitin, V A; Nogach, L V; Norman, B; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Paic, G; Pandey, S U; Pal, S K; Panebratsev, Y; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Perevoztchikov, V; Peryt, W; Petrov, V A; Phatak, S C; Picha, R; Planinic, M; Pluta, J; Porile, N; Porter, J; Poskanzer, A M; Potekhin, M; Potrebenikova, E; Potukuchi, B V K S; Prindle, D; Pruneau, C; Putschke, J; Rai, G; Rakness, G; Raniwala, R; Raniwala, S; Ravel, O; Ray, R L; Razin, S V; Reichhold, D; Reid, J G; Renault, G; Retiere, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevski, O V; Romero, J L; Rose, A; Roy, C; Ruan, L J; Rykov, V; Sahoo, R; Sakrejda, I; Salur, S; Sandweiss, J; Savin, I; Schambach, J; Scharenberg, R P; Schmitz, N; Schroeder, L S; Schweda, K; Seger, J; Seliverstov, D; Seyboth, P; Shahaliev, E; Shao, M; Sharma, M; Shestermanov, K E; Shimanskii, S S; Singaraju, R N; Simon, F; Skoro, G; Smirnov, N; Snellings, R; Sood, G; Sorensen, P; Sowinski, J; Spinka, H M; Srivastava, B; Stanislaus, S; Stock, R; Stolpovsky, A; Strikhanov, M; Stringfellow, B; Struck, C; Suaide, A A P; Sugarbaker, E; Suire, C; Sumbera, M; Surrow, B; Symons, T J M; Szanto de Toledo, A; Szarwas, P; Tai, A; Takahashi, J; Tang, A H; Thein, D; Thomas, J H; Tikhomirov, V; Tokarev, M; Tonjes, M B; Trainor, T A; Trentalange, S; Tribble, R E; Trivedi, M D; Trofimov, V; Tsai, O; Ullrich, T; Underwood, D G; Van Buren, G; VanderMolen, A M; Vasiliev, A N; Vasiliev, M; Vigdor, S E; Viyogi, Y P; Voloshin, S A; Waggoner, W; Wang, F; Wang, G; Wang, X L; Wang, Z M; Ward, H; Watson, J W; Wells, R; Westfall, G D; Whitten, C; Wieman, H; Willson, R; Wissink, S W; Witt, R; Wood, J; Wu, J; Xu, N; Xu, Z; Xu, Z Z; Yakutin, A E; Yamamoto, E; Yang, J; Yepes, P; Yurevich, V I; Zanevski, Y V; Zborovský, I; Zhang, H; Zhang, H Y; Zhang, W M; Zhang, Z P; Zołnierczuk, P A; Zoulkarneev, R; Zoulkarneeva, J; Zubarev, A N
2003-10-24
We report high statistics measurements of inclusive charged hadron production in Au+Au and p+p collisions at sqrt[s(NN)]=200 GeV. A large, approximately constant hadron suppression is observed in central Au+Au collisions for 5<p(T)<12 GeV/c. The collision energy dependence of the yields and the centrality and p(T) dependence of the suppression provide stringent constraints on theoretical models of suppression. Models incorporating initial-state gluon saturation or partonic energy loss in dense matter are largely consistent with observations. We observe no evidence of p(T)-dependent suppression, which may be expected from models incorporating jet attenuation in cold nuclear matter or scattering of fragmentation hadrons.
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pH-Induced transformation of ligated Au25 to brighter Au23 nanoclusters.
Waszkielewicz, Magdalena; Olesiak-Banska, Joanna; Comby-Zerbino, Clothilde; Bertorelle, Franck; Dagany, Xavier; Bansal, Ashu K; Sajjad, Muhammad T; Samuel, Ifor D W; Sanader, Zeljka; Rozycka, Miroslawa; Wojtas, Magdalena; Matczyszyn, Katarzyna; Bonacic-Koutecky, Vlasta; Antoine, Rodolphe; Ozyhar, Andrzej; Samoc, Marek
2018-05-01
Thiolate-protected gold nanoclusters have recently attracted considerable attention due to their size-dependent luminescence characterized by a long lifetime and large Stokes shift. However, the optimization of nanocluster properties such as the luminescence quantum yield is still a challenge. We report here the transformation of Au25Capt18 (Capt labels captopril) nanoclusters occurring at low pH and yielding a product with a much increased luminescence quantum yield which we have identified as Au23Capt17. We applied a simple method of treatment with HCl to accomplish this transformation and we characterized the absorption and emission of the newly created ligated nanoclusters as well as their morphology. Based on DFT calculations we show which Au nanocluster size transformations can lead to highly luminescent species such as Au23Capt17.
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2008-07-28
This final rule prohibits Medicare Advantage (MA) organizations, including organizations offering MA plans to employer and union group health plan sponsors, from making midyear changes to nonprescription drug benefits, premiums, and cost-sharing submitted in their approved bids for a given contract year. This final rule also clarifies that MA organizations offering certain kinds of plans restricted to employer and union group health plan sponsors and not open to general enrollment may continue to offer benefit enhancements as they do currently, through means other than midyear benefit enhancements (MYBEs). Programs of all-inclusive care for elderly (PACE) are not subject to the provisions of this final rule and may continue to offer enhanced benefits as specified in our guidance for PACE plans.
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2007-04-10
This final rule establishes competitive bidding programs for certain Medicare Part B covered items of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) throughout the United States in accordance with sections 1847(a) and (b) of the Social Security Act. These competitive bidding programs, which will be phased in over several years, utilize bids submitted by DMEPOS suppliers to establish applicable payment amounts under Medicare Part B.
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Squitieri, Lee; Chung, Kevin C
2017-07-01
In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-03
... Billing for Skilled Nursing Facilities for FY 2014; Correction AGENCY: Centers for Medicare & Medicaid...; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2014.'' DATES: These...
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Wittenborn, John; Brady, Joanne; Dougherty, Michelle; Rein, David
2017-04-01
We forecast the health and budgetary impact of hepatitis C (HCV) treatment on the Medicare program based on currently observed rates of treatment among Medicare and non-Medicare patients and identify the impact of higher rates of treatment among non-Medicare populations. We developed a computer microsimulation model to conduct an epidemiologic forecast, a budgetary impact analysis, and a cost-effectiveness analysis of the treatment of HCV based on three scenarios: 1) no treatment, 2) continuation of current-treatment rates, and 3) treatment rates among non-Medicare patients increased to match that of Medicare patients. The simulated population is based on National Health and Nutrition Examination Survey data. HCV progression rates and costs were calculated in Surveillance, Epidemiology, and End Results Program Medicare 5% claims data from the Chronic Hepatitis Cohort Study and published literature. We estimate that 13.6% of patients with HCV in the United States are enrolled in Medicare, but 75% will enter Medicare in the next 20 years. Medicare patients were over 5 times as likely to be treated in 2014-2015 as other patients. Medicare paid over $9 billion in treatment costs in both 2015 and 2016 and will total $28.4 billion from 2017-2026. Increasing treatment rates among non-Medicare patients would lead to 234,000 more patients being treated, reduce HCV mortality by 19%, and decrease Medicare costs by $18.6 billion from 2017-2026. We find that treatment remains cost-effective under most assumptions, costing $31,718 per quality adjusted life year gained. Conclusion : Medicare treats a disproportionately large share of HCV patients. Continued low rates of treatment among non-Medicare HCV patients will result in both reduced and deferred treatment, shifting future treatment costs to Medicare while increasing overall medical management costs, morbidity, and mortality. ( Hepatology Communications 2017;1:99-109).
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Younossi, Zobair M; Zheng, Li; Stepanova, Maria; Venkatesan, Chapy; Mishra, Alita
2014-01-01
Objective The aim of this study is to assess recent trends in health resource utilisation and patient outcomes of Medicare beneficiaries with chronic liver disease (CLD). Setting Liver-related mortality is the 10th leading cause of death in the USA, and hepatitis C virus (HCV) and obesity-related non-alcoholic fatty liver disease are the major causes of CLD. As the US population ages and becomes more obese, the impact of CLD is expected to become more prominent for the Medicare population. Participants This is a retrospective cohort study of Medicare beneficiaries with a diagnosis of CLD based on inpatient (N=21 576; 14 977 unique patients) and outpatient (N=515 990; 244 196 patients) claims from 2005 to 2010. Primary and secondary outcome measures The study outcomes included hospital length of stay (LOS) and inpatient mortality as well as inpatient and outpatient inflation-adjusted payments. Results Between 2005 and 2010, there was an annual decrease in LOS of 3.17% for CLD-related hospitalisations. Risk-adjusted in-hospital mortality decreased (OR 0.90, 95% CI 0.87 to 0.94), while short-term postdischarge mortality remained stable (1.00, 0.98 to 1.03). Inpatient per-claim payment increased from $11 769 in 2005 to $12 347 in 2010 (p=0.0006). Similarly, the average yearly payments for outpatient care increased from $366 to $404 (p<0.0001). This change in payment was observed together with a consistent decrease in the proportion of beneficiary-paid amount (25.4–20%, p<0.0001) as opposed to Medicare-paid amount (73.1–80%, p<0.0001). The major predictors of higher outpatient payments were younger age, Asian race or Hispanic ethnicity, living in California, and having more diagnoses and outpatient procedures per claim. The predictors of inpatient spending also included younger age, location and the number of inpatient procedures. Conclusions Length of inpatient stay and inpatient mortality among Medicare beneficiaries with CLD decreased, while inpatient
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2015-08-04
This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it specifies a SNF all-cause all-condition hospital readmission measure, as well as adopts that measure for a new SNF Value-Based Purchasing (VBP) Program, and includes a discussion of SNF VBP Program policies we are considering for future rulemaking to promote higher quality and more efficient health care for Medicare beneficiaries. Additionally, this final rule will implement a new quality reporting program for SNFs as specified in the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). It also amends the requirements that a long-term care (LTC) facility must meet to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program, by establishing requirements that implement the provision in the Affordable Care Act regarding the submission of staffing information based on payroll data.
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Comparative study of I- V methods to extract Au/FePc/p-Si Schottky barrier diode parameters
NASA Astrophysics Data System (ADS)
Oruç, Çiğdem; Altındal, Ahmet
2018-01-01
So far, various methods have been proposed to extract the Schottky diode parameters from measured current-voltage characteristics. In this work, Schottky barrier diode with structure of Au/2(3),9(10),16(17),23(24)-tetra(4-(4-methoxyphenyl)-8-methylcoumarin-7 oxy) phthalocyaninatoiron(II) (FePc)/p-Si was fabricated and current-voltage measurements were carried out on it. In addition, current-voltage measurements were also performed on Au/p-Si structure, without FePc, to clarify the influence of the presence of an interface layer on the device performance. The measured current-voltage characteristics indicate that the interface properties of a Schottky barrier diode can be controlled by the presence of an organic interface layer. It is found that the room temperature barrier height of Au/FePc/p-Si structure is larger than that of the Au/p-Si structure. The obtained forward bias current-voltage characteristics of the Au/FePc/p-Si device was analysed by five different analytical methods. It is found that the extracted values of SBD parameters strongly depends on the method used.
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NASA Astrophysics Data System (ADS)
Sorensen, Paul Richard
2003-06-01
Measurements of identified particles over a broad transverse momentum pT range may provide particularly strong evidence for the existence of a thermalized partonic state in heavy-ion collisions ( i.e. a quark-gluon plasma). Of particular interest are the centrality dependence and the azimuthal anisotropy in the yield of baryons and mesons at intermediate pT. The first measurements of v2---an event-by-event azimuthal anisotropy parameter---and the nuclear modification factor RCP for mid-rapidity K0S and Λ + L¯ production in Au+Au collisions at ultra-relativistic energy are presented. The K0S , Λ and L¯ candidates are selected based on characteristics of their decays in the STAR Time Projection Chamber (TPC). A statistical treatment is used to extract v2(pT) and RCP(pT) from their invariant mass distributions. These measurements establish the particle type dependence of v2 and RCP in the kinematic region 0.4 < pT < 6.0 and |y| < 1.0. In the low pT region (pT < 1.0 GeV/c) the v2 values for different particles are increasing with pT and follow a mass dependence similar to that expected from hydrodynamical models of Au+Au collisions---where, at a given pT, the particle with the larger mass will have a smaller v2. At higher p T however, v2 of the heavier Λ hyperon continues to increase while v2 of the lighter K0S meson saturates at v2 ˜ 0.13 for 2.0 < pT < 5.0 GeV/c. At intermediate pT the v2 of K0S and Λ + L¯ are shown to follow a number-of-constituent-quark scaling with vkaon2pT /22≈v lambda2pT/3 3 . The binary collision scaled centrality ratio RCP shows that Λ + L¯ production at intermediate pT increases more rapidly with system size than kaon production: This is consistent with a scenario where multi-parton dynamics play an important role in particle production. At pT ≈ 5.5 GeV/c Λ + L¯ , K0S , and charged hadron production are all suppressed by a similar amount: a factor of three below expectations from binary nucleon-nucleon collision scaling (i
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-02
...This proposed rule is a supplement to the fiscal year (FY) 2011 hospital inpatient prospective payment systems (IPPS) and long- term care prospective payment system (LTCH PPS) proposed rule published in the May 4, 2010 Federal Register. This supplemental proposed rule would implement certain statutory provisions relating to Medicare payments to hospitals for inpatient services that are contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act). It would also specify statutorily required changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs, and for long-term care hospital costs.
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Hellander, Ida; Himmelstein, David U; Woolhandler, Steffie
2013-01-01
Previous research has documented Medicare overpayments to the private Medicare Advantage (MA) plans that compete with traditional fee-for-service Medicare. This research has assessed individual categories of overpayment for, at most, a few years. However, no study has calculated the total overpayments to private plans since the program's inception. Prior to 2004, selective enrollment of healthier seniors was the major source of excess payments. We estimate this has added US$41 billion to Medicare's costs since 1985. Medicare adopted a risk-adjustment scheme in 2004, but this has not curbed private plans' ability to game the payment system. This has added US$122.5 billion to Medicare's costs since 2004. Congress mandated increased payment to private plans in the 2003 Medicare Modernization Act, which was mitigated, to a degree, by the subsequent Affordable Care Act. In total, we find that Medicare has overpaid private insurers by US$282.6 billion since 1985. Risk adjustment does not work in for-profit MA plans, which have a financial incentive, the data, and the ingenuity to game whatever system Medicare devises. It is time to end Medicare's costly experiment with privatization. The U.S. needs to adopt a single-payer national health insurance program with effective methods for controlling costs.
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77 FR 46439 - Medicare Program; Prior Authorization for Power Mobility Device (PMD) Demonstration
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-03
... DOJ. Medicare Fraud Strike Force teams are a key component of HEAT, since their inception and based on... primary focus of investigation for these strike forces. The Comprehensive Error Rate Testing (CERT... various prior authorization scenarios: Scenario 1: When a submitter sends a prior authorization request to...
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76 FR 31340 - Medicare Program; Notification of Closure of St. Vincent's Medical Center
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-31
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1587-N... & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This notice announces the closure of St. Vincent's Medical Center and the initiation of an application process for hospitals to apply to the Centers for...
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Patents, Innovation, and the Welfare Effects of Medicare Part D*
Gailey, Adam; Lakdawalla, Darius; Sood, Neeraj
2013-01-01
Purpose To evaluate the efficiency consequences of the Medicare Part D program. Methods We develop and empirically calibrate a simple theoretical model to examine the static and dynamic welfare effects of Medicare Part D. Findings We show that Medicare Part D can simultaneously reduce static deadweight loss from monopoly pricing of drugs and improve incentives for innovation. We estimate that even after excluding the insurance value of the program, the welfare gain of Medicare Part D roughly equals its social costs. The program generates $5.11 billion of annual static deadweight loss reduction, and at least $3.0 billion of annual value from extra innovation. Implications Medicare Part D and other public prescription drug programs can be welfare-improving, even for risk-neutral and purely self-interested consumers. Furthermore, negotiation for lower branded drug prices may further increase the social return to the program. Originality This study demonstrates that pure efficiency motives, which do not even surface in the policy debate over Medicare Part D, can nearly justify the program on their own merits. PMID:20575239
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2007-12-05
This rule with comment period finalizes the Medicare program provisions relating to contract determinations involving Medicare Advantage (MA) organizations and Medicare Part D prescription drug plan sponsors, including eliminating the reconsideration process for review of contract determinations, revising the provisions related to appeals of contract determinations, and clarifying the process for MA organizations and Part D plan sponsors to complete corrective action plans. In this final rule with comment period, we also clarify the intermediate sanction and civil money penalty (CMP) provisions that apply to MA organizations and Medicare Part D prescription drug plan sponsors, modify elements of their compliance plans, retain voluntary self-reporting for Part D sponsors and implement a voluntary self-reporting recommendation for MA organizations, and revise provisions to ensure HHS has access to the books and records of MA organizations and Part D plan sponsors' first tier, downstream, and related entities. Although we have decided not to finalize the mandatory self-reporting provisions that we proposed, CMS remains committed to adopting a mandatory self-reporting requirement. To that end, we are requesting comments that will assist CMS in crafting a future proposed regulation for a mandatory self-reporting requirement.
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Will managed care's role in Medicare expand?
Grimaldi, P L
1996-10-01
Managed care's penetration of the Medicare market has grown dramatically over the last several years. Nevertheless, most beneficiaries remain with fee-for-service providers and most health maintenance organizations (HMOs) do not contract with Medicare. Because of the program's dire financial outlook, Medicare almost certainly will be restructured soon to encourage more beneficiaries to enroll with HMOs and entice more managed care plans into becoming Medicare risk contractors.
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The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization.
Romley, John A; Axeen, Sarah; Lakdawalla, Darius N; Chernew, Michael E; Bhattacharya, Jay; Goldman, Dana P
2015-06-01
To explore the relationship between commercial health care prices and Medicare spending/utilization across U.S. regions. Claims from large employers and Medicare Parts A/B/D over 2007-2009. We compared prices paid by commercial health plans to Medicare spending and utilization, adjusted for beneficiary health and the cost of care, across 301 hospital referral regions. A 10 percent lower commercial price (around the average level) is associated with 3.0 percent higher Medicare spending per member per year, and 4.3 percent more specialist visits (p < .01). Commercial health care prices are negatively associated with Medicare spending across regions. Providers may respond to low commercial prices by shifting service volume into Medicare. Further investigation is needed to establish causality. © Health Research and Educational Trust.
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Saleh, Shadi S; Freire, Chris; Morris-Dickinson, Gwendolyn; Shannon, Trip
2012-06-01
To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. Randomized controlled trial. A general hospital in upstate New York State. Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months. The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. Cost-benefit ratio of the PDCT program; self-management skills and abilities. The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
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Florence, Curtis S; Atherly, Adam; Thorpe, Kenneth E
2006-10-01
. To examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer. Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and benefits data taken from the Checkbook Guide to health plans. We estimate individual plan choice models where the choice of health plan is a function of out-of-pocket premium, actuarial value, plan attributes, and individual characteristics. Plan attributes include plan structure (fee-for-service/preferred provider organization, point-of-service, or health maintenance organization), drug benefit structure, and whether or not the plan covers other types of spending such as dental services and diabetic supplies. The models are estimated by conditional logit. Our study focuses on three populations that currently choose FEHBP as their primary health care coverage and are similar to the Medicare population: current employees and retirees who are approaching the age of Medicare eligibility (ages 60-64) and current federal employees age 65+. Current employees age 65+ are eligible for Medicare, but their FEHBP plan is their primary payer. Retirees and employees 60-64 are not yet eligible for Medicare but are similar in many respects to recently age-eligible Medicare beneficiaries. We also estimate our model for current employees age 55 and younger as a comparison group. We select a random sample of retirees and employees age 60-64, as well as all current employees age 65+, from the OPM administrative database for the calendar year 2001. The plan choices available to each person are determined by the plans participating in their metropolitan statistical area. We match plan premium and attribute information from the Checkbook Guide to each plan in the enrollee's list of choices. We find that current workers 65+, 60-64, and non-Medicare eligible retirees are sensitive to variation in plan
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Florence, Curtis S; Atherly, Adam; Thorpe, Kenneth E
2006-01-01
Objective To examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer. Data Sources Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and benefits data taken from the Checkbook Guide to health plans. Study Design We estimate individual plan choice models where the choice of health plan is a function of out-of-pocket premium, actuarial value, plan attributes, and individual characteristics. Plan attributes include plan structure (fee-for-service/preferred provider organization, point-of-service, or health maintenance organization), drug benefit structure, and whether or not the plan covers other types of spending such as dental services and diabetic supplies. The models are estimated by conditional logit. Our study focuses on three populations that currently choose FEHBP as their primary health care coverage and are similar to the Medicare population: current employees and retirees who are approaching the age of Medicare eligibility (ages 60–64) and current federal employees age 65+. Current employees age 65+ are eligible for Medicare, but their FEHBP plan is their primary payer. Retirees and employees 60–64 are not yet eligible for Medicare but are similar in many respects to recently age-eligible Medicare beneficiaries. We also estimate our model for current employees age 55 and younger as a comparison group. Data Collection Methods We select a random sample of retirees and employees age 60–64, as well as all current employees age 65+, from the OPM administrative database for the calendar year 2001. The plan choices available to each person are determined by the plans participating in their metropolitan statistical area. We match plan premium and attribute information from the Checkbook Guide to each plan in the enrollee's list of choices. Principal Findings We find that current workers
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Sintered Cr/Pt and Ni/Au ohmic contacts to B 12P 2
Frye, Clint D.; Kucheyev, Sergei O.; Edgar, James H.; ...
2015-04-09
With this study, icosahedral boron phosphide (B 12P 2) is a wide-bandgap semiconductor possessing interesting properties such as high hardness, chemical inertness, and the reported ability to self-heal from irradiation by high energy electrons. Here, the authors developed Cr/Pt and Ni/Au ohmic contacts to epitaxially grown B 12P 2 for materials characterization and electronic device development. Cr/Pt contacts became ohmic after annealing at 700 °C for 30 s with a specific contact resistance of 2×10 –4 Ω cm 2, as measured by the linear transfer length method. Ni/Au contacts were ohmic prior to any annealing, and their minimum specific contactmore » resistance was ~l–4 × 10 –4 Ω cm 2 after annealing over the temperature range of 500–800 °C. Rutherford backscattering spectrometry revealed a strong reaction and intermixing between Cr/Pt and B 12P 2 at 700 °C and a reaction layer between Ni and B 12P 2 thinner than ~25 nm at 500 °C.« less
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How Successful Is Medicare Advantage?
Newhouse, Joseph P; McGuire, Thomas G
2014-01-01
Context Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving funds for the Medicare program. Recent changes in Medicare policy, including improved risk adjustment, however, may have changed this picture. Methods This article summarizes findings from our group's work evaluating MA's recent performance and investigating payment options for improving its performance even more. We studied the behavior of both beneficiaries and plans, as well as the effects of Medicare policy. Findings Beneficiaries make “mistakes” in their choice of MA plan options that can be explained by behavioral economics. Few beneficiaries make an active choice after they enroll in Medicare. The high prevalence of “zero-premium” plans signals inefficiency in plan design and in the market's functioning. That is, Medicare premium policies interfere with economically efficient choices. The adverse selection problem, in which healthier, lower-cost beneficiaries tend to join MA, appears much diminished. The available measures, while limited, suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM). In counties, greater MA penetration appears to improve TM's performance. Conclusions Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA. On average, MA plans appear to offer higher value than TM, and positive spillovers from MA into TM imply that reimbursement should not necessarily be neutral. Policy changes in Medicare that reform the way that beneficiaries are charged for MA plan
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How successful is Medicare Advantage?
Newhouse, Joseph P; McGuire, Thomas G
2014-06-01
Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving funds for the Medicare program. Recent changes in Medicare policy, including improved risk adjustment, however, may have changed this picture. This article summarizes findings from our group's work evaluating MA's recent performance and investigating payment options for improving its performance even more. We studied the behavior of both beneficiaries and plans, as well as the effects of Medicare policy. Beneficiaries make "mistakes" in their choice of MA plan options that can be explained by behavioral economics. Few beneficiaries make an active choice after they enroll in Medicare. The high prevalence of "zero-premium" plans signals inefficiency in plan design and in the market's functioning. That is, Medicare premium policies interfere with economically efficient choices. The adverse selection problem, in which healthier, lower-cost beneficiaries tend to join MA, appears much diminished. The available measures, while limited, suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM). In counties, greater MA penetration appears to improve TM's performance. Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA. On average, MA plans appear to offer higher value than TM, and positive spillovers from MA into TM imply that reimbursement should not necessarily be neutral. Policy changes in Medicare that reform the way that beneficiaries are charged for MA plan membership are warranted to move more
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Ohmic contacts to p-GaN Using Au/Ni-Mg-O Metallization
NASA Astrophysics Data System (ADS)
Liday, Jozef; Vogrinčič, Peter; Hotový, Ivan; Bonanni, Alberta; Sitter, Helmut; Lalinský, Tibor; Vanko, Gabriel; Řeháček, Vlastimil; Breza, Juraj; Ecke, Gernot
2010-11-01
Electrical characteristics and elemental depth profiles of ohmic contacts to p-GaN using Au/Ni-Mg-O
x metallization have been investigated. The objective was to examine the possibilities of increasing the charge carrier concentration in the surface region of GaN by adding Mg, thus of a p-type dopant into the Au/NiOx metallization structure. For this purpose, a Ni-Mg-Ox layer with a low concentration of Mg was deposited on p-GaN by dc reactive magnetron sputtering. The top Au layer was deposited in a similar way. The fabricated contact structures were annealed in N2. When the Ni-Mg layer in the Au/Ni-Mg-Ox /p-GaN structure was deposited in an atmosphere with a low concentration of oxygen (0.2 at%), the structure exhibited a low resistance ohmic nature. The contact resistance was lower than in the case of a Au/Ni-Ox /p-GaN structure without the Mg dopant in the metallic layer. An increase in the concentration of oxygen in the working atmosphere resulted in higher values of the contact resistance of the Au/Ni-Mg-Ox /p-GaN structure. In our opinion the ohmic nature of the contact structure is related to the existence of a metal/p-NiO/p-GaN scheme. The measured values of the contact resistance in the Au/Ni-Mg-Ox /p-GaN structure in comparison with the Au/Ni-Ox /p-GaN structure are caused by an increased charge carrier concentration in the surface region of p-GaN, which is a consequence of Mg diffusion from the Ni-Mg-Ox layer. -
DaVanzo, Joan E; El-Gamil, Audrey M; Dobson, Allen; Sen, Namrata
2010-09-01
Medicare skilled nursing facility (SNF) residents with chronic wounds require more resources and have relatively high healthcare expenditures compared to Medicare patients without wounds. A retrospective cohort study was conducted using 2006 Medicare Chronic Condition Warehouse claims data for SNF, inpatient, outpatient hospital, and physician supplier settings along with 2006 Long-Term Care Minimum Data Set (MDS) information to compare Medicare expenditures between two groups of SNF residents with a diagnosis of pressure, venous, ischemic, or diabetic ulcers whose wounds healed during the 10-month study period. The study group (n = 372) was managed using a structured, comprehensive wound management protocol provided by an external wound management team. The matched comparison group consisted of 311 SNF residents who did not receive care from the wound management team. Regression analyses indicate that after controlling for resident comorbidities and wound severity, study group residents experienced lower rates of wound-related hospitalization per day (0.08% versus 0.21%, P < 0.01) and shorter wound episodes (94 days versus 115 days, P < 0.01) than comparison group patients. Total Medicare costs were $21,449.64 for the study group and $40,678.83 for the comparison group (P < 0.01) or $229.07 versus $354.26 (P < 0.01) per resident episode day. Additional studies including wounds that do not heal are warranted. Increasing the number of SNF residents receiving the care described in this study could lead to significant Medicare cost savings. Incorporating wound clinical outcomes into a pay-for-performance measures for SNFs could increase broader SNF adoption of comprehensive wound care programs to treat chronic wounds.
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42 CFR 417.454 - Charges to Medicare enrollees.
Code of Federal Regulations, 2010 CFR
2010-10-01
... (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Enrollment, Entitlement, and Disenrollment under Medicare Contract § 417.454 Charges to... of the contract period, all premiums, enrollment fees, and other charges collected from its Medicare...
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Watnick, Suzanne; Weiner, Daniel E; Shaffer, Rachel; Inrig, Jula; Moe, Sharon; Mehrotra, Rajnish
2012-09-01
In addition to extending health insurance coverage, the Affordable Care Act of 2010 aims to improve quality of care and contain costs. To this end, the act allowed introduction of bundled payments for a range of services, proposed the creation of accountable care organizations (ACOs), and established the Centers for Medicare and Medicaid Innovation to test new care delivery and payment models. The ACO program began April 1, 2012, along with demonstration projects for bundled payments for episodes of care in Medicaid. Yet even before many components of the Affordable Care Act are fully in place, the Medicare ESRD Program has instituted legislatively mandated changes for dialysis services that resemble many of these care delivery reform proposals. The ESRD program now operates under a fully bundled, case-mix adjusted prospective payment system and has implemented Medicare's first-ever mandatory pay-for-performance program: the ESRD Quality Incentive Program. As ACOs are developed, they may benefit from the nephrology community's experience with these relatively novel models of health care payment and delivery reform. Nephrologists are in a position to assure that the ACO development will benefit from the ESRD experience. This article reviews the new ESRD payment system and the Quality Incentive Program, comparing and contrasting them with ACOs. Better understanding of similarities and differences between the ESRD program and the ACO program will allow the nephrology community to have a more influential voice in shaping the future of health care delivery in the United States.
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Physician trainees' decision making and information processing: choice size and Medicare Part D.
Barnes, Andrew J; Hanoch, Yaniv; Martynenko, Melissa; Wood, Stacey; Rice, Thomas; Federman, Alex D
2013-01-01
Many patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians' decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious financial consequences. Seventy medical students and internal medicine residents completed a within-subject design using Mouselab, a computer program that allows the information-acquisition process to be examined. We examined highly numerate physician trainees' decision processes, strategy, and their ability to pick the cheapest drug plan-as price was deemed the most important factor in Medicare beneficiaries' plan choice-from either 3 or 9 drug plans. Before adjustment, participants were significantly more likely to identify the lowest cost plan when facing three versus nine choices (67.3% vs. 32.8%, p<0.01) and paid significantly less in excess premiums ($60.00 vs. $128.51, p<0.01). Compared to the three-plan condition, in the nine-plan condition participants spent significantly less time acquiring information on each attribute (p<0.05) and were more likely to employ decision strategies focusing on comparing alternate plans across a single attribute (search pattern, p<0.05). After adjusting for decision process and strategy, numeracy, and amount of medical training, the odds were 10.75 times higher that trainees would choose the lowest cost Medicare Part D drug plan when facing 3 versus 9 drug plans (p<0.05). Although employing more efficient search strategies in the complex choice environment, physician trainees experienced similar difficulty in choosing the lowest cost prescription drug plans as older patients do. Our results add further evidence that simplifications to the Medicare Part D decision environment are needed and suggest physicians' role in their patients' Part D choices may be most productive when assisting seniors with forecasting their expected medication needs
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NASA Astrophysics Data System (ADS)
Alver, B.; Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Chai, Z.; Chetluru, V.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kotuła, J.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Li, W.; Lin, W. T.; Loizides, C.; Manly, S.; McLeod, D.; Michałowski, J.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Sedykh, I.; Skulski, W.; Smith, C. E.; Steadman, S. G.; Steinberg, P.; Stephans, G. S. F.; Stodulski, M.; Sukhanov, A.; Tonjes, M. B.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Vaurynovich, S. S.; Verdier, R.; Veres, G. I.; Wadsworth, B.; Walters, P.; Wenger, E.; Wolfs, F. L. H.; Wosiek, B.; Woźniak, K.; Wuosmaa, A. H.; Wysłouch, B.
2011-02-01
Pseudorapidity distributions of charged particles emitted in Au+Au, Cu+Cu, d+Au, and p+p collisions over a wide energy range have been measured using the PHOBOS detector at the BNL Relativistic Heavy-Ion Collider (RHIC). The centrality dependence of both the charged particle distributions and the multiplicity at midrapidity were measured. Pseudorapidity distributions of charged particles emitted with |η|<5.4, which account for between 95% and 99% of the total charged-particle emission associated with collision participants, are presented for different collision centralities. Both the midrapidity density dNch/dη and the total charged-particle multiplicity Nch are found to factorize into a product of independent functions of collision energy, sNN, and centrality given in terms of the number of nucleons participating in the collision, Npart. The total charged particle multiplicity, observed in these experiments and those at lower energies, assumes a linear dependence of (lnsNN)2 over the full range of collision energy of sNN=2.7-200 GeV.
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Effect of medicare payment on rural health care systems.
McBride, Timothy D; Mueller, Keith J
2002-01-01
Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.
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The Role of Medicare's Inpatient Cost-Sharing in Medicaid Entry.
Keohane, Laura M; Trivedi, Amal N; Mor, Vincent
2018-04-01
To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge. In a regression discontinuity analysis, we take advantage of this Medicare benefit feature to test whether beneficiaries with greater cost-sharing have higher rates of Medicaid enrollment. We identified 221,248 Medicare beneficiaries with an initial hospital stay and a readmission 53-59 days later (no deductible) or 60-66 days later (charged a deductible). Among beneficiaries in low-socioeconomic areas with two hospitalizations, those readmitted 60-66 days after discharge were 21 percent more likely to join Medicaid compared with those readmitted 53-59 days following their initial hospitalization (absolute difference in adjusted risk of Medicaid entry: 3.7 percent vs. 3.1 percent, p = .01). Increasing Medicare cost-sharing requirements may promote Medicaid enrollment among low-income beneficiaries. Potential savings from an increased cost-sharing in the Medicare program may be offset by increased Medicaid participation. © Health Research and Educational Trust.
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42 CFR 423.159 - Electronic prescription drug program.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159 Section 423.159 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...
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42 CFR 423.800 - Administration of subsidy program.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Administration of subsidy program. 423.800 Section 423.800 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost...
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Trends in Medicare Part D Medication Therapy Management Eligibility Criteria
Wang, Junling; Shih, Ya-Chen Tina; Qin, Yolanda; Young, Theo; Thomas, Zachary; Spivey, Christina A.; Solomon, David K.; Chisholm-Burns, Marie
2015-01-01
Background To increase the enrollment rate of medication therapy management (MTM) programs in Medicare Part D plans, the US Centers for Medicare & Medicaid Services (CMS) lowered the allowable eligibility thresholds based on the number of chronic diseases and Part D drugs for Medicare Part D plans for 2010 and after. However, an increase in MTM enrollment rates has not been realized. Objectives To describe trends in MTM eligibility thresholds used by Medicare Part D plans and to identify patterns that may hinder enrollment in MTM programs. Methods This study analyzed data extracted from the Medicare Part D MTM Programs Fact Sheets (2008–2014). The annual percentages of utilizing each threshold value of the number of chronic diseases and Part D drugs, as well as other aspects of MTM enrollment practices, were analyzed among Medicare MTM programs that were established by Medicare Part D plans. Results For 2010 and after, increased proportions of Medicare Part D plans set their eligibility thresholds at the maximum numbers allowable. For example, in 2008, 48.7% of Medicare Part D plans (N = 347:712) opened MTM enrollment to Medicare beneficiaries with only 2 chronic disease states (specific diseases varied between plans), whereas the other half restricted enrollment to patients with a minimum of 3 to 5 chronic disease states. After 2010, only approximately 20% of plans opened their MTM enrollment to patients with 2 chronic disease states, with the remaining 80% restricting enrollment to patients with 3 or more chronic diseases. Conclusion The policy change by CMS for 2010 and after is associated with increased proportions of plans setting their MTM eligibility thresholds at the maximum numbers allowable. Changes to the eligibility thresholds by Medicare Part D plans might have acted as a barrier for increased MTM enrollment. Thus, CMS may need to identify alternative strategies to increase MTM enrollment in Medicare plans. PMID:26380030
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Layton, Timothy J; Ryan, Andrew M
2015-12-01
To evaluate the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. Publicly available data from CMS from 2009 to 2014 on Medicare Advantage plan quality ratings, the counties in the service area of each plan, and the benchmarks used to construct plan payments. The Medicare Advantage Quality Bonus Payment Demonstration began in 2012. Under the Demonstration, all Medicare Advantage plans were eligible to receive bonus payments based on plan-level quality scores (star ratings). In some counties, plans were eligible to receive bonus payments that were twice as large as in other counties. We used this variation in incentives to evaluate the effects of bonus size on star ratings and the number of plan offerings in the Demonstration using a differences-in-differences identification strategy. We used matching to create a comparison group of counties that did not receive double bonuses but had similar levels of the preintervention outcomes. Results from the difference-in-differences analysis suggest that the receipt of double bonuses was not associated with an increase in star ratings. In the matched sample, the receipt of double bonuses was associated with a statistically insignificant increase of +0.034 (approximately 1 percent) in the average star rating (p > .10, 95 percent CI: -0.015, 0.083). In contrast, the receipt of double bonuses was associated with an increase in the number of plans offered. In the matched sample, the receipt of double bonuses was associated with an overall increase of +0.814 plans (approximately 5.8 percent) (p < .05, 95 percent CI: 0.078, 1.549). We estimate that the double bonuses increased payments by $3.43 billion over the first 3 years of the Demonstration. At great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan
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Payment policy and the growth of Medicare Advantage.
Zarabozo, Carlos; Harrison, Scott
2009-01-01
This paper reviews recent trends in Medicare Advantage, examining program costs, access to plans, enrollment, plan bids, and benchmarks. We find that current policy has favored the growth of particular types of plans. Bid data show that plans are paid, on average, 113 percent of what expenditures would have been under the traditional Medicare program. Although some of the plan payments are used to finance extra benefits for enrollees, paying plans at higher than fee-for-service levels could affect the sustainability of the Medicare program and result in increased costs for all taxpayers and beneficiaries.
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Medicare and Medicaid fraud and abuse regulations.
Liang, F Z; Black, B L
1991-11-01
Specific business arrangements that are protected under legislation and regulations governing parties doing business with Medicare or Medicaid are discussed. Regulations implementing the Medicare and Medicaid Patient Protection Act of 1987 specify practices and activities that are not subject to criminal penalties under the antikickback provisions of the Social Security Act or to exclusion from Medicare or state health-care programs. As of July 29, 1991, all organized health-care settings that receive payments from either Medicare or state health-care programs must comply with these regulations. The final rule sets forth "safe harbors"--exceptions to prohibitions against (1) kickbacks, bribes, rebates, and other illegal activities involving remunerations for patient referrals and (2) inducements to purchase or lease goods paid for by Medicare or state health-care programs. The safe harbors comprise 11 broad categories--investment interests, space rental, equipment rental, personal services and management contracts, purchase of a medical practice, referral services, warranties, discounts, employees, group purchasing organizations, and waiver of deductibles and coinsurance. Implications for pharmacy are discussed. These regulations will affect the purchase of pharmaceuticals by institutional pharmacies. Each institution should review its current practices to determine whether they are within the safe harbors.
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The experience of rural independent pharmacies with medicare part D: reports from the field.
Radford, Andrea; Slifkin, Rebecca; Fraser, Roslyn; Mason, Michelle; Mueller, Keith
2007-01-01
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) created prescription drug coverage for Medicare beneficiaries through a new Part D program, the single largest addition to Medicare since its creation in 1965. Prior to program implementation in January 2006, concerns had been voiced as to how independent pharmacies, which represent a higher proportion of all retail pharmacies in rural areas, would fare under the new program. This article describes first-hand reports from rural pharmacist-owners about their experiences with Medicare Part D plans in the first 7 months of 2006 in order to gain a more thorough understanding of the challenges faced by rural independent pharmacies as a result of program implementation. A semi-structured interview protocol was utilized in telephone interviews with 22 pharmacist-owners of rural independent pharmacies in 10 states. The rural independent pharmacists interviewed are experiencing major changes in payment, administrative burden, and interaction with patients as a result of the shift of patients into Medicare Part D plans. While administrative burden has greatly increased, payment and clinical interaction have decreased. Actions should be considered that would help rural independent pharmacists adjust to the new circumstances of having Medicare patients mirror, for administrative and payment purposes, commercially insured patients. Long-term modification of existing policies and regulations may be necessary to assure reasonable access to pharmaceuticals for rural populations. Further study is needed to determine how best to target these modifications to essential pharmacies.
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Shih, Ya-Chen Tina; Chien, Chun-Ru; Moguel, Rocio; Hernandez, Mike; Hajek, Richard A; Jones, Lovell A
2016-04-01
To assess the cost-effectiveness of implementing a patient navigation (PN) program with capitated payment for Medicare beneficiaries diagnosed with lung cancer. Cost-effectiveness analysis. A Markov model to capture the disease progression of lung cancer and characterize clinical benefits of PN services as timeliness of treatment and care coordination. Taking a payer's perspective, we estimated the lifetime costs, life years (LYs), and quality-adjusted life years (QALYs) and addressed uncertainties in one-way and probabilistic sensitivity analyses. Model inputs were extracted from the literature, supplemented with data from a Centers for Medicare and Medicaid Services demonstration project. Compared to usual care, PN services incurred higher costs but also yielded better outcomes. The incremental cost and effectiveness was $9,145 and 0.47 QALYs, respectively, resulting in an incremental cost-effectiveness ratio of $19,312/QALY. One-way sensitivity analysis indicated that findings were most sensitive to a parameter capturing PN survival benefit for local-stage patients. CE-acceptability curve showed the probability that the PN program was cost-effective was 0.80 and 0.91 at a societal willingness-to-pay of $50,000 and $100,000/QALY, respectively. Instituting a capitated PN program is cost-effective for lung cancer patients in Medicare. Future research should evaluate whether the same conclusion holds in other cancers. © Health Research and Educational Trust.
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Will Medicare Advantage payment reforms impact plan rebates and enrollment?
Nicholas, Lauren Hersch
2014-01-01
To assess the relationship between Medicare Advantage (MA) plan rebates and enrollment and simulate the effects of Affordable Care Act (ACA) payment reforms. First difference regressions of county-level MA payment and enrollment data from CMS from 2006 to 2010. A $10 decrease in the per member/per month rebate to MA plans was associated with a 0.20 percentage point (0.9%) decrease in MA penetration (P < .001) and a 7.1% decline in the average MA enrollee's risk score (P < .001). These effects are small overall, but larger in counties with low levels of traditional Medicare spending; a $10 decrease in monthly rebates was associated with a 0.64 percentage point decline in MA penetration and a 10% decrease in risk score. ACA reforms are predicted to reduce the level of rebates in lower-spending counties, leading to enrollment decreases of 1.7 to 1.9 percentage points in the lowest-spending counties. The simulation predicts that the disenrollment would come from MA enrollees with higher risk scores. MA enrollment responds to availability of supplemental benefits supported by rebates. ACA provisions designed to lower MA spending will predominantly affect Medicare beneficiaries living in counties where MA plans may be unable to offer a comparable product at a price similar to that of traditional Medicare.
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Trends in laboratory test volumes for Medicare Part B reimbursements, 2000-2010.
Shahangian, Shahram; Alspach, Todd D; Astles, J Rex; Yesupriya, Ajay; Dettwyler, William K
2014-02-01
Changes in reimbursements for clinical laboratory testing may help us assess the effect of various variables, such as testing recommendations, market forces, changes in testing technology, and changes in clinical or laboratory practices, and provide information that can influence health care and public health policy decisions. To date, however, there has been no report, to our knowledge, of longitudinal trends in national laboratory test use. To evaluate Medicare Part B-reimbursed volumes of selected laboratory tests per 10,000 enrollees from 2000 through 2010. Laboratory test reimbursement volumes per 10,000 enrollees in Medicare Part B were obtained from the Centers for Medicare & Medicaid Services (Baltimore, Maryland). The ratio of the most recent (2010) reimbursed test volume per 10,000 Medicare enrollees, divided by the oldest data (usually 2000) during this decade, called the volume ratio, was used to measure trends in test reimbursement. Laboratory tests with a reimbursement claim frequency of at least 10 per 10,000 Medicare enrollees in 2010 were selected, provided there was more than a 50% change in test reimbursement volume during the 2000-2010 decade. We combined the reimbursed test volumes for the few tests that were listed under more than one code in the Current Procedural Terminology (American Medical Association, Chicago, Illinois). A 2-sided Poisson regression, adjusted for potential overdispersion, was used to determine P values for the trend; trends were considered significant at P < .05. Tests with the greatest decrease in reimbursement volumes were electrolytes, digoxin, carbamazepine, phenytoin, and lithium, with volume ratios ranging from 0.27 to 0.64 (P < .001). Tests with the greatest increase in reimbursement volumes were meprobamate, opiates, methadone, phencyclidine, amphetamines, cocaine, and vitamin D, with volume ratios ranging from 83 to 1510 (P < .001). Although reimbursement volumes increased for most of the selected tests, other
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Disentangling flow and signals of Chiral Magnetic Effect in U+U, Au+Au and p+Au collisions
NASA Astrophysics Data System (ADS)
Tribedy, Prithwish; STAR Collaboration
2017-11-01
We present STAR measurements of the charge-dependent three-particle correlator γ a , b = 〈 cos (ϕ1a + ϕ2b - 2ϕ3) 〉 /v2 { 2 } and elliptic flow v2 { 2 } in U+U, Au+Au and p+Au collisions at RHIC. The difference Δγ = γ (opposite-sign) - γ (same-sign) measures charge separation across the reaction plane, a predicted signal of the Chiral Magnetic Effect (CME). Although charge separation has been observed, it has been argued that the measured separation can also be explained by elliptic flow related backgrounds. In order to separate the two effects we perform measurements of the γ-correlator where background expectations differ from magnetic field driven effects. A differential measurement of γ with the relative pseudorapidity (Δη) between the first and second particles indicate that Δγ in peripheral A+A and p+A collisions are dominated by short-range correlations in Δη. However, a relatively wider component of the correlation in Δη tends to vanish the same way as projected magnetic field as predicted by MC-Glauber simulations.
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NASA Astrophysics Data System (ADS)
Ian, Ka Wa; Zawawiand, Mohamad Adzhar Md; Missous, Mohamed
2014-03-01
This work described the fabrication and performances of strained channel In0.52Al0.47As/In0.7Ga0.3As/InP pHEMTs with thermally evaporated Pd/Ti/Au gate metallization. The electrical characteristics of these Pd-gate devices are studied to investigate the effects of changing the Pd metal thickness, annealing temperature and annealing time. Following annealing at 200 °C for 35 min, a 10 nm Pd-gate device displays a VTH of -0.25 V, which is significantly smaller compared to those with Ti/Au gate schemes showing VTH = -0.75 V. A 1 um gate length device exhibits an improved Gm of 580 mS mm-1 (from 500 mS mm-1), a high IDSmax of 400 mA mm-1 (from 330 mA mm-1) and good fT and fmax of 24.5 and 49 GHz commensurate with the 1 µm gate length. All these enhancements are attributed to the controllable gate sinking of Pd. The device shows no significant degradation even after annealing at 230 °C for more than 5 h, which implies that the reliability of these Pd-gate structures is excellent.
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Risk Adjustment for Medicare Total Knee Arthroplasty Bundled Payments.
Clement, R Carter; Derman, Peter B; Kheir, Michael M; Soo, Adrianne E; Flynn, David N; Levin, L Scott; Fleisher, Lee
2016-09-01
The use of bundled payments is growing because of their potential to align providers and hospitals on the goal of cost reduction. However, such gain sharing could incentivize providers to "cherry-pick" more profitable patients. Risk adjustment can prevent this unintended consequence, yet most bundling programs include minimal adjustment techniques. This study was conducted to determine how bundled payments for total knee arthroplasty (TKA) should be adjusted for risk. The authors collected financial data for all Medicare patients (age≥65 years) undergoing primary unilateral TKA at an academic center over a period of 2 years (n=941). Multivariate regression was performed to assess the effect of patient factors on the costs of acute inpatient care, including unplanned 30-day readmissions. This analysis mirrors a bundling model used in the Medicare Bundled Payments for Care Improvement initiative. Increased age, American Society of Anesthesiologists (ASA) class, and the presence of a Medicare Major Complications/Comorbid Conditions (MCC) modifier (typically representing major complications) were associated with increased costs (regression coefficients, $57 per year; $729 per ASA class beyond I; and $3122 for patients meeting MCC criteria; P=.003, P=.001, and P<.001, respectively). Differences in costs were not associated with body mass index, sex, or race. If the results are generalizable, Medicare bundled payments for TKA encompassing acute inpatient care should be adjusted upward by the stated amounts for older patients, those with elevated ASA class, and patients meeting MCC criteria. This is likely an underestimate for many bundling models, including the Comprehensive Care for Joint Replacement program, incorporating varying degrees of postacute care. Failure to adjust for factors that affect costs may create adverse incentives, creating barriers to care for certain patient populations. [Orthopedics. 2016; 39(5):e911-e916.]. Copyright 2016, SLACK Incorporated.
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A Political History of Medicare and Prescription Drug Coverage
Oliver, Thomas R; Lee, Philip R; Lipton, Helene L
2004-01-01
This article examines the history of efforts to add prescription drug coverage to the Medicare program. It identifies several important patterns in policymaking over four decades. First, prescription drug coverage has usually been tied to the fate of broader proposals for Medicare reform. Second, action has been hampered by divided government, federal budget deficits, and ideological conflict between those seeking to expand the traditional Medicare program and those preferring a greater role for private health care companies. Third, the provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 reflect earlier missed opportunities. Policymakers concluded from past episodes that participation in the new program should be voluntary, with Medicare beneficiaries and taxpayers sharing the costs. They ignored lessons from past episodes, however, about the need to match expanded benefits with adequate mechanisms for cost containment. Based on several new circumstances in 2003, the article demonstrates why there was a historic opportunity to add a Medicare prescription drug benefit and identify challenges to implementing an effective policy. PMID:15225331
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Disease management for chronically ill beneficiaries in traditional Medicare.
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.
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42 CFR 417.452 - Liability of Medicare enrollees.
Code of Federal Regulations, 2010 CFR
2010-10-01
... SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Enrollment, Entitlement, and Disenrollment under Medicare Contract § 417.452...
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10 CFR 1705.03 - Systems of records notification.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 10 Energy 4 2013-01-01 2013-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities Safety...
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10 CFR 1705.03 - Systems of records notification.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 10 Energy 4 2012-01-01 2012-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities Safety...
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10 CFR 1705.03 - Systems of records notification.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 10 Energy 4 2014-01-01 2014-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities Safety...
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10 CFR 1705.03 - Systems of records notification.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities Safety...
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10 CFR 1705.03 - Systems of records notification.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 10 Energy 4 2011-01-01 2011-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities Safety...
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Medicare risk contracting: Determinants of market entry
Porell, Frank W.; Wallack, Stanley S.
1990-01-01
The Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 made it more attractive for health maintenance organizations (HMOs) and other competitive medical plans to enter into risk contracts with Medicare. Since the start of the TEFRA program in April 1985, more than 160 HMOs have had risk contracts with Medicare under the program. An investigation of factors associated with TEFRA risk-market entry at the end of 1986 revealed that high adjusted average per capita cost payment levels, prior Medicare cost-contract experience, and prior Federal qualification were the most important factors distinguishing market entrants from nonentrants. PMID:10113567
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Das, Anup; Norton, Edward C; Miller, David C; Ryan, Andrew M; Birkmeyer, John D; Chen, Lena M
2016-05-01
In fiscal year 2015 the Centers for Medicare and Medicaid Services expanded its Hospital Value-Based Purchasing program by rewarding or penalizing hospitals for their performance on both spending and quality. This represented a sharp departure from the program's original efforts to incentivize hospitals for quality alone. How this change redistributed hospital bonuses and penalties was unknown. Using data from 2,679 US hospitals that participated in the program in fiscal years 2014 and 2015, we found that the new emphasis on spending rewarded not only low-spending hospitals but some low-quality hospitals as well. Thirty-eight percent of low-spending hospitals received bonuses in fiscal year 2014, compared to 100 percent in fiscal year 2015. However, low-quality hospitals also began to receive bonuses (0 percent in fiscal year 2014 compared to 17 percent in 2015). All high-quality hospitals received bonuses in both years. The Centers for Medicare and Medicaid Services should consider incorporating a minimum quality threshold into the Hospital Value-Based Purchasing program to avoid rewarding low-quality, low-spending hospitals. Project HOPE—The People-to-People Health Foundation, Inc.
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78 FR 29139 - Medicare Program; Bundled Payments for Care Improvement Model 1 Open Period
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-17
... initiative. DATES: Model 1 of the Bundled Payments for Care Improvement Deadline: Interested organizations... initiative. For additional information on this initiative go to the CMS Center for Medicare and Medicaid Innovation Web site at http://innovation.cms.gov/initiatives/BPCI-Model-1/index.html . SUPPLEMENTARY...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-30
... Disorders Fourth Edition--Text Revision. DRGs Diagnosis-related groups. FY Federal fiscal year. ICD-9-CM...) coding and diagnosis-related groups (DRGs) classification changes discussed in the annual update to the... for the following patient-level characteristics: Medicare Severity diagnosis related groups (MS-DRGs...
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76 FR 18766 - Early Retiree Reinsurance Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-05
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-9996-N] Early Retiree Reinsurance Program AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This notice announces that CMS is exercising its authority under section 1102(f) of the...
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Use of Medicare's Diabetes Self-Management Training Benefit
ERIC Educational Resources Information Center
Strawbridge, Larisa M.; Lloyd, Jennifer T.; Meadow, Ann; Riley, Gerald F.; Howell, Benjamin L.
2015-01-01
Medicare began reimbursing for outpatient diabetes self-management training (DSMT) in 2000; however, little is known about program utilization. Individuals diagnosed with diabetes in 2010 were identified from a 20% random selection of the Medicare fee-for-service population (N = 110,064). Medicare administrative and claims files were used to…
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2014-08-06
This final rule will update the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs). These changes will be applicable to IPF discharges occurring during the fiscal year (FY) beginning October 1, 2014 through September 30, 2015. This final rule will also address implementation of ICD-10-CM and ICD-10-PCS codes; finalize a new methodology for updating the cost of living adjustment (COLA), and finalize new quality measures and reporting requirements under the IPF quality reporting program.
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Charged antiparticle to particle ratios near midrapidity in p+p collisions at √(sNN)=200GeV
NASA Astrophysics Data System (ADS)
Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Becker, B.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Busza, W.; Carroll, A.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Harrington, A. S.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Khan, N.; Kulinich, P.; Kuo, C. M.; Lee, J. W.; Lin, W. T.; Manly, S.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Roland, C.; Roland, G.; Sagerer, J.; Sarin, P.; Sedykh, I.; Skulski, W.; Smith, C. E.; Steinberg, P.; Stephans, G. S.; Sukhanov, A.; Tonjes, M. B.; Trzupek, A.; Vale, C.; Nieuwenhuizen, G. J.; Verdier, R.; Veres, G. I.; Wolfs, F. L.; Wosiek, B.; Woźniak, K.; Wysłouch, B.; Zhang, J.
2005-02-01
The ratios of the yields of primary charged antiparticles to particles have been obtained for pions, kaons, and protons near midrapidity for p+p collisions at √(sNN)=200GeV. Ratios of <π-/π+>=1.000±0.012 (stat.) ±0.019 (syst.),
=0.93±0.05 (stat.) ±0.03 (syst.), and <p¯/p>=0.85±0.04 (stat.) ±0.03 (syst.) have been measured. The reported values represent the ratio of the yields averaged over the rapidity range of 0.1 -
Measuring coding intensity in the Medicare Advantage program.
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.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-08
... applicable manufacturers of drugs, devices, biologicals, or medical supplies covered under title XVIII of the Act (Medicare) or a State plan under title XIX (Medicaid) or XXI of the Act (the Children's Health..., ``Conflict of Interest in Medical Research, Education and Practice.'' Given these recommendations and other...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-26
... Skilled Nursing Facilities for FY 2012; Correction AGENCY: Centers for Medicare & Medicaid Services (CMS... Nursing Facilities for FY 2012'' that appeared in the August 8, 2011 Federal Register. DATES: Effective... October 1, 2011. II. Summary of Errors The Addendum to the Skilled Nursing Facility (SNF) Prospective...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-08
...: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: This proposed rule..., especially the teaching status adjustment factor. Therefore, we implemented a 3-year moving average approach... moving average to calculate the facility-level adjustment factors. For FY 2011, we issued a notice to...
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42 CFR 411.108 - Taking into account entitlement to Medicare.
Code of Federal Regulations, 2010 CFR
2010-10-01
... HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT Limitations... basis of ESRD, age, or disability (or eligible on the basis of ESRD) include, but are not limited to... Medicare on the basis of disability without denying or terminating coverage for similarly situated...
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76 FR 54599 - Medicare Program; Medicare Advantage and Prescription Drug Benefit Programs
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-01
... pricing, coverage, and payment processes in the Part D program, and requirements governing the marketing.... Camille Brown, (410) 786-0274, Marketing issues. SUPPLEMENTARY INFORMATION: I. Background The Balanced... the Secretary to revise the marketing requirements for Part C and Part D plans in several areas. MIPPA...
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Pseudorapidity distributions of charged particles in d + Au and p + p collisions at √sNN = 200 GeV
NASA Astrophysics Data System (ADS)
Nouicer, Rachid;
the PHOBOS Collaboration; Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Becker, B.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Busza, W.; Carroll, A.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Harrington, A. S.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Khan, N.; Kulinich, P.; Kuo, C. M.; Lee, J. W.; Lin, W. T.; Manly, S.; Mignerey, A. C.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Roland, C.; Roland, G.; Sagerer, J.; Sarin, P.; Sedykh, I.; Skulski, W.; Smith, C. E.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tonjes, M. B.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Veres, G. I.; Wolfs, F. L. H.; Wosiek, B.; Wozniak, K.; Wysłouch, B.; Zhang, J. 2004-08-01
The measured pseudorapidity distributions of primary charged particles are presented for d+Au and p+p collisions at {\\sqrt{sNN} = {200 GeV} } over a wide pseudorapidity range of |η|<= 5.4. The results for d+Au collisions are presented for minimum-bias events and as a function of collision centrality. The measurements for p+p collisions are shown for minimum-bias events. The ratio of the charged particle multiplicity in d+Au and p+A collisions relative to that for inelastic p+p collisions is found to depend only on langNpartrang, and it is remarkably independent of collision energy and system mass. The deuteron and gold fragmentation regions in d+Au collisions are in good agreement with proton nucleus data at lower energies.
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Compendia and anticancer therapy under Medicare.
Tillman, Katherine; Burton, Brijet; Jacques, Louis B; Phurrough, Steve E
2009-03-03
In 1993, Congress directed the Medicare program to refer to 3 existing published compendia, American Medical Association Drug Evaluations (AMA-DE), United States Pharmacopoeia Drug Information for the Health Professional (USP-DI), and American Hospital Formulary Service Drug Information (AHFS-DI), to identify unlabeled but medically accepted uses of drugs and biologicals in anticancer chemotherapy regimens. Public discussion during the preceding years had centered on whether to designate unlabeled uses of anticancer treatments as experimental and thus outside the scope of Medicare benefits. American Medical Association Drug Evaluations and USP-DI subsequently ceased publication, and the Medicare program faced increasing calls to revise the list of acceptable compendia, as authorized in the statute. In 2007, the Centers for Medicare & Medicaid Services used its regulatory authority to establish a publicly transparent process to revise the list. The Centers for Medicare & Medicaid Services considered 5 requests in 2008 and added National Comprehensive Cancer Network Drugs and Biologics Compendium, DRUGDEX, and Clinical Pharmacology to the list of compendia. DrugPoints was not added, and AMA-DE was removed. Because of the potential for conflicts of interest to lead to biased judgments, the 2008 Medicare Improvements for Patients and Providers Act has a provision that explicitly prohibits inclusion of compendia that do not have a publicly transparent process for evaluating therapies and identifying potential conflicts of interest.
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Medicare Advantage Penetration and Hospital Costs Before and After the Affordable Care Act.
Henke, Rachel Mosher; Karaca, Zeynal; Gibson, Teresa B; Cutler, Eli; White, Chapin; Wong, Herbert S
2018-04-01
Research has suggested that growth in the Medicare Advantage (MA) program indirectly benefits the entire 65+-year-old population by reducing overall expenditures and creating spillover effects of patient care practices. Medicare programs and innovations initiated by the Affordable Care Act (ACA) have encouraged practices to adopt models applying to all patient populations, which may influence the continued benefits of MA program growth. This study investigated the relationship between MA program growth and inpatient hospital costs and utilization before and after the ACA. Primary data sources were 2005-2014 Health Care Cost and Utilization Project hospital data and 2004-2013 Centers for Medicare & Medicaid Services enrollment data. County-year-level regression analysis with fixed effects examined the relationship between Medicare managed care penetration and hospital cost per enrollee. We decomposed results into changes in utilization, severity, and severity-adjusted inpatient resource use. Analyses were stratified by whether the admission was urgent or nonurgent. A 10% increase in MA penetration was associated with a 3-percentage point decrease in inpatient cost per Medicare enrollee before the ACA. This effect was more prominent in nonurgent admissions and diminished after the ACA. Results suggest that MA enrollment growth is associated with diminished spillover reductions in hospital admission costs after the ACA. We did not observe a strong relationship between MA enrollment and inpatient days per enrollee. Future research should examine whether spillover effects still are observed in outpatient settings.
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NASA Astrophysics Data System (ADS)
Wu, Hong-Mao; Lin, Kuan-Ju; Yu, Yi-Hsiuan; Ho, Chan-Yuan; Wei, Ming-Hsiung; Lu, Fu-Hsing; Tseng, Wenjea J.
2014-01-01
Surface-selective deposition of gold (Au) on electroless plated poly(methyl methacrylate)-nickel (PMMA-Ni) beads was prepared chemically by a facile redox-transmetalation route in which the Ni atoms on the PMMA surface were reacted with Au precursors, i.e., chloroauric acid (HAuCl4), in water to form predominately core-shell PMMA-Au composite particles without the need of reducing agent. The Ni layer acted as a sacrificial template to facilitate the selective transmetalation deposition of a metallic Au film. When pH of the precursor solution was adjusted from 6 to 9, morphology of the Au film changed from a uniform particulate film consisting of assemblies of Au nanoparticles, to densely packed, continuous film with platelet Au crystals, and finally to isolated Au islands on the PMMA surface with a raspberry-like core-shell morphology. Uniformly dense Au coating with a thickness of about 200 nm was formed on the PMMA beads at pH of 7 to 8, which gave rise to an electrical resistivity as low as 3 × 10-2 Ω cm.
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Shea, Alisa M; Curtis, Lesley H; Hammill, Bradley G; DiMartino, Lisa D; Abernethy, Amy P; Schulman, Kevin A
2008-07-09
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) altered reimbursements for outpatient chemotherapy drugs and drug administration services. Anecdotal reports suggest that these adjustments may have negatively affected access to chemotherapy for Medicare beneficiaries. To compare patient wait times and travel distances for chemotherapy before and after the enactment of the MMA. Analysis of a nationally representative 5% sample of claims from the Centers for Medicare & Medicaid Services for the period 2003 through 2006. Patients were Medicare beneficiaries with incident breast cancer, colorectal cancer, leukemia, lung cancer, or lymphoma who received chemotherapy in inpatient hospital, institutional outpatient, or physician office settings. Days from incident diagnosis to first chemotherapy visit and distance traveled for treatment, controlling for age, sex, race/ethnicity, cancer type, geographic region, comorbid conditions, and year of diagnosis and treatment. There were 5082 incident cases of breast cancer, colorectal cancer, leukemia, lung cancer, or lymphoma in 2003; 5379 cases in 2004; 5116 cases in 2005; and 5288 cases in 2006. Approximately 70% of patients received treatment in physician office settings in each year. Although the distribution of treatment settings in 2004 and 2005 was not significantly different from 2003 (P = .24 and P = .72, respectively), there was a small but significant change from 2003 to 2006 (P = .02). The proportion of patients receiving chemotherapy in inpatient settings decreased from 10.2% in 2003 to 8.8% in 2006 (P = .03), and the proportion in institutional outpatient settings increased from 21.1% to 22.5% (P = .004). The proportion in physician offices remained at 68.7% (P = .29). The median time from diagnosis to initial chemotherapy visit was 28 days in 2003, 27 days in 2004, 29 days in 2005, and 28 days in 2006. In multivariate analyses, average wait times for chemotherapy were 1.96 days
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Medicare Part D formulary coverage since program inception: are beneficiaries choosing wisely?
Jackson, E Anne; Axelsen, Kirsten J
2008-11-01
To evaluate how Medicare Part D formulary composition has changed since program inception, including comparison of plans eligible for full premium subsidy (ie, benchmark plans) with their counterparts. The study used publicly available data released by the Centers for Medicare & Medicaid Services to generate snapshots of formulary coverage and enrollment levels in each plan year. The analysis included all Part D plans and tracked formulary coverage of 152 of the most common brand name and generic drugs prescribed to seniors. Since 2006, the number of products available without restriction has increased and the number of drugs not on formulary has decreased. However, it appears that beneficiaries (subsidized beneficiaries in particular) may not be using their open-enrollment periods to reevaluate the available plan offerings. Beneficiaries need to reevaluate the Part D options available on an annual basis to maintain enrollment with the most appropriate plan available. Although all plans meet the proscribed formulary requirements, some plans offer richer drug coverage with more drugs available on an unrestricted basis. Benchmark plan status allows Part D plans to maintain or gain significant Medicare enrollment from year to year. Careful oversight should be provided to ensure that the level of formulary coverage offered at benchmark and other plans remains consistent.
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Effects of the Medicare Alzheimer's Disease Demonstration on Medicare Expenditures
Newcomer, Robert; Miller, Robert; Clay, Ted; Fox, Patrick
1999-01-01
Applicants were randomized either into a group with a limited Medicare community care service benefit and case management or into a control group receiving their regular medical care. Analyses assess whether or not community care management affected health care use. A tendency toward reduced expenditures was observed for the treatment group, combining all demonstration sites, and when observing each separately. These differences were or approached statistical significance in two sites for Medicare Part A and Parts A and B expenditures averaged over 3 years. Expenditure reductions approached budget neutrality with program costs in two sites. PMID:11482124
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-01
...-Loss Provision 3. Future Refinements VIII. Secretary's Recommendations IX. Waiver of Notice and Comment... corresponding meanings in alphabetical order below: BBRA Medicare, Medicaid and SCHIP [State Children's Health... 1886(s)(2)(A)(ii) of the Social Security Act (the Act) and a 0.5 percentage point reduction for economy...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-02
.... Monitoring Impact of FY 2012 Policy Changes and Certain SNF Practices A. RUG Distributions B. Group Therapy... Common Procedure Coding System HR-III Hybrid Resource Utilization Groups, Version 3 IHS IGI (Information... OCN OMB Control Number OMB Office of Management and Budget OMRA Other Medicare-Required Assessment PPS...
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78 FR 2407 - Medicare Payment Advisory Commission Nomination Letters
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-11
... GOVERNMENT ACCOUNTABILITY OFFICE Medicare Payment Advisory Commission Nomination Letters AGENCY: Government Accountability Office (GAO). ACTION: Notice on letters of nomination. SUMMARY: The Balanced Budget Act of 1997 established the Medicare Payment Advisory Commission (MedPAC) and gave the Comptroller...
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76 FR 81503 - Medicare Payment Advisory Commission Nomination Letters
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-28
... GOVERNMENT ACCOUNTABILITY OFFICE Medicare Payment Advisory Commission Nomination Letters AGENCY: Government Accountability Office (GAO). ACTION: Notice on letters of nomination. SUMMARY: The Balanced Budget Act of 1997 established the Medicare Payment Advisory Commission (MedPAC) and gave the Comptroller...
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42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2011 CFR
2011-10-01
..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2011-10-01 2011-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality improvement...
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42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2010 CFR
2010-10-01
..., psychosocial, or clinical domains (for example, quality of life indicators, depression scales, or chronic... 42 Public Health 3 2010-10-01 2010-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality improvement...
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42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2014 CFR
2014-10-01
..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2014-10-01 2014-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...
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42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2012 CFR
2012-10-01
..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2012-10-01 2012-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...
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42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2013 CFR
2013-10-01
..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2013-10-01 2013-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...
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Stone, Devin A; Dickensheets, Bridget A; Poisal, John A
2018-02-01
To compare Medicaid fee-for-service (FFS) inpatient hospital payments to expected Medicare payments. Medicaid and Medicare claims data, Medicare's MS-DRG grouper and inpatient prospective payment system pricer (IPPS pricer). Medicaid FFS inpatient hospital claims were run through Medicare's MS-DRG grouper and IPPS pricer to compare Medicaid's actual payment against what Medicare would have paid for the same claim. Average inpatient hospital claim payments for Medicaid were 68.8 percent of what Medicare would have paid in fiscal year 2010, and 69.8 percent in fiscal year 2011. Including Medicaid disproportionate share hospital (DSH), graduate medical education (GME), and supplemental payments reduces a substantial proportion of the gap between Medicaid and Medicare payments. Medicaid payments relative to expected Medicare payments tend to be lower and vary by state Medicaid program, length of stay, and whether payments made outside of the Medicaid claims process are included. © Health Research and Educational Trust.
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42 CFR 424.535 - Revocation of enrollment and billing privileges in the Medicare program.
Code of Federal Regulations, 2012 CFR
2012-10-01
... enrollment and billing privileges in the Medicare program. (a) Reasons for revocation. CMS may revoke a... agreement or supplier agreement for the following reasons: (1) Noncompliance. The provider or supplier is... murder, rape, assault, and other similar crimes for which the individual was convicted, including guilty...
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42 CFR 424.535 - Revocation of enrollment and billing privileges in the Medicare program.
Code of Federal Regulations, 2013 CFR
2013-10-01
... enrollment and billing privileges in the Medicare program. (a) Reasons for revocation. CMS may revoke a... agreement or supplier agreement for the following reasons: (1) Noncompliance. The provider or supplier is... murder, rape, assault, and other similar crimes for which the individual was convicted, including guilty...
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42 CFR 424.535 - Revocation of enrollment and billing privileges in the Medicare program.
Code of Federal Regulations, 2011 CFR
2011-10-01
... and billing privileges in the Medicare program. (a) Reasons for revocation. CMS may revoke a currently... supplier agreement for the following reasons: (1) Noncompliance. The provider or supplier is determined not... beneficiaries. (i) Offenses include— (A) Felony crimes against persons, such as murder, rape, assault, and other...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-24
...). These revisions would implement certain provisions under the Medicare Improvements for Patients and... with the Social Security Act. The comment period for the proposed rule, which would have ended on June... Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. 4. By hand or courier. If you prefer...
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42 CFR 460.90 - PACE benefits under Medicare and Medicaid.
Code of Federal Regulations, 2011 CFR
2011-10-01
... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Services § 460.90 PACE benefits under Medicare and Medicaid. If a Medicare...
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Reforming funding for chronic illness: Medicare-CDM.
Swerissen, Hal; Taylor, Michael J
2008-02-01
Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-10
... System AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice of Single Source Award... care system through a single source award. The Indian Health Service (IHS), Tribes and Tribal... adoption and impact of these new authorities on the Indian health care system. Amount of the Award The...
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1980-07-24
This rule sets forth expanded standards for protection of personal funds of patients in skilled nursing facilities (SNFs) and intermediate care facilities (ICFs) that participate in the Medicare or Medicaid programs. The changes are required for SNFs by Section 21(a) of Pub. L. 95-142, the Medicare-Medcaid Anti-Fraud and Abuse Amendments of 1977, and for ICFs by Section 8(c) of Pub. L. 95-292, the End-Stage Renal Disease Amendments of 1978. The intent is to safeguard patient funds from misuse by facilities, and to assure that personal funds held by the the facilities are fully accounted for and made available to patients when they need or want them.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-08
... information posted on our Center for Medicare and Medicaid Innovation (CMMI) Web site and in the Pioneer ACO Application. (For more information see http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care... postmarked on or before July 18, 2011.'' Authority: Section 1115A of the Social Security Act. Dated: June 2...
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Kinenkinda, Xavier; Mukuku, Olivier; Chenge, Faustin; Kakudji, Prosper; Banzulu, Peter; Kakoma, Jean-Baptiste; Kizonde, Justin
2017-01-01
Introduction La fréquence de la césarienne (CS) ne cesse d'augmenter ces dernières décennies mais cette augmentation diffère énormément d'un pays à un autre et dans un même milieu, d'une institution médicale à une autre. L'objectif de cette étude est d'étudier la fréquence, les indications et la morbi-mortalité maternelle et périnatale de la césarienne (CS) à Lubumbashi, République Démocratique du Congo (RDC). Méthodes Étude multicentrique, rétrospective, descriptive et analytique de 3643 CS consécutives sur un total de 34199 accouchements dans cinq formations hospitalières de référence à Lubumbashi (RDC) entre le 1er janvier 2009 et le 31 décembre 2013. Les données sociodémographiques, les indications, l'environnement obstétrical et la morbi-mortalité maternelle et périnatale ont été analysés au logiciel Epi Info 2011. Les fréquences exprimées en pourcentage et les moyennes avec leurs écart-types ont été calculés. Le test de Chi-carré et le test exact de Fisher lorsque recommandés ont été utilisés pour la comparaison des fréquences au seuil de signification de p<0,05. Résultats La fréquence moyenne de césarienne était de 10,65%. Elle est passée de 10,24% en 2009 à 11,38% en 2013 soit une croissance de 11,13% (p=0,03). Cinquante-un virgule quatre pourcent de CS étaient effectuées après tentative de la voie basse et 48,6% dans un contexte d'urgence obstétricale. Les indications sont restées constantes et dominées par la disproportion fœto-pelvienne (18,6%), la souffrance fœtale aiguë (11,9%), la mal présentation fœtale (10,1%), le placenta prævia (9,2%) et le bassin rétréci (8,4%). La morbidité maternelle s'élève à 11,6% matérialisée par les complications hémorragiques dans 6,1%. La mortalité maternelle globale est passée de 2,3‰ en 2009 à 6,4‰ en 2013 soit une inflation de 178,26%. Pour la voie haute, elle est passée de 4‰ à 16,7‰ pour les 4 dernières années prises ensemble
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A study of the Au/Ni ohmic contact on p-GaN
DOE Office of Scientific and Technical Information (OSTI.GOV)
Qiao, D.; Yu, L. S.; Lau, S. S.
2000-10-01
The formation mechanism of the ohmic Au/Ni/p-GaN contact has been investigated. We found that it is essential to (i) deposit a structure of Au and Ni in the proper deposition sequence, and (ii) anneal the bilayer structure in an oxygen containing ambient. Our findings indicated that oxygen assists the layer-reversal reactions of the metallized layers to form a structure of NiO/Au/p-GaN. The presence of oxygen during annealing appears to increase the conductivity of the p-GaN. It is further suggested that Ni removes or reduces the surface contamination of the GaN sample before or during layer reversal. In the final contactmore » structure, an Au layer, which has a large work function, is in contact with the p-GaN substrate. The presence of Au in the entire contacting layer improves the conductivity of the contact. An ohmic formation mechanism based on our experimental results is proposed and discussed in this work. (c) 2000 American Institute of Physics.« less
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42 CFR 423.159 - Electronic prescription drug program.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 3 2012-10-01 2012-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions...
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42 CFR 423.159 - Electronic prescription drug program.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 3 2014-10-01 2014-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions...
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42 CFR 423.159 - Electronic prescription drug program.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 3 2013-10-01 2013-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions...
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Magnetic susceptibilities of liquid Cr-Au, Mn-Au and Fe-Au alloys
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ohno, S.; Shimakura, H.; Tahara, S.
The magnetic susceptibility of liquid Cr-Au, Mn-Au, Fe-Au and Cu-Au alloys was investigated as a function of temperature and composition. Liquid Cr{sub 1-c}Au{sub c} with 0.5 ≤ c and Mn{sub 1-c}Au{sub c} with 0.3≤c obeyed the Curie-Weiss law with regard to their dependence of χ on temperature. The magnetic susceptibilities of liquid Fe-Au alloys also exhibited Curie-Weiss behavior with a reasonable value for the effective number of Bohr magneton. On the Au-rich side, the composition dependence of χ for liquid TM-Au (TM=Cr, Mn, Fe) alloys increased rapidly with increasing TM content, respectively. Additionally, the composition dependences of χ for liquidmore » Cr-Au, Mn-Au, and Fe-Au alloys had maxima at compositions of 50 at% Cr, 70 at% Mn, and 85 at% Fe, respectively. We compared the composition dependences of χ{sub 3d} due to 3d electrons for liquid binary TM-M (M=Au, Al, Si, Sb), and investigated the relationship between χ{sub 3d} and E{sub F} in liquid binary TM-M alloys at a composition of 50 at% TM.« less
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Magnetic field directional discontinuities - Characteristics between 0.46 and 1.0 AU
NASA Technical Reports Server (NTRS)
Lepping, R. P.; Behannon, K. W.
1986-01-01
Based on Mariner 10 data, a statistical survey and an application of the Sonnerup-Cahill variance procedure to a visual identification with 1.2-s averages for time intervals corresponding to the equally spaced heliocentric distances of 1.0, 0.72 and 0.46 AU, are employed to study the characteristics of directional discontinuities (DDs) in the interplanetary magnetic field. Analysis using two methods demonstrated that the ratio of tangential discontinuities (TDs) to rotational discontinuities (RDs) decreased with decreasing radial distance. Decreases in average discontinuity thickness of 41 percent between 1.0 and 0.72 AU, and 56 percent between 1.0 and 0.46 AU, were found for both TDs and RDs, in agreement with Pioneer 10 data between 1 and 5 AU. Normalization of the individual DD thicknesses with respect to the estimated local proton gyroradius (R sub L) gave a nearly constant average thickness at the three locations, 36 + or - 5 R sub L, for both RDs and TDs.
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Coordination of health coverage for Medicare enrollees: living with HIV/AIDS in California.
Eichner, J; Kahn, J G
2001-08-01
Because Medicare does not cover a large part of the health care that its enrollees living with HIV/AIDS require, they need other coverage to supplement Medicare. Medicaid is a major source of that supplemental coverage. In California, Medicare enrollees with HIV/AIDS who were also enrolled in Medi-Cal (California's Medicaid program) had total payments from both programs of $177 million, or an average of $28,956 per person in the fee-for-service-system in 1998. Of that total, Medicare paid for 38 percent, mainly for inpatient visits and ambulatory care, while Medi-Cal paid 62 percent, mainly for prescription drugs. For these dual enrollees, many of Medicare's benefit gaps--including a large share of prescription drugs, nursing facility services and home care--are being filled by Medi-Cal. Data in this Medicare Brief indicate that the incremental cost to the federal government of filling gaps in the Medicare benefits package would be considerably less than the full cost of the additional benefits. Through Medicaid and other programs, the federal government is already paying a substantial part of public program expenditures for dual enrollees with HIV/AIDS. Other issues to consider are how the dual Medicare-Medicaid funding streams affect the programs' cost efficiency, and from the perspective of Medicare enrollees and providers, how well the dual programs coordinate to meet the needs of people with HIV/AIDS and other chronic conditions.
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... Choosing to start hospice care is a difficult decision. The information in this booklet and support from a doctor ... may need hospice care in all health care decisions. The information in this booklet describes the Medicare Program at ...
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Financial Incentives and Physician Practice Participation in Medicare's Value-Based Reforms.
Markovitz, Adam A; Ramsay, Patricia P; Shortell, Stephen M; Ryan, Andrew M
2017-07-26
To evaluate whether greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms. Publicly available data from Medicare's Physician Compare (n = 1,278; January 2012 to November 2013) and nationally representative physician practice data from the National Survey of Physician Organizations 3 (NSPO3; n = 907,538; 2013). We used regression analysis to examine practice-level relationships between prior exposure to performance incentives and participation in key Medicare value-based payment reforms: accountable care organization (ACO) programs, the Physician Quality Reporting System ("Physician Compare"), and the Meaningful Use of Health Information Technology program ("Meaningful Use"). Prior experience and success with financial incentives were measured as (1) the percentage of practices' revenue from financial incentives for quality or efficiency; and (2) practices' exposure to public reporting of quality measures. We linked physician participation data from Medicare's Physician Compare to the NSPO3 survey. There was wide variation in practices' exposure to performance incentives, with 64 percent exposed to financial incentives, 45 percent exposed to public reporting, and 2.2 percent of practice revenue coming from financial incentives. For each percentage-point increase in financial incentives, there was a 0.9 percentage-point increase in the probability of participating in ACOs (standard error [SE], 0.1, p < .001) and a 0.8 percentage-point increase in the probability of participating in Meaningful Use (SE, 0.1, p < .001), controlling for practice characteristics. Financial incentives were not associated with participation in Physician Compare. Among ACO participants, a 1 percentage-point increase in incentives was associated with a 0.7 percentage-point increase in the probability of being "very well" prepared to utilize cost and quality data
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42 CFR 423.159 - Electronic prescription drug program.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 3 2011-10-01 2011-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions. For purposes of this...
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Praveen, Raju; Ramaraj, Ramasamy
2016-10-05
Visible light active photocatalysts consisting of gold nanoparticle (Au NP) decorated chemically reduced graphene oxide-P25 nanocomposite materials (CRGO-P25-Au NCMs) were prepared through a one-pot chemical reduction method. The nanocomposite materials were characterized using diffuse reflectance spectroscopy (DRS), X-ray diffraction (XRD), high-resolution transmission electron microscopy (HRTEM) and electrochemical impedance spectroscopy (EIS) analyses. The performances of CRGO-P25-Au NCM modified ITO electrodes were evaluated towards the photoelectrochemical oxidation of methanol. The photoelectrode fabricated using CRGO-P25-Au NCM exhibited a higher photocurrent of 293 μA cm -2 compared to other control electrodes. The CRGO-P25-Au NCMs were also used for the photocatalytic reduction of highly toxic chromium(vi) ions to chromium(iii) ions in the presence of oxalic acid as a sacrificial electron donor. The results showed that around 75% of the Cr(vi) ions were photocatalytically reduced to Cr(iii) ions by the CRGO-P25-Au NCM within the light irradiation time of 1 h. In both applications, the enhanced catalytic activity of the CRGO-P25-Au NCM was attributed to the improved visible light absorption and the reduced charge recombination exerted by the interaction of CRGO and Au NPs with P25 and their synergistic effects.
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Understanding the Impacts of the Medicare Modernization Act: Concerns of Congressional Staff
ERIC Educational Resources Information Center
Mueller, Keith J.; Coburn, Andrew F.; MacKinney, Clinton; McBride, Timothy D.; Slifkin, Rebecca T.; Wakefield, Mary K.
2005-01-01
Sweeping changes to the Medicare program embodied in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), including a new prescription drug benefit, changes in payment policies, and reform of the Medicare managed-care program, have major implications for rural health care. The most efficient mechanism for research to…
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42 CFR 460.90 - PACE benefits under Medicare and Medicaid.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false PACE benefits under Medicare and Medicaid. 460.90 Section 460.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) PACE Services § 460.90 PACE benefits under Medicare and Medicaid. If a Medicare...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-05
... access to care, quality of care, health outcomes, and expenditures. DATES: Supporting information to... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-5058-N... Tests Demonstration. The Demonstration is mandated by section 3113 of the Affordable Care Act. This...
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PACE and the Medicare+Choice risk-adjusted payment model.
Temkin-Greener, H; Meiners, M R; Gruenberg, L
2001-01-01
This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.
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Disenrollment from Medicare HMOs.
Call, K T; Dowd, B E; Feldman, R; Lurie, N; McBean, M A; Maciejewski, M
2001-01-01
Since the program's inception, there has been great interest in determining whether beneficiaries who enter and subsequently leave Medicare health maintenance organizations (HMOs) are more or less costly than those remaining in fee-for-service (FFS) Medicare. To examine whether relatively high-cost beneficiaries disenroll from Medicare HMOs (disenrollment bias) and whether disenrollment bias varies by Medicare HMO market characteristics. In addition, we compare rates of surgical procedures and hospitalizations for ambulatory care-sensitive conditions for disenrollees and continuing FFS beneficiaries. Cross-sectional analysis of 1994 Medicare data. Medicare beneficiaries were first sampled from the 124 counties with at least 1000 Medicare HMO enrollees. From this pool, HMO disenrollees and a sample of continuing FFS beneficiaries were drawn. The FFS beneficiaries were assigned dates of "pseudodisenrollment." Expenditures and inpatient service use were compared for 6 months after disenrollment or pseudodisenrollment. The HMO disenrollees were no more likely than the continuing FFS beneficiaries to have positive total expenditures (Part A plus Part B) or Part B expenditures in the first 6 months after disenrollment. However, disenrollees were more likely to have Part A expenditures. Among beneficiaries with spending, disenrollees had higher total and Part B expenditures than continuing FFS beneficiaries. Moreover, the disparity in total and Part B spending between disenrollees and continuing FFS beneficiaries increased with HMO market penetration. Although Part A spending was higher for disenrollees with spending, it was not sensitive to changes in market share. The HMO disenrollees received more surgical procedures and were hospitalized for more of the ambulatory care-sensitive conditions than the FFS beneficiaries. On several measures, Medicare HMOs experienced favorable disenrollment relative to continuing FFS beneficiaries as recently as 1994, which increased as
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Improving Medicare coverage of psychological services for older Americans.
Karlin, Bradley E; Humphreys, Keith
2007-10-01
Professional psychology's ability to meet older Americans' psychological needs and to simultaneously thrive as a profession will be closely tied to the federal Medicare program over the coming decades. Despite legislative changes in the 1980s providing professional autonomy to psychologists and expanding coverage for mental health services, Medicare coverage policies, reimbursement mechanisms, and organizational traditions continue to limit older Americans' access to psychological services. This article describes how psychologists can influence Medicare coverage policy. Specifically, the authors examine widely unrecognized policy processes and recent political developments and analyze the recent creation of a new Medicare counseling benefit, applying J. W. Kingdon's (1995) well-known model of policy change. These recent developments offer new opportunities for expanding Medicare coverage of psychological services, particularly in the areas of prevention, screening, and early intervention. The article provides an analysis to guide psychologists in engaging in strategic advocacy and incorporating psychological prevention and early intervention services into Medicare. As Medicare policy entrepreneurs, psychologists can improve the well-being of millions of Americans who rely on the national health insurance program and, in so doing, can help shape the future practice of psychology. Copyright 2007 APA, all rights reserved.
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The welfare impact of Medicare HMOs.
Town, Robert; Liu, Su
2003-01-01
We estimate the welfare associated with the Medicare HMO program, now known as Medicare+Choice (M+C). We find that the creation of the M+C program resulted in approximately $15.6 billion in consumer surplus and $52 billion in profits from 1993 to 2000 (in 2000 dollars). This program most likely generated significant net social welfare. However, we find that consumer surplus is geographically unevenly distributed. Prescription drug coverage accounts for approximately 45% of the estimated consumer surplus for 2000. Consumer surplus increases in the number of plans in a county, and most of the increase in welfare is due to increased premium competition.
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Colorimetric detection of melamine based on p-chlorobenzenesulfonic acid-modified AuNPs
NASA Astrophysics Data System (ADS)
Li, Jianfang; Huang, Pengcheng; Wu, Fangying
2016-06-01
A highly selective and sensitive method is developed for colorimetric detection of melamine using gold nanoparticles (AuNPs) functionalized with p-chlorobenzenesulfonic acid. The addition of melamine induced the aggregation of AuNPs, as evidenced from the morphological characterizations and the color changed from red wine to blue, which could also be monitored by the UV-visible spectrometer and even naked eyes. This process caused a significant increase in the absorbance ratio (A650nm/A520nm) of p-chlorobenzenesulfonic acid-AuNPs. Under optimized conditions, the system exhibited a linear response to melamine in the range of 6.0 × 10-7-1.5 × 10-6 mol L-1 with a correlation coefficient of 0.997, and the limit of detection can even be 2.3 nM, which was much lower than some other methods and the safe limits (20 μM in both the USA and EU, 8.0 μM for infant formula in China, 1.2 μM in the CAC (Codex Alimentarius Commission) review for melamine in liquid infant formula). More importantly, the developed method presented excellent tolerance to coexisting common metal ions such as Ca2+, Zn2+, whose concentration is 1000 times of melamine, so that it had been applied to the analysis of melamine in liquid milk and milk powder with the recovery of 97.0-101 % and 100-103 %, respectively, indicating that the proposed method is quite a highly effective means to determine melamine in milk products.
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Savings estimate for a Medicare insured group
Birnbaum, Howard; Holland, Stephen K.; Lenhart, Gregory; Reilly, Helena L.; Hoffman, Kevin; Pardo, Dennis P.
1991-01-01
Estimates of the savings potential of a managed-care program for a Medicare retiree population in Michigan under a hypothetical Medicare insured group (MIG) are presented in this article. In return for receiving an experience-rated capitation payment, a MIG would administer all Medicare and employer complementary benefits for its enrollees. A study of the financial and operational feasibility of implementing a MIG for retirees of a national corporation involving an analysis of 1986 claims data finds that selected managed-care initiatives implemented by a MIG would generate an annual savings of 3.8 percent of total (Medicare plus complementary) expenditures. Although savings are less than the 5 percent to be retained by Medicare, this finding illustrates the potential for savings from managed-care initiatives to Medicare generally and to MIGs elsewhere, where savings may be greater if constraints are less restrictive. PMID:10113700
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-24
... continued recognition as a national accrediting organization for hospitals that wish to participate in the... effective September 26, 2012, through September 26, 2018. DATES: This final notice is effective September 26... accreditation by an approved national accrediting organization (AO) that all applicable Medicare conditions are...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-07
... Fiscal Year 2011 Final Wage Indices Implementing the Medicare and Medicaid Extenders Act AGENCY: Centers... fiscal year (FY) 2011 wage indices and hospital reclassifications and other related tables which reflect... reclassifications and special exception wage indices through September 30, 2011. DATES: Applicability Date: The...
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Lippincott, Christine; Foronda, Cynthia; Zdanowicz, Martin; McCabe, Brian E; Ambrosia, Todd
2017-08-01
The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P < .001) and were more likely to adopt electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P < .001; Level 6 or 7: odds ratio = 4.02, P < .001). This study suggested a positive relationship between Magnet status and electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.
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Vertical integration strategies: revenue effects in hospital and Medicare markets.
Cody, M
1996-01-01
The purpose of this study was to evaluate the revenue effects of seven vertically integrated strategies on California hospitals. The strategies investigated were managed care contracts, physician affiliations, ambulatory care, ambulatory surgery, home health services, inpatient rehabilitation, and skilled nursing care. The study population included 242 not-for-profit hospitals in continuous operation from 1983 to 1990. Many hospitals developed vertically integrated programs in the 1980s as inpatient utilization fell in response to the Medicare Prospective Payment program. Net revenue rose on average by $2,080 from 1983 to 1990, but fell by $2,421 from the Medicare program. On the whole, the more physicians affiliated with a hospital, the higher the net revenue. However, in the Medicare population, the number of managed care contracts was significant. The pre-hospital strategies generated significant revenue, while the post-hospital strategies did not. In the Medicare program, inpatient rehabilitation significantly reduced revenue.
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... get about Medicare Lost/incorrect Medicare card Report fraud & abuse File a complaint Identity theft: protect yourself ... the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 Sign Up / Change Plans ...
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2015-08-17
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2016. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Pathway for Sustainable Growth Reform(SGR) Act of 2013, the Protecting Access to Medicare Act of 2014, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, and other legislation. We also are addressing the update of the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2016.As an interim final rule with comment period, we are implementing the statutory extensions of the Medicare dependent,small rural hospital (MDH)Program and changes to the payment adjustment for low-volume hospitals under the IPPS.We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2016 and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific providers (acute care hospitals,PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare, including related provisions for eligible hospitals and critical access hospitals participating in the Medicare Electronic Health Record (EHR)Incentive Program. We also are updating policies relating to the
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... your Medicare coverage — Original Medicare or a Medicare Advantage Plan (Part C). What Part A covers Medicare ... health plans cover Medicare health plans include Medicare Advantage, Medical Savings Account (MSA), Medicare Cost plans, PACE, ...
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Hot Hole Collection and Photoelectrochemical CO2 Reduction with Plasmonic Au/p-GaN Photocathodes.
DuChene, Joseph S; Tagliabue, Giulia; Welch, Alex J; Cheng, Wen-Hui; Atwater, Harry A
2018-04-11
Harvesting nonequilibrium hot carriers from plasmonic-metal nanostructures offers unique opportunities for driving photochemical reactions at the nanoscale. Despite numerous examples of hot electron-driven processes, the realization of plasmonic systems capable of harvesting hot holes from metal nanostructures has eluded the nascent field of plasmonic photocatalysis. Here, we fabricate gold/p-type gallium nitride (Au/p-GaN) Schottky junctions tailored for photoelectrochemical studies of plasmon-induced hot-hole capture and conversion. Despite the presence of an interfacial Schottky barrier to hot-hole injection of more than 1 eV across the Au/p-GaN heterojunction, plasmonic Au/p-GaN photocathodes exhibit photoelectrochemical properties consistent with the injection of hot holes from Au nanoparticles into p-GaN upon plasmon excitation. The photocurrent action spectrum of the plasmonic photocathodes faithfully follows the surface plasmon resonance absorption spectrum of the Au nanoparticles and open-circuit voltage studies demonstrate a sustained photovoltage during plasmon excitation. Comparison with Ohmic Au/p-NiO heterojunctions confirms that the vast majority of hot holes generated via interband transitions in Au are sufficiently hot to inject above the 1.1 eV interfacial Schottky barrier at the Au/p-GaN heterojunction. We further investigated plasmon-driven photoelectrochemical CO 2 reduction with the Au/p-GaN photocathodes and observed improved selectivity for CO production over H 2 evolution in aqueous electrolytes. Taken together, our results offer experimental validation of photoexcited hot holes more than 1 eV below the Au Fermi level and demonstrate a photoelectrochemical platform for harvesting hot carriers to drive solar-to-fuel energy conversion.
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Shih, Terry; Ryan, Andrew M; Gonzalez, Andrew A; Dimick, Justin B
2015-06-01
To project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. The Hospital Readmissions Reduction Program will potentially expand penalties for higher-than-predicted readmission rates to cardiac procedures in the near future. The impact of these penalties on minority-serving hospitals is unknown. We examined national Medicare beneficiaries undergoing coronary artery bypass grafting in 2008 to 2010 (N = 255,250 patients, 1186 hospitals). Using hierarchical logistic regression, we calculated hospital observed-to-expected readmission ratios. Hospital penalties were projected according to the Hospital Readmissions Reduction Program formula using only coronary artery bypass grafting readmissions with a 3% maximum penalty of total Medicare revenue. Hospitals were classified into quintiles according to proportion of black patients treated. Minority-serving hospitals were defined as hospitals in the top quintile whereas non-minority-serving hospitals were those in the bottom quintile. Projected readmission penalties were compared across quintiles. Forty-seven percent of hospitals (559 of 1186) were projected to be assessed a penalty. Twenty-eight percent of hospitals (330 of 1186) would be penalized less than 1% of total Medicare revenue whereas 5% of hospitals (55 of 1186) would receive the maximum 3% penalty. Minority-serving hospitals were almost twice as likely to be penalized than non-minority-serving hospitals (61% vs 32%) and were projected almost triple the reductions in reimbursement ($112 million vs $41 million). Minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery. Given these hospitals' narrow profit margins, readmission penalties may have a profound impact on these hospitals' ability to care for disadvantaged patients.
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Veilleux, Jean Wright
2012-01-01
This Article argues that the current approach of the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to enforcement of the Ethics in Patient Referrals Act (the "Stark Law") is unnecessarily punitive and discourages health-care providers from self-disclosing even very minor violations of the Stark Law. This Article suggests a number of specific changes to encourage provider self-disclosure and proposes that CMS create a demonstration project under the authority of the Patient Protection and Affordable Care Act to test the reforms. A demonstration project provides the perfect vehicle to prove that increased self-disclosure protocols for the Stark Law can decrease the government's costs of enforcement, improve program integrity, and encourage providers to deal responsibly with the inevitable minor lapses in compliance that arise in such an enormous government program as Medicare.