No effect of user fee exemption on perceived quality of delivery care in Burkina Faso: a case-control study.

PubMed

Philibert, Aline; Ridde, Valéry; Bado, Aristide; Fournier, Pierre

2014-03-11

Although many developing countries have developed user fee exemption policies to move towards universal health coverage as a priority, very few studies have attempted to measure the quality of care. The present paper aims at assessing whether women's satisfaction with delivery care is maintained with a total fee exemption in Burkina Faso. A quasi-experimental design with both intervention and control groups was carried out. Six health centres were selected in rural health districts with limited resources. In the intervention group, delivery care is free of charge at health centres while in the control district women have to pay 900 West African CFA francs (U$2). A total of 870 women who delivered at the health centre were interviewed at home after their visit over a 60-day range. A series of principal component analyses (PCA) were carried out to identify the dimension of patients' satisfaction. Women's satisfaction loaded satisfactorily on a three-dimension principal component analysis (PCA): 1-provider-patient interaction; 2-nursing care services; 3-environment. Women in both the intervention and control groups were satisfied or very satisfied in 90% of cases (in 31 of 34 items). For each dimension, average satisfaction was similar between the two groups, even after controlling for socio-demographic factors (p = 0.436, p = 0.506, p = 0.310, respectively). The effects of total fee exemption on satisfaction were similar for any women without reinforcing inequalities between very poor and wealthy women (p ≥ 0.05). Although the wealthiest women were more dissatisfied with the delivery environment (p = 0.017), the poorest were more highly satisfied with nursing care services (p = 0.009). Contrary to our expectations, total fee exemption at the point of service did not seem to have a negative impact on quality of care, and women's perceptions remained very positive. This paper shows that the policy of completely abolishing user fees with organized implementation is certainly a way for developing countries to engage in universal coverage while maintaining the quality of care.

Low Volume Exemption for New Chemical Review under TSCA

EPA Pesticide Factsheets

Certain categories of new low-volume chemical substances are exempt from full premanufacture notice (PMN) review, i.e., chemicals manufactured at 10,000 kg/year or less. LVE substances undergo a 30-day review and are not subject to a user fee.

‘Rowing against the current’: the policy process and effects of removing user fees for caesarean sections in Benin

PubMed Central

Cresswell, Jenny A; Makoutodé, Patrick; De Brouwere, Vincent; Witter, Sophie; Filippi, Veronique; Kanhonou, Lydie G; Goufodji, Sourou B; Lange, Isabelle L; Lawin, Lionel; Affo, Fabien; Marchal, Bruno

2018-01-01

Background In 2009, the Benin government introduced a user fee exemption policy for caesarean sections. We analyse this policy with regard to how the existing ideas and institutions related to user fees influenced key steps of the policy cycle and draw lessons that could inform the policy dialogue for universal health coverage in the West African region. Methods Following the policy stages model, we analyse the agenda setting, policy formulation and legitimation phase, and assess the implementation fidelity and policy results. We adopted an embedded case study design, using quantitative and qualitative data collected with 13 tools at the national level and in seven hospitals implementing the policy. Results We found that the initial political goal of the policy was not to reduce maternal mortality but to eliminate the detention in hospitals of mothers and newborns who cannot pay the user fees by exempting a comprehensive package of maternal health services. We found that the policy development process suffered from inadequate uptake of evidence and that the policy content and process were not completely in harmony with political and public health goals. The initial policy intention clashed with the neoliberal orientation of the political system, the fee recovery principles institutionalised since the Bamako Initiative and the prevailing ideas in favour of user fees. The policymakers did not take these entrenched factors into account. The resulting tension contributed to a benefit package covering only caesarean sections and to the variable implementation and effectiveness of the policy. Conclusion The influence of organisational culture in the decision-making processes in the health sector is often ignored but must be considered in the design and implementation of any policy aimed at achieving universal health coverage in West African countries. PMID:29564156

User fee exemption policies in Mali: sustainability jeopardized by the malfunctioning of the health system

PubMed Central

2015-01-01

In Mali, where rates of attendance at healthcare facilities remain far below what is needed, three user fee exemption policies were instituted to promote access to care. These related to HIV/AIDS treatment, as of 2004, caesarean sections, since 2005, and treatment of malaria in children under five and pregnant women, since 2007. Our qualitative study compared these three policies, looking at their implementation provisions, functioning and outcomes. In each healthcare facility, we analysed documentation and carried out three months of on-site observations. We also conducted a total of 254 formal and informal interviews with health personnel and patients. While these exemptions substantially improved users' access to care, their implementation revealed deep dysfunctions in the health system that undermined them all, regardless of the policy studied. These policies provoked resistance among health professionals that manifested in their practices and revealed, in particular, the profit-generation logic within which they operate today. These dysfunctions reflect the State's incapacity to exercise its regulatory role and to establish policies that are aligned with the way the health system really works. PMID:26559879

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

PubMed

Dong, Ke; Boehm, Garth; Zheng, Qiang

2017-06-01

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

Implementation of patient charges at primary care facilities in Kenya: implications of low adherence to user fee policy for users and facility revenue

PubMed Central

Opwora, Antony; Waweru, Evelyn; Toda, Mitsuru; Noor, Abdisalan; Edwards, Tansy; Fegan, Greg; Molyneux, Sassy; Goodman, Catherine

2015-01-01

With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups. We present data on user fee implementation, revenue and expenditure from a nationally representative survey of Kenyan primary health facilities. Data were collected from 248 randomly selected public health centres and dispensaries in 2010, comprising an interview with the health worker in charge, exit interviews with curative outpatients, and a financial record review. Adherence to user fee policy was assessed for eight tracer conditions based on health worker reports, and patients were asked about actual amounts paid. No facilities adhered fully to the user fee policy across all eight tracers, with adherence ranging from 62.2% for an adult with tuberculosis to 4.2% for an adult with malaria. Three quarters of exit interviewees had paid some fees, with a median payment of US dollars (USD) 0.39, and a quarter of interviewees were required to purchase additional medical supplies at a later stage from a private drug retailer. No consistent pattern of association was identified between facility characteristics and policy adherence. User fee revenues accounted for almost all facility cash income, with average revenue of USD 683 per facility per year. Fee revenue was mainly used to cover support staff, non-drug supplies and travel allowances. Adherence to user fee policy was very low, leading to concerns about the impact on access and the financial burden on households. However, the potential to ensure adherence was constrained by the facilities’ need for revenue to cover basic operating costs, highlighting the need for alternative funding strategies for peripheral health facilities. PMID:24837638

Studying complex interventions: reflections from the FEMHealth project on evaluating fee exemption policies in West Africa and Morocco.

PubMed

Marchal, Bruno; Van Belle, Sara; De Brouwere, Vincent; Witter, Sophie

2013-11-08

The importance of complexity in health care policy-making and interventions, as well as research and evaluation is now widely acknowledged, but conceptual confusion reigns and few applications of complexity concepts in research design have been published. Taking user fee exemption policies as an entry point, we explore the methodological consequences of 'complexity' for health policy research and evaluation. We first discuss the difference between simple, complicated and complex and introduce key concepts of complex adaptive systems theory. We then apply these to fee exemption policies. We describe how the FEMHealth research project attempts to address the challenges of complexity in its evaluation of fee exemption policies for maternal care. We present how the development of a programme theory for fee exemption policies was used to structure the overall design. This allowed for structured discussions on the hypotheses held by the researchers and helped to structure, integrate and monitor the sub-studies. We then show how the choice of data collection methods and tools for each sub-study was informed by the overall design. Applying key concepts from complexity theory proved useful in broadening our view on fee exemption policies and in developing the overall research design. However, we encountered a number of challenges, including maintaining adaptiveness of the design during the evaluation, and ensuring cohesion in the disciplinary diversity of the research teams. Whether the programme theory can fulfil its claimed potential to help making sense of the findings is yet to be tested. Experience from other studies allows for some moderate optimism. However, the biggest challenge complexity throws at health system researchers may be to deal with the unknown unknowns and the consequence that complex issues can only be understood in retrospect. From a complexity theory point of view, only plausible explanations can be developed, not predictive theories. Yet here, theory-driven approaches may help.

28 CFR 505.3 - Inmates exempted from fee assessment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND ADMINISTRATION COST OF INCARCERATION FEE § 505.3 Inmates exempted from fee assessment. Inmates who... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmates exempted from fee assessment. 505... Guidelines, or any successor provisions, are exempt from fee assessment otherwise required by this part. ...

22 CFR 51.52 - Exemption from payment of passport fees.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Exemption from payment of passport fees. 51.52 Section 51.52 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.52 Exemption from payment of passport fees. (a) A person who is exempt from the payment of passport fees under...

22 CFR 51.52 - Exemption from payment of passport fees.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Exemption from payment of passport fees. 51.52 Section 51.52 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.52 Exemption from payment of passport fees. (a) A person who is exempt from the payment of passport fees under...

22 CFR 51.52 - Exemption from payment of passport fees.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Exemption from payment of passport fees. 51.52 Section 51.52 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.52 Exemption from payment of passport fees. (a) A person who is exempt from the payment of passport fees under...

22 CFR 51.52 - Exemption from payment of passport fees.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Exemption from payment of passport fees. 51.52 Section 51.52 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.52 Exemption from payment of passport fees. (a) A person who is exempt from the payment of passport fees under...

22 CFR 51.52 - Exemption from payment of passport fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Exemption from payment of passport fees. 51.52 Section 51.52 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.52 Exemption from payment of passport fees. (a) A person who is exempt from the payment of passport fees under...

Implementation of patient charges at primary care facilities in Kenya: implications of low adherence to user fee policy for users and facility revenue.

PubMed

Opwora, Antony; Waweru, Evelyn; Toda, Mitsuru; Noor, Abdisalan; Edwards, Tansy; Fegan, Greg; Molyneux, Sassy; Goodman, Catherine

2015-05-01

With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups. We present data on user fee implementation, revenue and expenditure from a nationally representative survey of Kenyan primary health facilities. Data were collected from 248 randomly selected public health centres and dispensaries in 2010, comprising an interview with the health worker in charge, exit interviews with curative outpatients, and a financial record review. Adherence to user fee policy was assessed for eight tracer conditions based on health worker reports, and patients were asked about actual amounts paid. No facilities adhered fully to the user fee policy across all eight tracers, with adherence ranging from 62.2% for an adult with tuberculosis to 4.2% for an adult with malaria. Three quarters of exit interviewees had paid some fees, with a median payment of US dollars (USD) 0.39, and a quarter of interviewees were required to purchase additional medical supplies at a later stage from a private drug retailer. No consistent pattern of association was identified between facility characteristics and policy adherence. User fee revenues accounted for almost all facility cash income, with average revenue of USD 683 per facility per year. Fee revenue was mainly used to cover support staff, non-drug supplies and travel allowances. Adherence to user fee policy was very low, leading to concerns about the impact on access and the financial burden on households. However, the potential to ensure adherence was constrained by the facilities' need for revenue to cover basic operating costs, highlighting the need for alternative funding strategies for peripheral health facilities. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014.

Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

PubMed

Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M

2018-01-01

In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

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

Code of Federal Regulations, 2011 CFR

2011-01-01

... not applicable to review of classification if made on the same sample as the original class or... 7 Agriculture 2 2011-01-01 2011-01-01 false Amounts of fees for classification; exemption. 28.116... Standards Act Fees and Costs § 28.116 Amounts of fees for classification; exemption. (a) For the...

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

Code of Federal Regulations, 2010 CFR

2010-01-01

... not applicable to review of classification if made on the same sample as the original class or... 7 Agriculture 2 2010-01-01 2010-01-01 false Amounts of fees for classification; exemption. 28.116... Standards Act Fees and Costs § 28.116 Amounts of fees for classification; exemption. (a) For the...

User fees, self-selection and the poor in Bangladesh.

PubMed

Thomas, S; Killingsworth, J R; Acharya, S

1998-03-01

The widespread uncontrolled introduction of user fees in any developing country is likely to have a disastrous impact on poorer patients. Furthermore, traditional targeting schemes aimed at their exemption are often expensive, difficult to administer and ineffective at reaching those in greatest need. This research study examines how user fees can raise revenue and target poorer patients, under the right market conditions, without resorting to costly targeting schemes. The authors draw their findings from case studies of cost recovery in the health and population sectors in Bangladesh. The mechanism suggested in the paper is to use self-selection. It is argued that under certain market conditions poorer patients will choose the health-care option that is appropriate to their means. They will thus identify themselves as poor without having to be selected or tested by an independent authority. This self-selection allows the relevant authorities to cross-subsidize their market choice by over-charging the non-poor in other segments of the market.

Global health actors no longer in favor of user fees: a documentary study.

PubMed

Robert, Emilie; Ridde, Valéry

2013-07-26

Since the advent of health user fees in low- and middle-income countries in the 1980s, the discourse of global health actors (GHAs) has changed to the disadvantage of this type of healthcare financing mechanism. The aim of the study was to identify and analyze the stance of GHAs in the debate on user fees. We conducted documentary research using public documents published by and officially attributed to GHAs from 2005 to 2011. We categorized GHAs into four groups: intergovernmental organizations, international non-governmental organizations, government agencies, and working groups and networks. We then classified the GHAs according to their stance relative to the abolition of user fees, and conducted a thematic analysis of their discourse to understand the arguments used by each GHA to justify its stance. We identified 56 GHAs, for which we analyzed 140 documents. Among them, 55% were in favor of the abolition of user fees or in favor of free care at the point of delivery. None of the GHAs stated that they were in favor of user fees; however, 30% did not take a stand. Only the World Bank declares that it is both in favor of user fees and in favor of free care at point of service. GHAs generally circumscribe their stance to specific populations (pregnant women, children under 5 years, etc.) or to specific health services (primary, basic, essential). Three types of arguments are used by GHAs to justify their stance: economic, moral and ethical, and pragmatic. The principle of "user pays" seems to have fizzled. Production and dissemination of evidence, as well as certain advocacy networks, may have contributed to this change in discourse. However, GHAs should go a step further and translate their words into action, so that free healthcare at the point of delivery becomes a reality in low- and middle-income countries. They should provide technical and financial support to those countries that have chosen to implement user fee exemption policies, sometimes influenced by a GHA.

Global health actors no longer in favor of user fees: a documentary study

PubMed Central

2013-01-01

Background Since the advent of health user fees in low- and middle-income countries in the 1980s, the discourse of global health actors (GHAs) has changed to the disadvantage of this type of healthcare financing mechanism. The aim of the study was to identify and analyze the stance of GHAs in the debate on user fees. Methods We conducted documentary research using public documents published by and officially attributed to GHAs from 2005 to 2011. We categorized GHAs into four groups: intergovernmental organizations, international non-governmental organizations, government agencies, and working groups and networks. We then classified the GHAs according to their stance relative to the abolition of user fees, and conducted a thematic analysis of their discourse to understand the arguments used by each GHA to justify its stance. Results We identified 56 GHAs, for which we analyzed 140 documents. Among them, 55% were in favor of the abolition of user fees or in favor of free care at the point of delivery. None of the GHAs stated that they were in favor of user fees; however, 30% did not take a stand. Only the World Bank declares that it is both in favor of user fees and in favor of free care at point of service. GHAs generally circumscribe their stance to specific populations (pregnant women, children under 5 years, etc.) or to specific health services (primary, basic, essential). Three types of arguments are used by GHAs to justify their stance: economic, moral and ethical, and pragmatic. Conclusions The principle of “user pays” seems to have fizzled. Production and dissemination of evidence, as well as certain advocacy networks, may have contributed to this change in discourse. However, GHAs should go a step further and translate their words into action, so that free healthcare at the point of delivery becomes a reality in low- and middle-income countries. They should provide technical and financial support to those countries that have chosen to implement user fee exemption policies, sometimes influenced by a GHA. PMID:23889807

Analysis of agency relationships in the design and implementation process of the equity fund in Madagascar.

PubMed

Honda, Ayako

2015-02-04

There are large gaps in the literature relating to the implementation of user fee policy and fee exemption measures for the poor, particularly on how such schemes are implemented and why many have not produced expected outcomes. In October 2003, Madagascar instituted a user fee exemption policy which established "equity funds" at public health centres, and used medicine sales revenue to subsidise the cost of medicine for the poor. This study examines the policy design and implementation process of the equity fund in Madagascar in an attempt to explore factors influencing the poor equity outcomes of the scheme. This study applied an agency-incentive framework to investigate the equity fund policy design and implementation practices. It analysed agency relationships established during implementation; examined incentive structures given to the agency relationships in the policy design; and considered how incentive structures were shaped and how agents responded in practice. The study employed a case-study approach with in-depth analysis of three equity fund cases in Madagascar's Boeny region. Policy design problems, triggering implementation problems, caused poor equity performance. These problems were compounded by the re-direction of policy objectives by health administrators and strong involvement of the administrators in the implementation of policy. The source of the policy design and implementation failure was identified as a set of principal-agent problems concerning: monitoring mechanisms; facility-based fund management; and the nature and level of community participation. These factors all contributed to the financial performance of the fund receiving greater attention than its ability to financially protect the poor. The ability of exemption policies to protect the poor from user fees can be found in the details of the policy design and implementation; and implications of the policy design and implementation in a specific context determine whether a policy can realise its objectives. The equity fund experience in Madagascar, which illustrates the challenges of beneficiary identification, casts doubts on the application of the 'targeting' approach in health financing and raises issues to be considered in universal health policy formulation. The agency framework provides a useful lens through which to examine policy process issues.

10 CFR 170.11 - Exemptions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Exemptions. 170.11 Section 170.11 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) FEES FOR FACILITIES, MATERIALS, IMPORT AND EXPORT LICENSES, AND OTHER REGULATORY SERVICES UNDER THE ATOMIC ENERGY ACT OF 1954, AS AMENDED General Provisions § 170.11 Exemptions. (a) No application fees, license fees, renewal...

10 CFR 170.11 - Exemptions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Exemptions. 170.11 Section 170.11 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) FEES FOR FACILITIES, MATERIALS, IMPORT AND EXPORT LICENSES, AND OTHER REGULATORY SERVICES UNDER THE ATOMIC ENERGY ACT OF 1954, AS AMENDED General Provisions § 170.11 Exemptions. (a) No application fees, license fees, renewal...

10 CFR 170.11 - Exemptions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Exemptions. 170.11 Section 170.11 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) FEES FOR FACILITIES, MATERIALS, IMPORT AND EXPORT LICENSES, AND OTHER REGULATORY SERVICES UNDER THE ATOMIC ENERGY ACT OF 1954, AS AMENDED General Provisions § 170.11 Exemptions. (a) No application fees, license fees, renewal...

10 CFR 170.11 - Exemptions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Exemptions. 170.11 Section 170.11 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) FEES FOR FACILITIES, MATERIALS, IMPORT AND EXPORT LICENSES, AND OTHER REGULATORY SERVICES UNDER THE ATOMIC ENERGY ACT OF 1954, AS AMENDED General Provisions § 170.11 Exemptions. (a) No application fees, license fees, renewal...

10 CFR 170.11 - Exemptions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Exemptions. 170.11 Section 170.11 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) FEES FOR FACILITIES, MATERIALS, IMPORT AND EXPORT LICENSES, AND OTHER REGULATORY SERVICES UNDER THE ATOMIC ENERGY ACT OF 1954, AS AMENDED General Provisions § 170.11 Exemptions. (a) No application fees, license fees, renewal...

Health fee exemptions: controversies and misunderstandings around a research programme. Researchers and the public debate

PubMed Central

2015-01-01

Our research programme on fee exemption policies in Burkina Faso, Mali and Niger involved sensitive topics with strong ideological and political connotations for the decision-makers, for health-workers, and for users. Thus we were confronted with reluctance, criticism, pressures and accusations. Our frank description of the shortcomings of these policies, based on rigorous research, and never polemical or accusatory, surprises political leaders and health managers, who are accustomed to official data, censored evaluations and discourse of justification. This reflexive paper aims to react to some misunderstandings that arose regularly: "By focusing on the problems, you will discourage the aid donors". "By focusing on the problems, you are playing into the hands of the opponents of fee exemption". "You should focus on what works and not on what doesn't work". "The comments and behaviour you report are not representative". "What you say is not new, we already knew about it". Double discourse prevails in aid-dependent countries. The official discourse is mostly sterilized and far removed from reality. It protects the routine of the local bureaucracies. But the private 'speak' is quite different, and everyone knows the everyday ruses, tricks and arrangements within the health system. Anthropologists collect the private speak and transmit it to the public sphere through their analyses in order to provide a serious account of a reality, and creating the conditions for an expert debate and a public debate. The national conference on fee exemption held in Niamey in 2012 was a success in this perspective: healthcare personnel spoke for the first time in a public setting about the numerous problems associated with the fee exemption policy, and they largely confirmed and even supplemented the results of our research. It is difficult to see how the healthcare system can be improved and better quality of service provided without starting from a rigorous diagnosis of these usually concealed realities. Such diagnosis gives arguments to reformers within the health system to make change happen. PMID:26559243

User fee exemptions are not enough: out-of-pocket payments for 'free' delivery services in rural Tanzania.

PubMed

Kruk, Margaret E; Mbaruku, Godfrey; Rockers, Peter C; Galea, Sandro

2008-12-01

To identify the main drivers of costs of facility delivery and the financial consequences for households among rural women in Tanzania, a country with a policy of delivery fee exemptions. We selected a representative sample of households in a rural district in western Tanzania. Women who given birth within 5 years were asked about payments for doctor's/nurse's fees, drugs, non-medical supplies, medical tests, maternity waiting home, transport and other expenses. Wealth was assessed using a household asset index. We estimated the proportion of women who cut down on spending or borrowed money/sold household items to pay for delivery in each wealth group. In all, 73.3% of women with facility delivery reported having made out-of-pocket payments for delivery-related costs. The average cost was 6272 Tanzanian shillings (TZS), [95% Confidence Interval (CI): 4916, 7628] or 5.0 United States dollars. Transport costs (53.6%) and provider fees (26.6%) were the largest cost components in government facilities. Deliveries in mission facilities were twice as expensive as those in government facilities. Nearly half (48.3%) of women reported cutting down on spending or borrowing money/selling household assets to pay for delivery, with the poor reporting this most frequently. Out-of-pocket payments for facility delivery were substantial and were driven by high transport costs, unofficial provider payments, and preference for mission facilities, which levy user charges. Novel approaches to financing maternal health services, such as subsidies for transport and care from private providers, are required to reduce the cost barriers to attended delivery.

Use of Fees to Discourage Nonmedical Exemptions to School Immunization Laws in US States

PubMed Central

Omer, Saad B.

2016-01-01

Recent outbreaks of vaccine-preventable diseases in the United States have renewed public discourse about state vaccine mandates for children entering schools. With acknowledgment of the challenge of eliminating religious and philosophical exemptions in most states, some have proposed instead to impose additional administrative burdens for parents seeking such exemptions. We review the use of taxes, fines, and fees as financial disincentives in public health. We argue that adding processing fees to a comprehensive set of administrative requirements for obtaining exemptions will avoid the use of taxpayer funding for exemption processing and will help tilt the balance of convenience in favor of vaccination. PMID:26691132

Live to 70 Years and Older or Suffer in Silence: Understanding Health Insurance Status Among the Elderly Under the NHIS in Ghana.

PubMed

Fenny, Ama P

2017-01-01

Ghana has introduced a National Health Insurance Scheme (NHIS). Embedded in the NHIS is a policy to exempt poor and vulnerable groups from premiums and user fees. There has been some debate as to why the start-off age for exemption among the elderly is 70 years. Ghana has a shorter life expectancy than middle- and high-income countries and its current age of retirement is 60 years. This study explores the financial and social implications of continuing to charge premiums to people aged 60 to 69 years. Based on the analysis of data from a representative household survey, it is recommended that the exemption policy should be expanded to include all vulnerable elderly persons, regardless of age.

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

PubMed

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

2015-06-01

Coverage of skilled delivery care has been increasing across most low-income countries; however, it remains far from universal and is very unequally distributed according to socioeconomic position. In an effort to increase coverage of skilled delivery care and reduce socioeconomic inequalities, governments of several countries in sub-Saharan Africa have recently adopted policies that remove user fees for facility-based delivery services. There is little rigorous evidence of the impact of these policies and few studies have examined effects on socioeconomic inequalities. This study investigates the impact of recent delivery fee exemption policies in Ghana, Senegal, and Sierra Leone on socioeconomic differences in the use of facility-based delivery services. Using Demographic and Health Survey data from nine sub-Saharan African countries, we evaluated the user fee policy changes using a difference-in-differences approach that accounts for underlying common secular trends and time invariant differences among countries, and allows for differential effects of the policy by socioeconomic position. Removing user fees was consistent with meaningful increases in facility deliveries across all categories of household wealth and maternal education. We found little evidence of differential effects of removing user fees across quartiles of household wealth, with increases of 5.4 facility deliveries per hundred live births (95% CI: 2.1, 8.8) among women in the poorest quartile and 6.8 per hundred live births (95% CI: 4.0, 9.7) for women in the richest quartile. However, our results suggest that educated women benefited more from removing user fees compared to women with no education. For women with at least some secondary education, the estimated effect was 8.6 facility deliveries per hundred live births (95% CI: 5.4, 11.9), but only 4.6 per hundred live births (95% CI: 2.2, 7.0) for women with no education (heterogeneity p-value = 0.04). Thus, while removing fees at the point of service increased facility deliveries across the socioeconomic gradient, it did not reduce inequalities defined by household wealth and may have contributed to a widening of educational inequalities. These findings emphasize the need for concerted efforts to address financial and other barriers that contribute to large and persistent socioeconomic inequalities in delivery care. Copyright © 2015 Elsevier Ltd. All rights reserved.

78 FR 50359 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Uniform Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... Organization (HMO) Benefit--Prime Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and... Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed...

Using willingness to pay to investigate regressiveness of user fees in health facilities in Tanzania.

PubMed

Bonu, Sekhar; Rani, Manju; Bishai, David

2003-12-01

The study uses data from the Tanzania Human Resources Development Survey (1994) on willingness to pay (WTP) for desired quality of health care at lower-level health facilities to assess potential regressiveness of user fees - a disproportionately higher negative effect of user fees on utilization of health services among the poor compared with the rich. Despite reports of extensive bypassing of the lower-level health facilities in Tanzania, the WTP for quality health care at these health facilities is surprisingly large. WTP was lower among the poor, female and elderly respondents. Almost one-quarter of the poorest 40% of the population was not willing to pay even when the quality of services met their expectations. The results suggest that: the utilization of health services at lower-level health facilities can be increased by improving the quality of care; and the implementation of uniform user charges in the public facilities may be regressive, adversely affecting utilization among the poor, women and the elderly. An effective system of exemptions and waivers will be required for the very poor who may not be able to pay even when quality of services is improved. The findings of the study have policy implications for the Tanzanian government's recent attempts to expand cost-sharing through community health funds at lower-level health facilities, being introduced since 1998.

47 CFR 1.1162 - General exemptions from regulatory fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Commission authorization in any other mass media radio service (except the international broadcast (HF... 47 Telecommunication 1 2010-10-01 2010-10-01 false General exemptions from regulatory fees. 1.1162 Section 1.1162 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule...

42 CFR 493.646 - Payment of fees.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS General Administration § 493.646 Payment of fees. (a) Except for CLIA-exempt laboratories, all laboratories are notified in writing by HHS or its designee of... been paid. (b) For State-exempt laboratories, HHS estimates the cost of conducting validation surveys...

76 FR 62100 - Approval of Filing Fees for Exempt Reporting Advisers and Private Fund Advisers

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... fund assets, combined liquidity fund and registered money market fund assets or private equity fund... Fees for Exempt Reporting Advisers and Private Fund Advisers AGENCY: Securities and Exchange Commission... fund advisers filing Form PF. SUMMARY: The Securities and Exchange Commission (``Commission'') is...

78 FR 30371 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

... states that the Marketing Fee will not apply to transactions resulting from any of the strategies... strategy transaction identified/defined in Footnote 13 to gain exemption from being assessed the Marketing... the caps described in Footnote 13 or exempt the transaction from the Marketing Fee pursuant to...

76 FR 67004 - Order Approving Filing Fees for Exempt Reporting Advisers and Private Fund Advisers

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-28

... billion or more in hedge fund assets, combined liquidity fund and registered money market fund assets or...] Order Approving Filing Fees for Exempt Reporting Advisers and Private Fund Advisers Section 204(c) of... funds (a ``private fund adviser'') to file proposed Form PF on a periodic basis.\\2\\ On September 30...

75 FR 67421 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Order Approving...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

... change to amend its By-Laws to remove the exemption from the trading activity fee (``TAF'') for... the exemption from the TAF for transactions in exchange listed options effected by a member for whom FINRA is not the DOEA. The TAF is one of three member regulatory fees FINRA uses to fund its member...

75 FR 28315 - CSX Transportation, Inc.-Abandonment Exemption-in Vigo County, IN

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-20

... later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,500 filing fee. See 49 CFR 1002.2(f)(25). All interested persons should be aware that... be accompanied by a $250 filing fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice...

78 FR 52235 - Wisconsin Central Ltd.-Abandonment Exemption-in Winnebago County, Wis.

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

...) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,600 filing fee. See 49 CFR 1002.2(f)(25). All interested persons..., 2013. Each trail use request must be accompanied by a $250 filing fee. See 49 CFR 1002.2(f)(27). All...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

...] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS... development of a generic drug user fee program. A user fee program could provide necessary supplemental... generic drug user fees. New legislation would be required for FDA to establish and collect user fees for...

9 CFR 130.10 - User fees for pet birds.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

9 CFR 130.10 - User fees for pet birds.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

9 CFR 130.10 - User fees for pet birds.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

9 CFR 130.10 - User fees for pet birds.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

9 CFR 130.10 - User fees for pet birds.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

76 FR 35946 - BNSF Railway Company-Abandonment Exemption-in Los Angeles County, CA.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

.... Any OFA under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,500 filing fee. See 49 CFR 1002.2... fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer to Docket No. AB 6...

78 FR 59424 - Wisconsin Central Ltd.-Abandonment Exemption-in Brown County, WI

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

... assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,600 filing fee. See 49 CFR 1002.2... $250 filing fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer to Docket...

77 FR 21153 - Georgia Department of Transportation-Abandonment Exemption-in Fulton County, GA

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-09

... assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,500 filing fee. See 49 CFR 1002.2... accompanied by a $250 filing fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer...

78 FR 66988 - Minnesota Northern Railroad, Inc.-Abandonment Exemption-in Polk County, Minn.

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,600 filing fee. See 49 CFR 1002.2... filing fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer to Docket No. AB...

22 CFR 51.53 - Refunds.

Code of Federal Regulations, 2013 CFR

2013-04-01

... DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.53 Refunds. (a) The Department will refund the passport application fee and the security surcharge to any person exempt from payment of passport... expedited passport processing fee if the Department fails to provide expedited passport processing as...

22 CFR 51.53 - Refunds.

Code of Federal Regulations, 2012 CFR

2012-04-01

... DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.53 Refunds. (a) The Department will refund the passport application fee and the security surcharge to any person exempt from payment of passport... expedited passport processing fee if the Department fails to provide expedited passport processing as...

22 CFR 51.53 - Refunds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.53 Refunds. (a) The Department will refund the passport application fee and the security surcharge to any person exempt from payment of passport... expedited passport processing fee if the Department fails to provide expedited passport processing as...

22 CFR 51.53 - Refunds.

Code of Federal Regulations, 2014 CFR

2014-04-01

... DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.53 Refunds. (a) The Department will refund the passport application fee and the security surcharge to any person exempt from payment of passport... expedited passport processing fee if the Department fails to provide expedited passport processing as...

22 CFR 51.53 - Refunds.

Code of Federal Regulations, 2011 CFR

2011-04-01

... DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Fees § 51.53 Refunds. (a) The Department will refund the passport application fee and the security surcharge to any person exempt from payment of passport... expedited passport processing fee if the Department fails to provide expedited passport processing as...

29 CFR 541.605 - Fee basis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... DELIMITING THE EXEMPTIONS FOR EXECUTIVE, ADMINISTRATIVE, PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES Salary Requirements § 541.605 Fee basis. (a) Administrative and professional employees may be paid on a...

75 FR 80894 - Delta Southern Railroad, Inc.-Abandonment Exemption-in Desha and Chicot Counties, Ark.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,500 filing fee. See 49 CFR 1002.2(f)(25). All... January 12, 2011. Each trail use request must be accompanied by a $250 filing fee. See 49 CFR 1002.2(f)(27...

77 FR 77183 - Union Pacific Railroad Company-Abandonment of Freight Easement Exemption-in Alameda County, Cal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,600 filing fee. See 49 CFR 1002.2(f)(25). All... January 22, 2013. Each trail use request must be accompanied by a $250 filing fee. See 49 CFR 1002.2(f)(27...

9 CFR 130.17 - User fees for other veterinary diagnostic laboratory tests performed at NVSL (excluding FADDL) or...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for other veterinary... FEES USER FEES § 130.17 User fees for other veterinary diagnostic laboratory tests performed at NVSL (excluding FADDL) or at authorized sites. (a) User fees for veterinary diagnostics tests performed at the...

9 CFR 130.17 - User fees for other veterinary diagnostic laboratory tests performed at NVSL (excluding FADDL) or...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for other veterinary... FEES USER FEES § 130.17 User fees for other veterinary diagnostic laboratory tests performed at NVSL (excluding FADDL) or at authorized sites. (a) User fees for veterinary diagnostics tests performed at the...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

...] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS... development of a generic drug user fee program. A user fee program could provide necessary supplemental... announcing its intention to hold a public meeting related to generic drug user fees. The Agency continues to...

22 CFR 122.3 - Registration fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... registration. (4) For registrants, including universities, exempt from income taxation pursuant to 26 U.S.C... eligible, the registrant and all of its subsidiaries/affiliates must be exempt from income taxation...

25 CFR 514.1 - Annual fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Commission. (4) If a tribe has a certificate of self-regulation, the rate of fees imposed shall be no more than .25 percent of assessable gross revenues from self-regulated class II gaming operations. (b) For... jurisdiction of the Commission and not exempt from paying fees pursuant to the self-regulation provisions shall...

40 CFR 180.33 - Fees.

Code of Federal Regulations, 2014 CFR

2014-07-01

... EXEMPTIONS FOR PESTICIDE CHEMICAL RESIDUES IN FOOD Procedural Regulations § 180.33 Fees. (a) Each petition... tolerance already established for the same pesticide chemical, or for the establishment of a tolerance on... the same pesticide chemical, shall be accompanied by a fee of $18,500 plus $1,225 for each raw...

9 CFR 130.15 - User fees for veterinary diagnostic isolation and identification tests performed at NVSL...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for veterinary diagnostic isolation and identification tests performed at NVSL (excluding FADDL) or other authorized site. 130.15... AGRICULTURE USER FEES USER FEES § 130.15 User fees for veterinary diagnostic isolation and identification...

9 CFR 130.15 - User fees for veterinary diagnostic isolation and identification tests performed at NVSL...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for veterinary diagnostic isolation and identification tests performed at NVSL (excluding FADDL) or other authorized site. 130.15... AGRICULTURE USER FEES USER FEES § 130.15 User fees for veterinary diagnostic isolation and identification...

9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for FADDL veterinary..., DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.14 User fees for FADDL veterinary diagnostics. (a... 167.00 Rabbit antiserum, any agent 1 mL 179.00 185.00 190.00 196.00 (b) Veterinary diagnostics tests...

9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

40 CFR 700.41 - Radon user fees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Radon user fees. 700.41 Section 700.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.41 Radon user fees. User fees relating to radon proficiency programs authorized under the...

40 CFR 700.41 - Radon user fees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Radon user fees. 700.41 Section 700.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.41 Radon user fees. User fees relating to radon proficiency programs authorized under the...

Two decades of maternity care fee exemption policies in Ghana: have they benefited the poor?

PubMed

Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Padmadas, Sabu S

2016-02-01

To investigate, the impact of maternity-related fee payment policies on the uptake of skilled birth care amongst the poor in Ghana. Population data representing 12 288 births between November 1990 and October 2008 from four consecutive rounds of the Ghana demographic and health surveys were used to examine the impact of four major maternity-related payment policies: the full-cost recovery 'cash and carry' scheme; 'antenatal care fee exemption'; 'delivery care fee exemption' and the 'National Health Insurance Scheme (NHIS)'. Concentration curves were used to analyse the rich-poor gap in the use of skilled birth care by the four policy interventions. Multilevel logistic regression was used to examine the effect of the policies on the uptake of skilled birth care, adjusting for relevant predictors and clustering within communities and districts. The uptake of skilled birth care over the policy periods for the poorest women was trivial when compared with their non-poor counterparts. The rich-poor gap in skilled birth care use was highly pronounced during the 'cash and carry' and 'free antenatal care' policies period. The benefits during the 'free delivery care' and ' NHIS' policy periods accrued more for the rich than the poor. There exist significant differences in skilled birth care use between and within communities and districts, even after adjusting for policy effects and other relevant predictors. The maternal care fee exemption policies specifically targeted towards the poorest women had limited impact on the uptake of skilled birth care. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Hospital charge exemptions for the poor in Shandong, China.

PubMed

Meng, Qingyue; Sun, Qiang; Hearst, Norman

2002-12-01

Rapid economic changes in China have produced soaring hospital charges, a breakdown of the old social health insurance system, a resulting crisis in hospital affordability and renewed interest in mechanisms for discounts or exemptions from hospital charges for the poor. Little is known, however, about how effective such systems are in practice. We studied nine public hospitals in Shandong Province that offer discount or exemption mechanisms for the poor. Methods included document review, key informant interviews, detailed review of financial records and focus group discussions. These hospitals receive little government subsidy and must support themselves almost entirely through user fees. Hospital managers saw discount mechanisms primarily as marketing tools and designed them to limit their cost. Only a small fraction of hospital services were eligible for discount, and these were usually low cost or low utilization items. Discounts were generally 10-50% for selected items with very few services exempted from charge. The total value of discounts granted was 1% or less of total hospital operating budgets. Correct identification of indigents was a major difficulty for hospitals. Only a minority of indigents received discounts, the process was sometimes arbitrary and some who received discounts were not really poor. Government policies requiring discounts for the poor were vague and not enforced. The exemption programmes studied do not provide effective protection from hospital charges for the poor. To be effective, exemption mechanisms would likely require both financing and regulation by the government as well as an accurate way to identify the poor.

76 FR 31823 - Technical Amendment to List of User Fee Airports: Addition of Dallas Love Field Municipal Airport...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

...] Technical Amendment to List of User Fee Airports: Addition of Dallas Love Field Municipal Airport, Dallas... fee airport designation for Dallas Love Field Municipal Airport, in Dallas, Texas. User fee airports... Love Field Municipal Airport. This document updates the list of user fee airports by adding Dallas Love...

21 CFR 1301.24 - Exemption of law enforcement officials.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Exemption of law enforcement officials. 1301.24 Section 1301.24 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE REGISTRATION OF MANUFACTURERS, DISTRIBUTORS, AND DISPENSERS OF CONTROLLED SUBSTANCES Exceptions to Registration and Fees § 1301.24 Exemption of law enforcement...

The human resource implications of improving financial risk protection for mothers and newborns in Zimbabwe

PubMed Central

2013-01-01

Background A paradigm shift in global health policy on user fees has been evident in the last decade with a growing consensus that user fees undermine equitable access to essential health care in many low and middle income countries. Changes to fees have major implications for human resources for health (HRH), though the linkages are rarely explicitly examined. This study aimed to examine the inter-linkages in Zimbabwe in order to generate lessons for HRH and fee policies, with particular respect to reproductive, maternal and newborn health (RMNH). Methods The study used secondary data and small-scale qualitative fieldwork (key informant interview and focus group discussions) at national level and in one district in 2011. Results The past decades have seen a shift in the burden of payments onto households. Implementation of the complex rules on exemptions is patchy and confused. RMNH services are seen as hard for families to afford, even in the absence of complications. Human resources are constrained in managing current demand and any growth in demand by high external and internal migration, and low remuneration, amongst other factors. We find that nurses and midwives are evenly distributed across the country (at least in the public sector), though doctors are not. This means that for four provinces, there are not enough doctors to provide more complex care, and only three provinces could provide cover in the event of all deliveries taking place in facilities. Conclusions This analysis suggests that there is a strong case for reducing the financial burden on clients of RMNH services and also a pressing need to improve the terms and conditions of key health staff. Numbers need to grow, and distribution is also a challenge, suggesting the need for differentiated policies in relation to rural areas, especially for doctors and specialists. The management of user fees should also be reviewed, particularly for non-Ministry facilities, which do not retain their revenues, and receive limited investment in return from the municipalities and district councils. Overall public investment in health needs to grow. PMID:23714143

The human resource implications of improving financial risk protection for mothers and newborns in Zimbabwe.

PubMed

Chirwa, Yotamu; Witter, Sophie; Munjoma, Malvern; Mashange, Wilson; Ensor, Tim; McPake, Barbara; Munyati, Shungu

2013-05-28

A paradigm shift in global health policy on user fees has been evident in the last decade with a growing consensus that user fees undermine equitable access to essential health care in many low and middle income countries. Changes to fees have major implications for human resources for health (HRH), though the linkages are rarely explicitly examined. This study aimed to examine the inter-linkages in Zimbabwe in order to generate lessons for HRH and fee policies, with particular respect to reproductive, maternal and newborn health (RMNH). The study used secondary data and small-scale qualitative fieldwork (key informant interview and focus group discussions) at national level and in one district in 2011. The past decades have seen a shift in the burden of payments onto households. Implementation of the complex rules on exemptions is patchy and confused. RMNH services are seen as hard for families to afford, even in the absence of complications. Human resources are constrained in managing current demand and any growth in demand by high external and internal migration, and low remuneration, amongst other factors. We find that nurses and midwives are evenly distributed across the country (at least in the public sector), though doctors are not. This means that for four provinces, there are not enough doctors to provide more complex care, and only three provinces could provide cover in the event of all deliveries taking place in facilities. This analysis suggests that there is a strong case for reducing the financial burden on clients of RMNH services and also a pressing need to improve the terms and conditions of key health staff. Numbers need to grow, and distribution is also a challenge, suggesting the need for differentiated policies in relation to rural areas, especially for doctors and specialists. The management of user fees should also be reviewed, particularly for non-Ministry facilities, which do not retain their revenues, and receive limited investment in return from the municipalities and district councils. Overall public investment in health needs to grow.

Measuring users' response to higher recreation fees

Treesearch

Stephen D. Reiling; Hsiang Tai Cheng; Cheryl Trott

1992-01-01

One of the arguments against higher fees at publicly-provided recreational facilities is that higher fees may force low-income users to reduce their use of facilities more than high-income users, or force them to stop using the facilities altogether if they cannot afford the higher fee. Measuring the impact of higher fees on current users with different income levels...

User fees for public health care services in Hungary: expectations, experience, and acceptability from the perspectives of different stakeholders.

PubMed

Baji, Petra; Pavlova, Milena; Gulácsi, László; Groot, Wim

2011-10-01

The introduction of user fees for health care services is a new phenomenon in Central-Eastern European Countries. In Hungary, user fees were first introduced in 2007, but abolished one year later after a referendum. The aim of our study is to describe the experiences and expectations of health system stakeholders in Hungary related to user fees as well as their approval of such fees. For our analysis we use both qualitative and quantitative data from focus-group discussions with health care consumers and physicians, and in-depth interviews with policy makers and health insurance representatives. Our findings suggest that the reasons behind the unpopularity of user fees might be (a) the rejection of the objectives of user fees defined by the government, (b) negative personal experiences with user fees, and (c) the general mistrust of the Hungarian population when it comes to the utilization of public resources. Successful policy implementation of user fees requires social consensus on the policy objectives, also there should be real improvements in health care provision noticeable for consumers, to assure the fees acceptance. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

75 FR 58004 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

... By-Laws to remove the exemption from the trading activity fee (``TAF'') for transactions in exchange... TAF is one of three member regulatory fees FINRA uses to fund its member regulation activities, which... activities.\\3\\ FINRA initially adopted the TAF in 2002 as a replacement for an earlier regulatory fee based...

A practical tool for modeling biospecimen user fees.

PubMed

Matzke, Lise; Dee, Simon; Bartlett, John; Damaraju, Sambasivarao; Graham, Kathryn; Johnston, Randal; Mes-Masson, Anne-Marie; Murphy, Leigh; Shepherd, Lois; Schacter, Brent; Watson, Peter H

2014-08-01

The question of how best to attribute the unit costs of the annotated biospecimen product that is provided to a research user is a common issue for many biobanks. Some of the factors influencing user fees are capital and operating costs, internal and external demand and market competition, and moral standards that dictate that fees must have an ethical basis. It is therefore important to establish a transparent and accurate costing tool that can be utilized by biobanks and aid them in establishing biospecimen user fees. To address this issue, we built a biospecimen user fee calculator tool, accessible online at www.biobanking.org . The tool was built to allow input of: i) annual operating and capital costs; ii) costs categorized by the major core biobanking operations; iii) specimen products requested by a biobank user; and iv) services provided by the biobank beyond core operations (e.g., histology, tissue micro-array); as well as v) several user defined variables to allow the calculator to be adapted to different biobank operational designs. To establish default values for variables within the calculator, we first surveyed the members of the Canadian Tumour Repository Network (CTRNet) management committee. We then enrolled four different participants from CTRNet biobanks to test the hypothesis that the calculator tool could change approaches to user fees. Participants were first asked to estimate user fee pricing for three hypothetical user scenarios based on their biobanking experience (estimated pricing) and then to calculate fees for the same scenarios using the calculator tool (calculated pricing). Results demonstrated significant variation in estimated pricing that was reduced by calculated pricing, and that higher user fees are consistently derived when using the calculator. We conclude that adoption of this online calculator for user fee determination is an important first step towards harmonization and realistic user fees.

78 FR 53702 - User Fees for Processing Installment Agreements and Offers in Compromise

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... User Fees for Processing Installment Agreements and Offers in Compromise AGENCY: Internal Revenue... document contains proposed amendments to the regulations that provide user fees for installment agreements... agencies to prescribe regulations that establish charges for services provided by the agencies (user fees...

The impact of user fees on health services utilization and infectious disease diagnoses in Neno District, Malawi: a longitudinal, quasi-experimental study.

PubMed

Watson, S I; Wroe, E B; Dunbar, E L; Mukherjee, J; Squire, S B; Nazimera, L; Dullie, L; Lilford, R J

2016-10-20

User fees have generally fallen out of favor across Africa, and they have been associated with reductions in access to healthcare. We examined the effects of the introduction and removal of user fees on outpatient attendances and new diagnoses of HIV, malaria, and tuberculosis in Neno District, Malawi where user fees were re-instated at three of 13 health centres in 2013 and subsequently removed at one of these in 2015. We conducted two analyses. Firstly, an unadjusted comparison of outpatient visits and new diagnoses over three periods between July 2012 and October 2015: during the period with no user fees, at the re-introduction of user fees at four centres, and after the removal of user fees at one centre. Secondly, we estimated a linear model of the effect of user fees on the outcome of interest that controlled for unobserved health centre effects, monthly effects, and a linear time trend. The introduction of user fees was associated with a change in total attendances of -68 % [95 % CI: -89 %, -12 %], similar reductions were observed for new malaria and HIV diagnoses. The removal of user fees was associated with an increase in total attendances of 352 % [213 %, 554 %] with similar increases for malaria diagnoses. The results were not sensitive to control group or model specification. User fees for outpatient healthcare services present a barrier to patients accessing healthcare and reduce detection of serious infectious diseases.

75 FR 75170 - APHIS User Fee Web Site

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-02

...] APHIS User Fee Web Site AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Notice... recover the costs of providing certain services. This notice announces the availability of a Web site that contains information about the Agency's user fees. ADDRESSES: The Agency's user fee Web site is located at...

77 FR 35992 - Agency Information Collection Activities: User Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... Activities: User Fees AGENCY: U.S. Customs and Border Protection (CBP), Department of Homeland Security... User Fees. This request for comment is being made pursuant to the Paperwork Reduction Act of 1995 (Pub... soliciting comments concerning the following information collection: Title: User Fees. OMB Number: 1651-0052...

75 FR 63845 - Medical Device User Fees; Public Meeting; Extension of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-18

...] Medical Device User Fees; Public Meeting; Extension of Comment Period AGENCY: Food and Drug Administration... stakeholders on the Agency's medical user fee program and requested suggestions regarding the commitments FDA... interested stakeholders to discuss the Agency's medical user fee program and requested suggestions regarding...

75 FR 24970 - FBI Records Management Division National Name Check Program Section User Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-06

... Division National Name Check Program Section User Fees AGENCY: Federal Bureau of Investigation (FBI), Justice. ACTION: Notice. SUMMARY: This notice establishes the user fee schedule for federal agencies... user fees for federal agencies requesting noncriminal name-based background checks of the Central...

78 FR 19714 - User Fees and Refunds for Premarket Approval Applications and Device Biologics License...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

...] User Fees and Refunds for Premarket Approval Applications and Device Biologics License Applications... availability of the guidance entitled ``User Fees and Refunds for Premarket Approval Applications (PMAs) and... for single copies of the guidance document entitled ``User Fees and Refunds for Premarket Approval...

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

PubMed

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

2012-11-01

About 20 years after initial calls for the introduction of user fees in health systems in sub-Saharan Africa, a growing coalition is advocating for their removal. Several African countries have abolished user fees for health care for some or all of their citizens. However, fee-for-service health care delivery remains a primary health care funding model in many countries in sub-Saharan Africa. Although the impact of user fees on utilization of health services and household finances has been studied extensively, further research is needed to characterize the multi-faceted health and social problems associated with charging user fees. This ethnographic study aims to identify consequences of user fees on gender inequality, food insecurity, and household decision-making for a group of women living in poverty. Ethnographic life history interviews were conducted with 24 women in Yirimadjo, Mali in 2007. Purposive sampling selected participants across a broad socio-economic spectrum. Semi-structured interviews addressed participants' past medical history, socio-economic status, social and family history, and access to health care. Interview transcripts were coded using the guiding analytical framework of structural violence. Interviews revealed that user fees for health care not only decreased utilization of health services, but also resulted in delayed presentation for care, incomplete or inadequate care, compromised food security and household financial security, and reduced agency for women in health care decision making. The effects of user fees were amplified by conditions of poverty, as well as gender and health inequality; user fees in turn reinforced the inequalities created by those very conditions. The qualitative data reveal multi-faceted health and socioeconomic effects of user fees, and illustrate that user fees for health care may impact quality of care, health outcomes, food insecurity, and gender inequality, in addition to impacting health care utilization and household finances. As many countries consider user fee abolition policies, these findings indicate the need to create a broader evaluation framework-one that can measure the health and socioeconomic impacts of user fee polices and of their removal. Copyright © 2012 Elsevier Ltd. All rights reserved.

78 FR 28926 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... Establishing Non- Display Usage Fees and Amending the Professional End-User Fees for NYSE Amex Options Market... proposes to establish non-display usage fees and to amend the Professional End-User fees for NYSE Amex... The Exchange proposes to establish non-display usage fees and to amend the Professional End-User fees...

77 FR 74201 - Customs Brokers User Fee Payment for 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-13

... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Customs Brokers User Fee... of the 2013 Customs Broker User Fee is due February 15, 2013. FOR FURTHER INFORMATION CONTACT: Craig... establish that effective April 1, 2007, an annual user fee of $138 is to be assessed for each customs broker...

77 FR 51818 - Agency Information Collection Activities; User Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... Activities; User Fees AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: 30... review and approval in accordance with the Paperwork Reduction Act: User Fees. This is a proposed...: User Fees. OMB Number: 1651-0052. Form Number: CBP Forms 339A, 339C and 339V. Abstract: The...

76 FR 65741 - Customs Brokers User Fee Payment for 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-24

... DEPARTMENT OF HOMELAND SECURITY Customs and Border Protection Customs Brokers User Fee Payment for... 2012 in accordance with the Tax Reform Act of 1986. DATES: Payment of the 2012 Customs Broker User Fee..., an annual user fee of $138 is to be assessed for each customs broker permit and national permit held...

76 FR 1626 - Customs Brokers User Fee Payment for 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-11

... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Customs Brokers User Fee... in accordance with the Tax Reform Act of 1986. DATES: Payment of the 2011 Customs Broker User Fee is... annual user fee of $138 is to be assessed for each customs broker permit and national permit held by an...

19 CFR 122.15 - User fee airports.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false User fee airports. 122.15 Section 122.15 Customs... AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at a user fee airport are the same procedures as those set forth...

19 CFR 122.15 - User fee airports.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false User fee airports. 122.15 Section 122.15 Customs... AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at a user fee airport are the same procedures as those set forth...

19 CFR 122.15 - User fee airports.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false User fee airports. 122.15 Section 122.15 Customs... AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at a user fee airport are the same procedures as those set forth...

76 FR 13629 - Revised Draft Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-14

...] Revised Draft Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and Biological... entitled ``User Fee Waivers, Reductions, and Refunds for Drug and Biological Products.'' This revised draft... industry entitled ``User Fee Waivers, Reductions, and Refunds for Drug and Biological Products.'' This...

8 CFR 240.63 - Application process.

Code of Federal Regulations, 2011 CFR

2011-01-01

... fingerprint fees as provided in § 103.7(b)(1) of this chapter, or a request for fee waiver, as provided in § 103.7(c) of this chapter. The fact that an applicant has also applied for asylum does not exempt the...

8 CFR 240.63 - Application process.

Code of Federal Regulations, 2010 CFR

2010-01-01

... fingerprint fees as provided in § 103.7(b)(1) of this chapter, or a request for fee waiver, as provided in § 103.7(c) of this chapter. The fact that an applicant has also applied for asylum does not exempt the...

Empowerment and Accountability in Implementing a "No-Fee School" Policy: A Challenge for School Governing Bodies

ERIC Educational Resources Information Center

Marishane, R. N.

2013-01-01

Empowerment, accountability and redress are prime objectives of school funding in the new South Africa. This is facilitated through the National Norms and Standards for School Funding. The application of the norms has led to the development of a "no-fee school" policy aimed at exempting poor parents from payment of school fees. The…

Biospecimen User Fees: Global Feedback on a Calculator Tool.

PubMed

Matzke, Lise A M; Babinszky, Sindy; Slotty, Alex; Meredith, Anna; Castillo-Pelayo, Tania; Henderson, Marianne K; Simeon-Dubach, Daniel; Schacter, Brent; Watson, Peter H

2017-02-01

The notion of attributing user fees to researchers for biospecimens provided by biobanks has been discussed frequently in the literature. However, the considerations around how to attribute the cost for these biospecimens and data have, until recently, not been well described. Common across most biobank disciplines are similar factors that influence user fees such as capital and operating costs, internal and external demand, and market competition. A biospecimen user fee calculator tool developed by CTRNet, a tumor biobank network, was published in 2014 and is accessible online at www.biobanking.org . The next year a survey was launched that tested the applicability of this user fee tool among a global health research biobank user base, including both cancer and noncancer biobanking. Participants were first asked to estimate user fee pricing for three hypothetical user scenarios based on their biobanking experience (estimated pricing) and then to calculate fees for the same scenarios using the calculator tool (calculated pricing). Results demonstrated variation in estimated pricing that was reduced by calculated pricing. These results are similar to those found in a similar previous study restricted to a group of Canadian tumor biobanks. We conclude that the use of a biospecimen user fee calculator contributes to reduced variation of user fees and for biobank groups (e.g., biobank networks), could become an important part of a harmonization strategy.

Biospecimen User Fees: Global Feedback on a Calculator Tool

PubMed Central

Babinszky, Sindy; Slotty, Alex; Meredith, Anna; Castillo-Pelayo, Tania; Henderson, Marianne K.; Simeon-Dubach, Daniel; Schacter, Brent; Watson, Peter H.

2017-01-01

The notion of attributing user fees to researchers for biospecimens provided by biobanks has been discussed frequently in the literature. However, the considerations around how to attribute the cost for these biospecimens and data have, until recently, not been well described. Common across most biobank disciplines are similar factors that influence user fees such as capital and operating costs, internal and external demand, and market competition. A biospecimen user fee calculator tool developed by CTRNet, a tumor biobank network, was published in 2014 and is accessible online at www.biobanking.org. The next year a survey was launched that tested the applicability of this user fee tool among a global health research biobank user base, including both cancer and noncancer biobanking. Participants were first asked to estimate user fee pricing for three hypothetical user scenarios based on their biobanking experience (estimated pricing) and then to calculate fees for the same scenarios using the calculator tool (calculated pricing). Results demonstrated variation in estimated pricing that was reduced by calculated pricing. These results are similar to those found in a similar previous study restricted to a group of Canadian tumor biobanks. We conclude that the use of a biospecimen user fee calculator contributes to reduced variation of user fees and for biobank groups (e.g., biobank networks), could become an important part of a harmonization strategy. PMID:27576065

78 FR 46970 - Medical Device User Fee Rates for Fiscal Year 2014

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

...] Medical Device User Fee Rates for Fiscal Year 2014 AGENCY: Food and Drug Administration, HHS. ACTION... procedures for medical device user fees for fiscal year (FY) 2014. The Federal Food, Drug, and Cosmetic Act.... The FY 2014 fee rates are provided in this document. These fees apply from October 1, 2013, through...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

...] Medical Device User Fee Rates for Fiscal Year 2011 AGENCY: Food and Drug Administration, HHS. ACTION... payment procedures for medical device user fees for fiscal year (FY) 2011. The Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device User Fee Amendments of 2007 (title II of the Food...

76 FR 33307 - Generic Drug User Fee; Notice of Public Meeting; Extension of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

...] Generic Drug User Fee; Notice of Public Meeting; Extension of Comment Period AGENCY: Food and Drug... on the development of a generic drug user fee program. The Agency is taking this action to allow..., 75 FR 47820, FDA published a notice soliciting comment on development of a generic drug user fee...

78 FR 53152 - Prescription Drug User Fee Rates for Fiscal Year 2014; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

...] Prescription Drug User Fee Rates for Fiscal Year 2014; Correction AGENCY: Food and Drug Administration, HHS... ``Prescription Drug User Fee Rates for Fiscal Year 2014'' that appeared in the Federal Register of August 2, 2013 (78 FR 46980). The document announced the Fiscal Year 2014 fee rates for the Prescription Drug User...

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

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for other veterinary... User fees for other veterinary diagnostic services or materials provided at NVSL (excluding FADDL). (a) User fees for other veterinary diagnostic services or materials available from NVSL (excluding FADDL...

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

Code of Federal Regulations, 2010 CFR

2010-01-01

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

29 CFR 1603.212 - Witness fees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 4 2011-07-01 2011-07-01 false Witness fees. 1603.212 Section 1603.212 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR PREVIOUSLY EXEMPT STATE AND LOCAL GOVERNMENT EMPLOYEE COMPLAINTS OF EMPLOYMENT DISCRIMINATION UNDER SECTION 304 OF THE...

29 CFR 1603.212 - Witness fees.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 4 2013-07-01 2013-07-01 false Witness fees. 1603.212 Section 1603.212 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR PREVIOUSLY EXEMPT STATE AND LOCAL GOVERNMENT EMPLOYEE COMPLAINTS OF EMPLOYMENT DISCRIMINATION UNDER SECTION 304 OF THE...

29 CFR 1603.212 - Witness fees.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 4 2014-07-01 2014-07-01 false Witness fees. 1603.212 Section 1603.212 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR PREVIOUSLY EXEMPT STATE AND LOCAL GOVERNMENT EMPLOYEE COMPLAINTS OF EMPLOYMENT DISCRIMINATION UNDER SECTION 304 OF THE...

29 CFR 1603.212 - Witness fees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Witness fees. 1603.212 Section 1603.212 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR PREVIOUSLY EXEMPT STATE AND LOCAL GOVERNMENT EMPLOYEE COMPLAINTS OF EMPLOYMENT DISCRIMINATION UNDER SECTION 304 OF THE...

29 CFR 1603.212 - Witness fees.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 4 2012-07-01 2012-07-01 false Witness fees. 1603.212 Section 1603.212 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR PREVIOUSLY EXEMPT STATE AND LOCAL GOVERNMENT EMPLOYEE COMPLAINTS OF EMPLOYMENT DISCRIMINATION UNDER SECTION 304 OF THE...

9 CFR 130.16 - User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at authorized sites. 130.16 Section 130.16 Animals... USER FEES § 130.16 User fees for veterinary diagnostic serology tests performed at NVSL (excluding...

9 CFR 130.16 - User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at authorized sites. 130.16 Section 130.16 Animals... USER FEES § 130.16 User fees for veterinary diagnostic serology tests performed at NVSL (excluding...

Perceptions and Implications of No-Fee School Policy: School-Based Management Perspectives

ERIC Educational Resources Information Center

Naong, M. N.

2013-01-01

The inception of no-fee schools and a school-fee exemption policy has become a contentious issue but also an exciting one for school managers in South Africa. Managers opposed to the policy have cited amongst others things, academic standards dropping, as well as parents who can afford to pay jumping on the bandwagon and refusing to pay. While the…

Professionally exempt nurses & the fee basis of payment.

PubMed

Bernard, Lucian J

2003-09-01

Within the home health industry, per-visit pay has long been used by agencies to compensate nurses. This "fee-based" system of compensation has been subject to scrutiny by the Department of Labor (DOL), which claims that this is not an appropriate method to compensate professional nurses who would qualify as "exempt" employees under the Fair Labor Standards Act. Recent court decisions have disagreed with the DOL's position on the issue, but home health agencies need to be careful about employee compensation statutes at both the federal and state level so as not to open themselves up to potentially devastating penalties.

49 CFR 1002.3 - Updating user fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... updating fees. Each fee shall be updated by updating the cost components comprising the fee. Cost... direct labor costs are direct labor costs determined by the cost study set forth in Revision of Fees For... by total office costs for the Offices directly associated with user fee activity. Actual updating of...

Out-of-pocket costs for paediatric admissions in district hospitals in Kenya

PubMed Central

Barasa, Edwine W; Ayieko, Philip; Cleary, Susan; English, Mike

2012-01-01

Objective To describe out-of-pocket costs of inpatient care for children under 5 years of age in district hospitals in Kenya. Methods A total of 256 caretakers of admitted children were interviewed in 2-week surveys conducted in eight hospitals in four provinces in Kenya. Caretakers were asked to report care seeking behaviour and expenditure related to accessing inpatient care. Family socio-economic status was assessed through reported expenditure in the previous month. Results Seventy eight percent of caretakers were required to pay user charges to access inpatient care for children. User charges (mean, US$ 8.1; 95% CI, 6.4–9.7) were 59% of total out-of-pocket costs, while transport costs (mean, US$ 4.9; 95% CI, 3.9–6.0) and medicine costs (mean, US$ 0.7; 95% CI, 0.5–1.0) were 36% and 5%, respectively. The mean total out-of-pocket cost per paediatric admission was US$ 14.1 (95% CI, 11.9–16.2). Out-of-pocket expenditures on health were catastrophic for 25.4% (95% CI, 18.4–33.3) of caretakers interviewed. Out-of-pocket expenditures were regressive, with a greater burden being experienced by households with lower socio-economic status. Conclusion Despite a policy of user fee exemption for children under 5 years of age in Kenya, our findings show that high unofficial user fees are still charged in district hospitals. Financing mechanisms that will offer financial risk protection to children seeking care need to be developed to remove barriers to child survival. PMID:22716184

A Comparative Analysis for Wilderness User Fee Policy.

ERIC Educational Resources Information Center

Leuschner, William A.; And Others

1987-01-01

Two similar wilderness areas, one of which charges user fees, were sampled in order to compare user characteristics, trip characteristics, and travel cost demand functions. The purpose was to examine the effect fees had on user behavior and choices of area. Results are presented. (MT)

77 FR 72359 - Animal Generic Drug User Fee Act; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-05

... increase the revenue stream stability and reduce application fee costs. III. What information should you...] Animal Generic Drug User Fee Act; Public Meeting; Request for Comments AGENCY: Food and Drug... announcing the following meeting: Animal Generic Drug User Fee Act. The topic to be discussed is proposed...

19 CFR 103.10 - Fees for services.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Fees for services. 103.10 Section 103.10 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... deleting exempt matter being withheld from records to be furnished, or for monitoring a requester's...

19 CFR 103.10 - Fees for services.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Fees for services. 103.10 Section 103.10 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... deleting exempt matter being withheld from records to be furnished, or for monitoring a requester's...

5 CFR 294.109 - Fees.

Code of Federal Regulations, 2013 CFR

2013-01-01

... direct costs associated with any response it has prepared. (5) If fees for document search are authorized... searching for documents and other direct costs of a search, even if a search fails to locate records or if records located are determined to be exempt from disclosure. Searches should be conducted in the most...

5 CFR 294.109 - Fees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... direct costs associated with any response it has prepared. (5) If fees for document search are authorized... searching for documents and other direct costs of a search, even if a search fails to locate records or if records located are determined to be exempt from disclosure. Searches should be conducted in the most...

5 CFR 2502.14 - Miscellaneous fee provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Charges for Search and Reproduction § 2502.14 Miscellaneous fee provisions. (a) Charging interest—notice... from the date of billing. (b) Charges for an unsuccessful search. OA may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from...

5 CFR 294.109 - Fees.

Code of Federal Regulations, 2012 CFR

2012-01-01

... direct costs associated with any response it has prepared. (5) If fees for document search are authorized... searching for documents and other direct costs of a search, even if a search fails to locate records or if records located are determined to be exempt from disclosure. Searches should be conducted in the most...

5 CFR 2502.14 - Miscellaneous fee provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Charges for Search and Reproduction § 2502.14 Miscellaneous fee provisions. (a) Charging interest—notice... from the date of billing. (b) Charges for an unsuccessful search. OA may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from...

5 CFR 294.109 - Fees.

Code of Federal Regulations, 2014 CFR

2014-01-01

... direct costs associated with any response it has prepared. (5) If fees for document search are authorized... searching for documents and other direct costs of a search, even if a search fails to locate records or if records located are determined to be exempt from disclosure. Searches should be conducted in the most...

5 CFR 2502.14 - Miscellaneous fee provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Charges for Search and Reproduction § 2502.14 Miscellaneous fee provisions. (a) Charging interest—notice... from the date of billing. (b) Charges for an unsuccessful search. OA may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from...

5 CFR 2502.14 - Miscellaneous fee provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Charges for Search and Reproduction § 2502.14 Miscellaneous fee provisions. (a) Charging interest—notice... from the date of billing. (b) Charges for an unsuccessful search. OA may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from...

77 FR 32672 - Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... (Principal Trust), 2012-11; D-11677, Weyerhaeuser Company (Weyerhaeuser) and Federalway Asset Management LP... interest in a Collective Fund and the receipt by Principal, thereby, of any investment management fee, any...; or (ii) Pays to Principal a Plan-Level Management Fee, based on total assets of such Client Plan...

77 FR 51814 - Draft Guidance for Industry on Generic Drug User Fee Amendments of 2012: Questions and Answers...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... costs to industry. GDUFA enables FDA to assess user fees to support critical and measurable enhancements... critical and measurable enhancements to FDA's generic drugs program. GDUFA establishes fees for abbreviated... current thinking on generic drug user fee amendments of 2012. It does not create or confer any rights for...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

...] Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014 AGENCY: Food and Drug... payment procedures for fiscal year (FY) 2014 animal drug user fees. The Federal Food, Drug, and Cosmetic... submissions. This notice establishes the fee rates for FY 2014. FOR FURTHER INFORMATION CONTACT: Visit FDA's...

9 CFR 130.51 - Penalties for nonpayment or late payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

9 CFR 130.51 - Penalties for nonpayment or late payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

9 CFR 130.51 - Penalties for nonpayment or late payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

9 CFR 130.51 - Penalties for nonpayment or late payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

9 CFR 130.51 - Penalties for nonpayment or late payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

Tax-exempt private placements: a new opportunity for not-for-profit providers.

PubMed

Ambrose, Jim; Harris, Andrew

2006-08-01

Tax-exempt private placements offer an attractive financing alternative for not-for-profit healthcare providers for which the public debt market is no longer a viable option. They offer the following advantages: Greater flexibility Lower fees. Less paperwork. Fewer players. Shorter time to complete.

7 CFR 500.25 - Payment of fees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

7 CFR 500.25 - Payment of fees.

Code of Federal Regulations, 2013 CFR

2013-01-01

... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

7 CFR 500.25 - Payment of fees.

Code of Federal Regulations, 2014 CFR

2014-01-01

... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

7 CFR 500.25 - Payment of fees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

7 CFR 500.25 - Payment of fees.

Code of Federal Regulations, 2012 CFR

2012-01-01

... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

7 CFR 504.3 - Payment of fees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Payment of fees. 504.3 Section 504.3 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE USER FEES § 504.3 Payment of fees. (a) Payment of user fees must accompany a culture deposit or...

Elimination of User-Fees in Tertiary Education: A Distributive Analysis for Ecuador

ERIC Educational Resources Information Center

Ponce, Juan; Loayza, Yessenia

2012-01-01

This paper offers new evidence and methods for understanding the distributive effect of a universal government policy to eliminate user fees in public universities in Ecuador. The main argument to eliminate user fees in higher education is that it will increase enrollment among the poor. In this regard, eliminating tuition fees is supposed to be a…

76 FR 76424 - Biologics Price Competition and Innovation Act of 2009; Proposed Recommendations for a User Fee...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-07

...] Biologics Price Competition and Innovation Act of 2009; Proposed Recommendations for a User Fee Program for... meeting to discuss the proposed recommendations for a user fee program for biosimilar biological products... 20993-0002, (301) 796-4463, Fax: (301) 847-8443, Email: BiosimilarsUser[email protected

78 FR 5133 - Technical Corrections Regarding the Methods of Collection of Certain User Fees by CBP

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

...] Technical Corrections Regarding the Methods of Collection of Certain User Fees by CBP AGENCY: U.S. Customs... electronic payments through the DTOPS. While CBP's preferred method of receiving user fee prepayment requests...

Street-level workers' inadequate knowledge and application of exemption policies in Burkina Faso jeopardize the achievement of universal health coverage: evidence from a cross-sectional survey.

PubMed

Ridde, Valéry; Leppert, Gerald; Hien, Hervé; Robyn, Paul Jacob; De Allegri, Manuela

2018-01-08

Street-level workers play a key role in public health policies in Africa, as they are often the ones to ensure their implementation. In Burkina Faso, the State formulated two different user-fee exemption policies for indigents, one for deliveries (2007), and one for primary healthcare (2009). The objective of this study was to measure and understand the determinants of street-level workers' knowledge and application of these exemption measures. We used cross-sectional data collected between October 2013 and March 2014. The survey targeted 1521 health workers distributed in 498 first-line centres, 18 district hospitals, 5 regional hospitals, and 11 private or other facilities across 24 districts. We used four different random effects models to identify factors associated with knowledge and application of each of the above-mentioned exemption policies. Only 9.2% of workers surveyed knew of the directive exempting the worst-off, and only 5% implemented it. Knowledge and application of the delivery exemption were higher, with 27% of all health workers being aware of the delivery exemption directive and 24.2% applying it. Mobile health workers were found to be consistently more likely to apply both exemptions. Health workers who were facility heads were significantly more likely to know about the indigent exemption for primary health care and to apply it. Health workers in districts with higher proportions of very poor people were significantly more likely to know about and apply the delivery exemption. Nearly 60% of respondents indicated either 5% or 10% as the percentage of people they would deem adequate to target for exemption. This quantitative study confirmed earlier qualitative results on the importance of training and informing health workers and monitoring the measures targeting equity, to ensure compliance with government directives. The local context (e.g., hierarchy, health system, interventions) and the ideas that street-level workers have about the policy instruments can influence their effective implementation. Methods for remunerating health workers and health centres also need to be adapted to ensure equity measures are applied to achieve universal healthcare.

Funding sources for Canadian biorepositories: the role of user fees and strategies to help fill the gap.

PubMed

Barnes, Rebecca O; Schacter, Brent; Kodeeswaran, Sugy; Watson, Peter H

2014-10-01

Biorepositories, the coordinating hubs for the collection and annotation of biospecimens, are under increasing financial pressure and are challenged to remain sustainable. To gain a better understanding of the current funding situation for Canadian biorepositories and the relative contributions they receive from different funding sources, the Canadian Tumour Repository Network (CTRNet) conducted two surveys. The first survey targeted CTRNet's six main nodes to ascertain the relative funding sources and levels of user fees. The second survey was targeted to a broader range of biorepositories (n=45) to ascertain business practices in application of user fees. The results show that >70% of Canadian biorepositories apply user fees and that the majority apply differential fees to different user groups (academic vs. industry, local vs. international). However, user fees typically comprise only 6% of overall operational budgets. We conclude that while strategies to drive up user fee levels need to be implemented, it is essential for the many stakeholders in the biomedical health research sector to consider this issue in order to ensure the ongoing availability of research biospecimens and data that are standardized, high-quality, and that are therefore capable of meeting research needs.

5 CFR 1631.14 - Fee schedule.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Disclosure of Records Under the Freedom of Information Act, 5 U.S.C. 552 § 1631.14 Fee schedule. (a) Manual... operator/programmer salary, plus 23.5 percent, apportionable to the search. The Board may assess charges... determined to be exempt from disclosure. (c) Duplication costs. (1) For copies of documents reproduced on a...

5 CFR 1631.14 - Fee schedule.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Disclosure of Records Under the Freedom of Information Act, 5 U.S.C. 552 § 1631.14 Fee schedule. (a) Manual... operator/programmer salary, plus 23.5 percent, apportionable to the search. The Board may assess charges... determined to be exempt from disclosure. (c) Duplication costs. (1) For copies of documents reproduced on a...

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

PubMed

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

2017-08-01

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

Stated choice models for predicting the impact of user fees at public recreation sites

Treesearch

Herbert W. Schroeder; Jordan Louviere

1999-01-01

A crucial question in the implementation of fee programs is how the users of recreation sites will respond to various levels and types of fees. Stated choice models can help managers anticipate the impact of user fees on people's choices among the alternative recreation sites available to them. Models developed for both day and overnight trips to several areas and...

Fairness of prices, user fee policy and willingness to pay among visitors to a national forest

Treesearch

Jin Young Chung; Gerard T. Kyle; James F. Petrick; James D. Absher

2011-01-01

Imposing user fees in Nature-Based Tourism (NBT) contexts has been a controversial issue. Based on the notions of justice and fairness, this study extended previous work examining the relationship between attitudes toward user fees and spending support. In a proposed structural model of price fairness, fee spending support, and willingness to pay (WTP), this paper...

Support for wilderness recreation fees: The influence of fee purpose and day versus overnight use

Treesearch

Christine A. Vogt; Daniel R. Williams

1999-01-01

This paper examines public support for new user fees established at the Desolation Wilderness in California as part of the Fee Demonstration Program. Traditional approaches to fee policy evaluations have typically focused on economic or revenue issues and equity impacts of various pricing strategies. Support for fees has been shown to vary by users in terms of...

75 FR 36149 - Union Pacific Railroad Company-Abandonment Exemption-in Kane County, IL.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,500 filing fee. See 49 CFR 1002.2(f)(25). All interested... 14, 2010. Each [[Page 36150

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

PubMed

Mladovsky, Philipa; Ba, Maymouna

2017-09-01

Plan Sésame (PS) is a user fee exemption policy launched in 2006 to provide free access to health services to Senegalese citizens aged 60 and over. Analysis of a large household survey evaluating PS echoes findings of other studies showing that user fee removal can be highly inequitable. 34 semi-structured interviews and 19 focus group discussions with people aged 60 and over were conducted in four regions in Senegal (Dakar, Diourbel, Matam and Tambacounda) over a period of six months during 2012. They were analysed to identify underlying causes of exclusion from/inclusion in PS and triangulated with the household survey. The results point to three steps at which exclusion occurs: (i) not being informed about PS; (ii) not perceiving a need to use health services under PS; and (iii) inability to access health services under PS, despite having the information and perceived need. We identify lay explanations for exclusion at these different steps. Some lay explanations point to social exclusion, defined as unequal power relations. For example, poor access to PS was seen to be caused by corruption, patronage, poverty, lack of social support, internalised discrimination and adverse incorporation. Other lay explanations do not point to social exclusion, for example: poor implementation; inadequate funding; high population demand; incompetent bureaucracy; and PS as a favour or moral obligation to friends or family. Within a critical realist paradigm, we interpret these lay explanations as empirical evidence for the presence of the following hidden underlying causal mechanisms: lacking capabilities; mobilisation of institutional bias; and social closure. However, social constructionist perspectives lead us to critique this paradigm by drawing attention to contested health, wellbeing and corruption discourses. These differences in interpretation lead to subsequent differential policy recommendations. This demonstrates the need for the adoption of a "multi-epistemological" perspective in studies of health inequity and social exclusion. Copyright © 2017 Elsevier Ltd. All rights reserved.

Establishment of revisit user fee program for Medicare survey and certification activities. Final rule.

PubMed

2007-09-19

This final rule will establish a system of revisit user fees applicable to health care facilities that have been cited for deficiencies during initial certification, recertification, or substantiated complaint surveys and require a revisit to confirm that corrections to previously-identified deficiencies have been remedied. Consistent with the President's long-term goal to promote quality of health care and to cut the deficit in half by fiscal year (FY) 2009, the FY 2007 Department of Health and Human Services' (HHS) budget request included both new mandatory savings proposals and a requirement that user fees be applied to health care providers that have failed to comply with Federal quality of care requirements. The "Revisit User Fees" will affect only those providers or suppliers for which a revisit is required to confirm that previously-identified failures to meet federal quality of care requirements have been remedied. The fees are estimated at $37.3 million annually and will recover the costs associated with the Medicare Survey and Certification program's revisit surveys. The fees will take effect on the date of publication of the final rule and will be in effect until the date that the continued authority provided by Congress expires. At the time of publication of this regulation the applicable date is September 30, 2007. If no legislation is enacted, the fees are not retroactive to the beginning of the fiscal year. Any provider or supplier that has a revisit survey conducted on or after the date of publication will be assessed a revisit user fee and will be notified of the assessment upon data system reconciliation which can occur following the closing of the fiscal year. The fees will be available to CMS until expended. The revisit user fee is included in the President's proposed FY 2008 budget. We note through the publication of this final rule that if authority for the revisit user fee is continued, we will use the current fee schedule in this rule for the assessment of such fees until such time as a new fee schedule notice is proposed and published in final form.

77 FR 16239 - Medical Device User Fee Act; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

...] Medical Device User Fee Act; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of... public meeting to discuss proposed recommendations for the reauthorization of the Medical Device User Fee... use them for the process for the review of medical device applications. The current legislative...

Discrimination through User Fees: Fact or Fiction?

ERIC Educational Resources Information Center

Manning, Robert E.; Baker, Sidney C.

1981-01-01

In addition to raising operating funds, user fees can alter types of park users and activities. A study was done in which the establishment of a dollar per car entrance fee was shown to have positive financial as well as environmental effects for a city-owned recreational park. (JN)

77 FR 45634 - Biosimilar User Fee Rates for Fiscal Year 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0007] Biosimilar User Fee Rates for Fiscal Year 2013 AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the rates for biosimilar user fees for...

Start-stop funding, its causes and consequences: a case study of the delivery exemptions policy in Ghana.

PubMed

Witter, Sophie; Adjei, Sam

2007-01-01

This article looks at the issue of sustaining funding for a public programme through the case study of the delivery exemptions policy in Ghana. The Government of Ghana introduced the policy of exempting users from delivery fees in September 2003 in the four most deprived regions of the country, and in April 2005 it was extended to the remaining six regions in Ghana. The aim of the policy of free delivery care was to reduce financial barriers to using maternity services. Using materials from key informant interviews at national and local levels in 2005, the article examines how the policy has been implemented and what the main constraints have been, as perceived by different actors in the health system. The interviews show that despite being a high-profile public policy and achieving positive results, the delivery exemptions policy quickly ran into implementation problems caused by inadequate funding. They suggest that facility and district managers bear the brunt of the damage that is caused when benefits that have been promised to the public cannot be delivered. There can be knock-on effects on other public programmes too. Despite these problems, start-stop funding and under-funding of public programmes is more the norm than the exception. Some of the factors causing erratic funding--such as party politics and intersectoral haggling over resources--are unavoidable, but others, such as communication and management failures can and should be addressed. Copyright (c) 2007 John Wiley & Sons, Ltd.

The intersection of urban form and mileage fees : findings from the Oregon road user fee pilot program

DOT National Transportation Integrated Search

2011-03-01

This report analyzes data from the 2006-2007 Oregon Road User Fee Pilot Program to assess if and how urban form variables correlate with travel behavior changes that participants made in response to the mileage fee program. The study tested the impac...

76 FR 79195 - Animal Drug User Fee Act; Reopening of the Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0656] Animal Drug User Fee Act; Reopening of the Comment Period AGENCY: Food and Drug Administration, HHS... notice, FDA requested comments on the Animal Drug User Fee Act (ADUFA) program to date and solicited...

76 FR 2617 - User Fees Relating to Enrolled Agents and Enrolled Retirement Plan Agents; Hearing Cancellation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

... User Fees Relating to Enrolled Agents and Enrolled Retirement Plan Agents; Hearing Cancellation AGENCY... regulations relating to the imposition of user fees for enrolled agents and enrolled retirement plan agents... FURTHER INFORMATION CONTACT: Richard A. Hurst of the Publications and Regulations Branch, Legal Processing...

Mileage-based user fees : defining a path toward implementation phase 2, an assessment of technology issues : final report

DOT National Transportation Integrated Search

2009-10-01

This report reviews technology options for a mileage-based user fee system in the state of Texas. The report was : compiled based on input from a diverse range of sources, including a literature review of existing mileage-based : user fee technical w...

49 CFR 360.5 - Updating user fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Structural equation modeling of users' response to wilderness recreation fees

Treesearch

Daniel R. Williams; Christine A. Vogt; Joar Vitterso

1999-01-01

This paper examines wilderness users' response to recently established overnight camping fees at the Desolation Wilderness in California. Fee program evaluations have typically focused on economic or revenue issues, distributional or equity impacts of various pricing strategies, and questions of price fairness. In the case of wilderness recreation fees, it is also...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

...-AC99 User Fees for 2010 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing... fees for cotton producers for 2010 crop cotton classification services under the Cotton Statistics and Estimates Act at the same level as in 2009. These fees are also authorized under the Cotton Standards Act of...

77 FR 33289 - User Fees for 2012 Crop Cotton Classification Services to Growers

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-06

... User Fees for 2012 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing... fees for cotton producers for 2012 crop cotton classification services under the Cotton Statistics and Estimates Act and the Cotton Standards Act of 1923 at $2.20 per bale--the same level as in 2011. This fee...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

...-AD11 User Fees for 2011 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing... fees for cotton producers for 2011 crop cotton classification services under the Cotton Statistics and Estimates Act at the same level as in 2010. These fees are also authorized under the Cotton Standards Act of...

9 CFR 130.30 - Hourly rate and minimum user fees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... covered by a flat rate user fee in § 130.7. (14) Export-related bird banding for identification. (15..., except those services covered by flat rate user fees elsewhere in this part, will be calculated at the... activities covered in § 130.11. (3) Obtaining samples required to be tested, either to obtain import permits...

77 FR 35878 - Establishment of User Fees for Filovirus Testing of Nonhuman Primate Liver Samples

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... Establishment of User Fees for Filovirus Testing of Nonhuman Primate Liver Samples AGENCY: Centers for Disease... comment on the establishment of user fees for filovirus testing of all nonhuman primates that die during... nonhuman primates. HHS/CDC took this action because (1) testing is no longer being offered by the only...

78 FR 55261 - Draft Guidance for Industry on Generic Drug User Fee Amendments of 2012: Questions and Answers...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-10

... public and reduce costs to industry. GDUFA enables FDA to assess user fees to support critical and... assess user fees to support critical and measurable enhancements to FDA's generic drugs program. GDUFA...). The draft guidance, when finalized, will represent the Agency's current thinking on ``Generic Drug...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... Service 7 CFR Part 28 [AMS-CN-12-0074] RIN 0581-AD30 User Fees for 2013 Crop Cotton Classification... Agricultural Marketing Service (AMS) is proposing to maintain user fees for cotton producers for 2013 crop cotton classification services under the Cotton Statistics and Estimates Act at the same level as in 2012...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... Service 7 CFR Part 28 [AMS-CN-10-0111; CN-11-001] RIN 0581-AD11 User Fees for 2011 Crop Cotton...: The Agricultural Marketing Service (AMS) is proposing to maintain user fees for cotton producers for 2011 crop cotton classification services under the Cotton Statistics and Estimates Act at the same...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

... Service 7 CFR Part 28 [Doc. AMS-CN-12-0005] RIN 0581-AD23 User Fees for 2012 Crop Cotton Classification... Agricultural Marketing Service (AMS) is proposing to maintain user fees for cotton producers for 2012 crop cotton classification services under the Cotton Statistics and Estimates Act at the same level as in 2011...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... Service 7 CFR Part 28 [AMS-CN-10-0001; CN-10-001] RIN 0581-AC99 User Fees for 2010 Crop Cotton...: The Agricultural Marketing Service (AMS) is proposing to maintain user fees for cotton producers for 2010 crop cotton classification services under the Cotton Statistics and Estimates Act at the same...

19 CFR 122.15 - User fee airports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false User fee airports. 122.15 Section 122.15 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at...

19 CFR 122.15 - User fee airports.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false User fee airports. 122.15 Section 122.15 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at...

17 CFR 270.12d1-1 - Exemptions for investments in money market funds.

Code of Federal Regulations, 2010 CFR

2010-04-01

...)(3) and 270.17e-1(d)(2), the payment of a commission, fee, or other remuneration to a broker shall be...) of the Act if: (1) The commission, fee, or other remuneration is paid in connection with the sale of... directors, the company's investment adviser performs the duties of the board of directors. [71 FR 36655...

17 CFR 4.7 - Exemption from certain part 4 requirements for commodity pool operators with respect to offerings...

Code of Federal Regulations, 2012 CFR

2012-04-01

... percentage amounts and computational basis for each such fee and include a statement that the CPO is not able... percentage amounts and computational basis for each such fee and include a statement that the CPO is not able... fund, the commodity pool operator must disclose the percentage amounts and computational basis for each...

From institutionalization of user fees to their abolition in West Africa: a story of pilot projects and public policies

PubMed Central

2015-01-01

This article analyzes the historical background of the institutionalization of user fees and their subsequent abolition in West Africa. Based on a narrative review, we present the context that frames the different articles in this supplement. We first show that a general consensus has emerged internationally against user fees, which were imposed widely in Africa in the 1980s and 1990s; at that time, the institutionalization of user fees was supported by evidence from pilot projects funded by international aid agencies. Since then there have been other pilot projects studying the abolition of user fees in the 2000s, but these have not yet had any real influence on public policies, which are often still chaotic. This perplexing situation might be explained more by ideologies and political will than by insufficient financial capacity of states. PMID:26559564

An analysis of physician antitrust exemption legislation: adjusting the balance of power.

PubMed

Hellinger, F J; Young, G J

2001-07-04

Current antitrust law restricts physicians from joining together to collectively negotiate. However, such activities may be approved by state laws under the so-called state action immunity doctrine and by federal legislation under an explicit antitrust exemption. In 1999, Texas became the first state to pass physician antitrust exemption legislation allowing physicians, under certain defined circumstances, to collectively negotiate fees with health plans. Last year, similar legislation was introduced in the US Congress, in 18 state legislatures, and in the District of Columbia. This legislation was passed only in the District of Columbia where its implementation was blocked by the city's financial control board. Nonetheless, legislation permitting physicians to collectively negotiate fees with managed care plans has been introduced in 10 state legislatures this year, and there is continued interest in introducing similar legislation in the US Congress. This analysis examines the basic features of this legislation and its potential impact on the balance of power between physicians and managed care plans.

75 FR 56564 - Prohibited Transaction Exemptions and Grant of Individual Exemptions Involving: 2010-26, PNC...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... all of its operational expenses; and (g) The Plan does not pay any fees or other expenses in... Applicant), D-11456; and 2010-27, The Finishing Trades Institute of the Mid-Atlantic Region (the Plan), L..., effective December 31, 1978, section 102 of Reorganization Plan No. 4 of 1978, 5 U.S.C. App. 1 (1996...

78 FR 67216 - Norfolk Southern Railway Company-Abandonment Exemption-in Lake County, Ind.

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... Junction Avenue in the City of Schererville, Ind.) and milepost MQ 283.10 (near the line's crossing of E... 14, 2014, or 10 days after service of a decision granting the petition for exemption, whichever occurs sooner. Each OFA must be accompanied by a $1,600 filing fee. See 49 CFR 1002.2(f)(25). All...

Demand for Primary Schooling in Rural Mali: Should User Fees Be Increased?

ERIC Educational Resources Information Center

Birdsall, Nancy; Orivel, Francois

1996-01-01

Assesses the effect of school fees on primary school attendance, using household and school survey data from rural Mali. Estimates elasticity of demand regarding fees and compares it with effects of distance and quality on enrollment. User fees can provide a partial solution to the quality/enrollment problem, but cannot solve the distance problem.…

Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia

PubMed Central

Masiye, Felix; Kaonga, Oliver; Kirigia, Joses M

2016-01-01

Background Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. Methods Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households’ out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. Results Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence. Conclusion Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of user fee removal on CHE among particularly poorest households. PMID:26795620

Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia.

PubMed

Masiye, Felix; Kaonga, Oliver; Kirigia, Joses M

2016-01-01

Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households' out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence. Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of user fee removal on CHE among particularly poorest households.

77 FR 20825 - Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

...] Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for Information... Administration (FDA) is announcing the availability of the guidance entitled ``Guidance for Industry and Food and... ``Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for Information...

78 FR 46958 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

...] Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2014 AGENCY: Food and Drug... and payment procedures for fiscal year (FY) 2014 generic new animal drug user fees. The Federal Food... for FY 2014. FOR FURTHER INFORMATION CONTACT: Visit FDA's Web site at http://www.fda.gov/ForIndustry...

9 CFR 156.7 - User fees under 9 CFR part 130.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.7 User fees under 9 CFR part 130. Use...

9 CFR 156.7 - User fees under 9 CFR part 130.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.7 User fees under 9 CFR part 130. Use...

9 CFR 156.7 - User fees under 9 CFR part 130.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.7 User fees under 9 CFR part 130. Use...

9 CFR 156.7 - User fees under 9 CFR part 130.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.7 User fees under 9 CFR part 130. Use...

Impact of user fees on day use attendance at New Hampshire state parks

Treesearch

Allison A. Rechisky; Bradford N. Williamson

1992-01-01

This paper examines state park day use attendance data over a ten year period, 1980 - 1990, for variations in attendance effected by increases in user fees. A non-controllable variable the weather has been taken into account. The results of this paper suggest that user fees can be successfully collected at specific locations and provide positive income without...

9 CFR 130.18 - User fees for veterinary diagnostic reagents produced at NVSL or other authorized site (excluding...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for veterinary diagnostic reagents produced at NVSL or other authorized site (excluding FADDL). 130.18 Section 130.18 Animals and... § 130.18 User fees for veterinary diagnostic reagents produced at NVSL or other authorized site...

9 CFR 130.18 - User fees for veterinary diagnostic reagents produced at NVSL or other authorized site (excluding...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for veterinary diagnostic reagents produced at NVSL or other authorized site (excluding FADDL). 130.18 Section 130.18 Animals and... § 130.18 User fees for veterinary diagnostic reagents produced at NVSL or other authorized site...

75 FR 58411 - Center for Veterinary Medicine eSubmitter Workshop; Public Workshop; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... health industry that submits new animal drug applications to CVM's Office of New Animal Drug Evaluation... agreed to in the Animal Drug User Fee Amendments (ADUFA II) of 2008 ( http://www.fda.gov/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/ucm044941.htm ). The ONADE will be soliciting feedback on both the e...

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

Treesearch

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

2008-01-01

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

76 FR 9402 - Michigan Air-Line Railway Co.-Abandonment Exemption-in Oakland County, MI

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

... offer of financial assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after... fee. See 49 CFR 1002.2(f)(25). All interested persons should be aware that, following abandonment of... be accompanied by a $250 filing fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice...

17 CFR 270.26a-2 - Exemptions from certain provisions of sections 26 and 27 for registered separate accounts and...

Code of Federal Regulations, 2010 CFR

2010-04-01

... deduction of certain fees and charges from the assets of such accounts. 270.26a-2 Section 270.26a-2... registered separate accounts and others regarding custodianship of and deduction of certain fees and charges... by any State or other governmental entity and, if the separate account is registered under the Act as...

Making waves. IRS zeroes in on bond pools, hospital groups' use of tax-exempt financing.

PubMed

Jaklevic, Mary Chris

2002-03-04

The unused debt of an Ohio hospital association has caught the attention of the Internal Revenue Service, which has been on the lookout for bogus pools that take advantage of tax-exempt financing to generate professional fees. Bondholders have been told that the federal agency is examining the loan pool, and similar scenarios may soon occur in other states.

8 CFR 286.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.1 Definitions... Management, Immigration and Naturalization Service, Room 6307, 425 I Street NW., Washington, DC 20536. (f) The term fee means the immigration user fee. (g) The term port of entry means a port or place...

Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017. Final rule.

PubMed

2016-03-08

This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional amendments regarding the annual open enrollment period for the individual market for the 2017 and 2018 benefit years; essential health benefits; cost sharing; qualified health plans; Exchange consumer assistance programs; network adequacy; patient safety; the Small Business Health Options Program; stand-alone dental plans; third-party payments to qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics.

Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis.

PubMed

Leone, Tiziana; Cetorelli, Valeria; Neal, Sarah; Matthews, Zoë

2016-01-28

Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. Women's experience of user fees in 5 African countries. Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities' births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries' choice. We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria). User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana. Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis

PubMed Central

Leone, Tiziana; Cetorelli, Valeria; Neal, Sarah; Matthews, Zoë

2016-01-01

Objectives Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. Setting Women's experience of user fees in 5 African countries. Primary and secondary outcome measures Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities’ births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries’ choice. Participants We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria). Results User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana. Conclusions Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care. PMID:26823178

7 CFR 354.4 - User fees for certain domestic services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE OVERTIME SERVICES RELATING TO IMPORTS AND EXPORTS; AND USER... appropriate, his or her agent, agrees to maintain a balance in the user fee payment account equal to the cost...

7 CFR 354.4 - User fees for certain domestic services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE OVERTIME SERVICES RELATING TO IMPORTS AND EXPORTS; AND USER... appropriate, his or her agent, agrees to maintain a balance in the user fee payment account equal to the cost...

75 FR 18887 - FBI Criminal Justice Information Services Division User Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

.... SUMMARY: This notice establishes the user fee schedule for fingerprint- based and name-based criminal... fingerprint-based and other identification services as authorized by federal law. These fees apply to federal, state and any other authorized entities requesting fingerprint identification records and name checks...

What is greener than a VMT tax? The case for an indexed energy user fee to finance us surface transportation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greene, David L

Highway finance in the United States is perceived by many to be in a state of crisis, primarily due to the erosion of motor fuel tax revenues due to inflation, fuel economy improvement, increased use of alternative sources of energy and diversion of revenues to other purposes. Monitoring vehicle miles of travel (VMT) and charging highway users per mile has been proposed as a replacement for the motor fuel tax. A VMT user fee, however, does not encourage energy efficiency in vehicle design, purchase and operation, as would a user fee levied on all forms of commercial energy used formore » transportation and indexed to the average efficiency of vehicles on the road and to inflation. An indexed roadway user toll on energy (IRoUTE) would induce two to four times as much reduction in greenhouse gas (GHG) emissions and petroleum use as a pure VMT user fee. However, it is not a substitute for pricing GHG emissions and would make only a small but useful contribution to reducing petroleum dependence. An indexed energy user fee cannot adequately address the problems of traffic congestion and heavy vehicle cost responsibility. It could, however, be a key component of a comprehensive system of financing surface transportation that would eventually also include time and place specific monitoring of VMT for congestion pricing, externality charges and heavy vehicle user fees.« less

32 CFR 811.5 - Customers exempt from fees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... would be inappropriate. AFI 16-101, International Affairs and Security Assistance Management, tells how... news productions, documentaries, or print products that inform the public on Air Force activities. ...

32 CFR 204.6 - Collections.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Collections. 204.6 Section 204.6 National... USER FEES § 204.6 Collections. (a) Collections of fees will be made in advance or simultaneously with..., and managing cash and debt collections. (b) Unless a statute provides otherwise, user fee collections...

User fees and maternity services in Ethiopia.

PubMed

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

2011-12-01

To examine user fees for maternity services and how they relate to provision, quality, and use of maternity services in Ethiopia. The national assessment of emergency obstetric and newborn care (EmONC) examined user fees for maternity services in 751 health facilities that provided childbirth services in 2008. Overall, only about 6.6% of women gave birth in health facilities. Among facilities that provided delivery care, 68% charged a fee in cash or kind for normal delivery. Health centers should be providing maternity services free of charge (the healthcare financing proclamation), yet 65% still charge for some aspect of care, including drugs and supplies. The average cost for normal and cesarean delivery was US $7.70 and US $51.80, respectively. Nineteen percent of these facilities required payment in advance for treatment of an obstetric emergency. The health facilities that charged user fees had, on average, more delivery beds, deliveries (normal and cesarean), direct obstetric complications treated, and a higher ratio of skilled birth attendants per 1000 deliveries than those that did not charge. The case fatality rate was 3.8% and 7.1% in hospitals that did and did not charge user fees, respectively. Utilization of maternal health services is extremely low in Ethiopia and, although there is a government decree against charging for maternity service, 65% of health centers do charge for some aspects of maternal care. As health facilities are not reimbursed by the government for the costs of maternity services, this loss of revenue may account for the more and better services offered in facilities that continue to charge user fees. User fees are not the only factor that determines utilization in settings where the coverage of maternity services is extremely low. Additional factors include other out-of-pocket payments such as cost of transport and food and lodging for accompanying relatives. It is important to keep quality of care in mind when user fees are under discussion. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

78 FR 9108 - Rusk County Rural Rail District-Abandonment Exemption-in Rusk County, TX

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-07

... assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than May 18, 2013, or 10 days after service... accompanied by a $1,600 filing fee. See 49 CFR 1002.2(f)(25). All interested persons should be aware that... request must be accompanied by a $250 filing fee. See 49 CFR 1002.2(f)(27). All filings in response to...

75 FR 65048 - CSX Transportation, Inc.-Abandonment Exemption-in Chesterfield and Darlington Counties, SC

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-21

... assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,500 filing fee. See 49 CFR 1002.2... will be due no later than November 10, 2010. Each trail use request must be accompanied by a $250...

An assessment of the effect of user fee policy reform on facility-based deliveries in rural Zambia.

PubMed

Chama-Chiliba, Chitalu Miriam; Koch, Steven Fredric

2016-12-07

Improving maternal health outcomes by reducing barriers to accessing maternal health services is a key goal for most developing countries. This paper analyses the effect of user fee removal, which was announced for rural areas of Zambia in April 2006, on the use of public health facilities for childbirth. Data from the 2007 Zambia Demographic and Health Survey, including birth histories for the five years preceding the survey, is linked to administrative data and geo-referenced health facility census data. We exploit a difference-in-differences design, due to a differential change in user fees at the district level; fees were removed in 54 rural districts, but not in the 18 remaining urban districts. We use multilevel modelling to estimate the effect of this policy change, based on 4018 births from May 2002 to September 2007, covering a period before and after the policy announcement in April 2006. The difference-in-difference estimates point to statistically insignificant changes in the proportion of women giving birth at home and in public facilities, but significant changes are found for deliveries in private (faith-based) facilities. Thus, the abolition of delivery fees is found to have some effect on where Zambian mothers choose to have their children born. The removal of user fees has not overcome barriers to the utilisation of delivery services at public facilities. User fee removal may also yield unintended consequences deterring the utilisation of delivery services. Therefore, abolishing user fees, alone, may not be sufficient to affect changes in utilisation; instead, other efforts, such as improving service quality, may have a greater impact.

Maintaining quality of health services after abolition of user fees: A Uganda case study

PubMed Central

Nabyonga-Orem, Juliet; Karamagi, Humphrey; Atuyambe, Lynn; Bagenda, Fred; Okuonzi, Sam A; Walker, Oladapo

2008-01-01

Background It has been argued that quality improvements that result from user charges reduce their negative impact on utilization especially of the poor. In Uganda, because there was no concrete evidence for improvements in quality of care following the introduction of user charges, the government abolished user fees in all public health units on 1st March 2001. This gave us the opportunity to prospectively study how different aspects of quality of care change, as a country changes its health financing options from user charges to free services, in a developing country setting. The outcome of the study may then provide insights into policy actions to maintain quality of care following removal of user fees. Methods A population cohort and representative health facilities were studied longitudinally over 3 years after the abolition of user fees. Quantitative and qualitative methods were used to obtain data. Parameters evaluated in relation to quality of care included availability of drugs and supplies and; health worker variables. Results Different quality variables assessed showed that interventions that were put in place were able to maintain, or improve the technical quality of services. There were significant increases in utilization of services, average drug quantities and stock out days improved, and communities reported health workers to be hardworking, good and dedicated to their work to mention but a few. Communities were more appreciative of the services, though expectations were lower. However, health workers felt they were not adequately motivated given the increased workload. Conclusion The levels of technical quality of care attained in a system with user fees can be maintained, or even improved without the fees through adoption of basic, sustainable system modifications that are within the reach of developing countries. However, a trade-off between residual perceptions of reduced service quality, and the welfare gains from removal of user fees should guide such a policy change. PMID:18471297

14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

Code of Federal Regulations, 2011 CFR

2011-01-01

... FLIGHT Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who... flight one year or less, but more than six months before launch, the user shall reimburse NASA an... shared flight six months or less before launch, the user shall reimburse NASA an occupancy fee of 90% of...

14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

Code of Federal Regulations, 2013 CFR

2013-01-01

... FLIGHT Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who... flight one year or less, but more than six months before launch, the user shall reimburse NASA an... shared flight six months or less before launch, the user shall reimburse NASA an occupancy fee of 90% of...

14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

Code of Federal Regulations, 2014 CFR

2014-01-01

... FLIGHT Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who... flight one year or less, but more than six months before launch, the user shall reimburse NASA an... shared flight six months or less before launch, the user shall reimburse NASA an occupancy fee of 90% of...

14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

Code of Federal Regulations, 2012 CFR

2012-01-01

... FLIGHT Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who... flight one year or less, but more than six months before launch, the user shall reimburse NASA an... shared flight six months or less before launch, the user shall reimburse NASA an occupancy fee of 90% of...

Feasibility of mileage-based user fees : application in rural/small urban areas of northeast Texas, final report, October 31, 2008.

DOT National Transportation Integrated Search

2008-10-31

This study explores the application of mileage-based user fees, or vehicle-miles traveled (VMT) fees, as an : alternative to the fuel tax in rural and small urban areas. The purpose of the study is to identify the issues : associated with implementat...

Interstate Variation in the Use of Fees To Fund K-12 Public Education.

ERIC Educational Resources Information Center

Wassmer, Robert W.; Fisher, Ronald C.

2002-01-01

Reviews state reliance of various user fees in public education; discusses conceptual issues regarding the use of school district user charges; analyzes statewide variations in school district user charges; suggests reasons for observed variations. (Contains 25 references.) (PKP)

77 FR 24561 - Union Pacific Railroad Company-Abandonment of Freight Easement Exemption-in Alameda and Santa...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... will be issued by July 23, 2012. Any OFA under 49 CFR 1152.27(b)(2) will be due no later than 10 days...,500 filing fee. See 49 CFR 1002.2(f)(25). All interested persons should be aware that, following... accompanied by a $250 filing fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer...

Determinants of use of supervised delivery care under Ghana's fee exemption policy for maternal healthcare: the case of the Central Region.

PubMed

Asante-Sarpong, Henrietta; Owusu, Adobea Yaa; Saravanan, Sheela; Appiah, Ernest; Abu, Mumuni

2016-07-19

Improving access to supervised and emergency obstetric care resources through fee reduction/exemption maternity care initiatives has been touted as one major strategy to avoiding preventable maternal deaths. Evaluations on the effect of Ghana's fee exemption policy for maternal healthcare have largely focused on how it has influenced health outcomes and patterns of use of supervised care with little attention to understanding the main factors influencing use. This study therefore sought to explore the main individual and health system factors influencing use of delivery care services under the policy initiative in the Central Region. A cross-sectional study was conducted using 412 mothers with children aged less than one year in one largely rural and another largely urban districts in the Central Region of Ghana from September to December 2013. Data were collected using a questionnaire survey on the socio-demographic characteristics of mothers, their knowledge and use of care under the fee free policy. Chi-square and Binary Logistic Regression tests were used to evaluate the main determinants of delivery care use under the policy. Out of the 412 mothers interviewed, 268 (65 %) reported having delivered their most recent birth under the fee exemption policy even though awareness about the policy was almost universal 401 (97.3 %) among respondents. Utilization however differed for the two study districts. Respondents in the Cape Coast Metropolis (largely urban) used delivery service more (75.7 %) than those in the largely rural Assin North Municipal area (54.4 %). Binary logistic regression results identified maternal age, parity, religion, place of residence, awareness and knowledge about the fee exemption policy for maternal healthcare as significantly associated with the likelihood of delivery care use under the policy. The likelihood of using supervised delivery care under the policy was lower for mothers aged 20-29 compared to those in the age bracket of 40-49 (Odds ratio (OR) = 0.069, p = 0.003). For their index (last child), mothers who already had 1, 2 or 3 births were more likely to deliver under the policy than those with five or more births. Mothers living in urban areas were 3.79 times more likely to use delivery services under the policy than those living in rural areas (OR = 3.793, p = 0.000). The likelihood of using delivery services under the policy was higher for mothers who were aware and had full knowledge of the total benefit package of the policy (OR = 13.820, p = 0.022 and OR = 2.985, p = 0.001 for awareness and full knowledge respectively). Delivery service use under the free maternal healthcare policy is relatively low (65 %) when compared with nearly universal awareness (97.3 %) about the policy. Factors influencing delivery service use under the policy operate at both individual and policy implementation levels. Effective interventions to improve delivery service use under the policy should target the underlying individual and health policy implementation factors identified in the study.

26 CFR 1.528-9 - Exempt function income.

Code of Federal Regulations, 2010 CFR

2010-04-01

... that the source of income be labeled as membership dues, fees, or assessments. What is important is... owner-members rather than in some other capacity such as customers for services. Generally, for the...

Passenger Fee Restructuring Exemptions Act of 2014

THOMAS, 113th Congress

Sen. Hirono, Mazie K. [D-HI

2014-01-27

Senate - 01/27/2014 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

78 FR 41090 - Exemption From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

... fees and expenses. JJ. ``Eligible Yield Supplement Agreement'' means any yield supplement agreement... provision described in subsections III.JJ.(1)-(3) without the consent of the Trustee; (5) It is entered into...

44 CFR 5.41 - FEMA publications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... obtain FEMA publications without charge from the FEMA Headquarters, Regional Offices, the FEMA Library at... purchased, in which case fees will be charged as set out in a FEMA catalogue. Non-exempt FEMA research...

44 CFR 5.41 - FEMA publications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... obtain FEMA publications without charge from the FEMA Headquarters, Regional Offices, the FEMA Library at... purchased, in which case fees will be charged as set out in a FEMA catalogue. Non-exempt FEMA research...

44 CFR 5.41 - FEMA publications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... obtain FEMA publications without charge from the FEMA Headquarters, Regional Offices, the FEMA Library at... purchased, in which case fees will be charged as set out in a FEMA catalogue. Non-exempt FEMA research...

44 CFR 5.41 - FEMA publications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... obtain FEMA publications without charge from the FEMA Headquarters, Regional Offices, the FEMA Library at... purchased, in which case fees will be charged as set out in a FEMA catalogue. Non-exempt FEMA research...

44 CFR 5.41 - FEMA publications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... obtain FEMA publications without charge from the FEMA Headquarters, Regional Offices, the FEMA Library at... purchased, in which case fees will be charged as set out in a FEMA catalogue. Non-exempt FEMA research...

76 FR 62497 - Grenada Railway LLC-Abandonment Exemption-in Grenada, Montgomery, Carroll, Holmes, Yazoo and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-07

... assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision granting the petition for exemption. Each OFA must be accompanied by a $1,500 filing fee. See 49 CFR 1002.2.... See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer to Docket No. AB 1087X...

76 FR 79267 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Approving a Proposed Rule Change Expanding...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for... ``Users'' of its co-location services, and to amend its Fee Schedule. The proposed rule change was...

User Fees in Primary Education

ERIC Educational Resources Information Center

Kattan, Raja Bentaouet; Burnett, Nicholas

2004-01-01

There are a large number of different "fees" that private households sometimes have to pay for publicly provided primary education, including tuition fees, textbook fees or costs and/or rental payments, compulsory uniforms, PTA dues, and various special fees such as exam fees, contributions to district education boards, and the like. In many…

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

PubMed

1992-01-01

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

The generic drug user fee amendments: an economic perspective

PubMed Central

Berndt, Ernst R; Murphy, Stephen J

2018-01-01

Abstract Since the vast majority of prescription drugs consumed by Americans are off patent (‘generic’), their regulation and supply is of wide interest. We describe events leading up to the US Congress's 2012 passage of the Generic Drug User Fee Amendments (GDUFA I) as part of the Food and Drug Administration Safety and Innovation Act (FDASIA). Under GDUFA I, generic manufacturers agreed to pay approximately $300 million in fees each year of the five-year program. In exchange, the US Food and Drug Administration (FDA) committed to performance goals. We describe GDUFA I’s FDA commitments, provisions, goals, and annual fee structure and compare it to that entailed in the authorization and implementation of GDUFA II on October 1, 2017. We explain how user fees required under GDUFA I erected barriers to entry and created scale and scope economies for incumbent manufacturers. Congress changed user fees under GDUFA II in part to lessen these incentives. In order to initiate and sustain user fees under GDUFA legislation, FDA requires the submission of self-reported data on generic manufacturers including domestic and foreign facilities. These data are public and our examination of them provides an unprecedented window into the recent organization of generic drug manufacturers supplying the US market. Our results suggest that generic drug manufacturing is increasingly concentrated and foreign. We discuss the implications of this observed market structure for GDUFA II’s implementation among other outcomes. PMID:29707218

Local sustainability and scaling up for user fee exemptions: medical NGOs vis-à-vis health systems

PubMed Central

2015-01-01

Free healthcare obviously works when a partner from abroad supplies a health centre or a health district with medicines and funding on a regular basis, provides medical, administrative and managerial training, and gives incentive bonuses and daily subsistence allowances to staff. The experiments by three international NGO in Burkina Faso, Mali and Niger have all been success stories. But withdrawing NGO support means that health centres that have enjoyed a time of plenty under NGO management will return to the fold of health centres run by the state in its present condition and the health system in its present condition, with the everyday consequences of late reimbursements and stock shortages. The local support given by international NGOs has more often than not an effect of triggering an addiction to aid instead of inducing local sustainability without infusion. In the same way, scaling up to the entire country a local pilot experiment conducted under an NGO involves its insertion into a national bureaucratic machine with its multiple levels, all of which are potential bottlenecks. Only experiments carried out under the "ordinary" management of the state are capable of laying bare the problems associated with this process. Without reformers 'on the inside' (within the health system itself and among health workers), no real reform of the health system induced by reformers 'from the outside' can succeed. The problems relating to the sustainability of public policies in Africa, especially when the policies benefit from development aid, in the area of health among others, are familiar to researchers and policy-makers. However, as far as user fee exemptions are concerned, debates about these problems have extended well beyond the narrow circle of experts and into the public domain in the countries concerned. Throughout our research, we have observed that the sustainability of free healthcare policies is a major concern of all the actors (health workers, users, managers and senior administrative staff), and an issue that has generated widespread scepticism, especially in Mali and Niger [1,2]. There is general unease about the state's ability to reimburse health centres and to provide essential inputs. The scepticism is fuelled by a two-fold negative experience: decades of incoherent public policies at national level, plagued by bad management and uncertain funding, on the one hand; and the endless U-turns by donors, the double binds of frequent contradictions in their funding policies and the short-term nature of the programmes they enact, on the other [3]. The first years of exemption policies, which were beset by late reimbursements and more or less chronic stock shortages, only added to the scepticism. The disquiet appears to be justified: despite their positive impact in terms of health centre attendance, without funding guaranteed over time, efficient management, secure supply channels and motivated staff, free healthcare policies fall foul of a host of adverse effects at every level of the health pyramid. PMID:26559444

Alternative Fuels Data Center

Science.gov Websites

state-issued PEV license plates may use HOV lanes regardless of the number of passengers and are exempt from parking fees charged by any state or county authority. PEVs displaying state PEV license plates

22 CFR 171.14 - Fees to be charged-general.

Code of Federal Regulations, 2011 CFR

2011-04-01

... searching for records responsive to a FOIA request and operator/programmer salary attributable to the search... applicability of a specific exemption to a particular record or portion of a record. (c) Duplication of records...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

75 FR 49502 - Medical Device User Fee Act; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

... Federal Food, Drug, and Cosmetic Act (FD&C Act) requires that before FDA begins negotiations with the...)) requires that, before FDA begins negotiations with the regulated industry on user fee reauthorization, we...

9 CFR 130.9 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false [Reserved] 130.9 Section 130.9 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.9 [Reserved] ...

Royalty Fees Part I: The Copyright Clearance Center and Publishers.

ERIC Educational Resources Information Center

Eiblum, Paula; Ardito, Stephanie C.

1998-01-01

Discussion of copyrights, royalty fees, and intellectual property focuses on the Copyright Clearance Center and publishers. Topics include results of a survey of library and information science journal publishers; how users verify royalty fees; how publishers determine fees; royalty fee reporting; and terms and conditions imposed on electronic…

Mileage-Based User Fees : Prospects and Challenges

DOT National Transportation Integrated Search

2012-06-01

This report reviews the current research regarding mileage-based user fees for vehicle travel (MBUF), possibly as a replacement or supplement to fuel taxes, which is currently the primary source of transportation revenues in New York State and the na...

Development of a mileage-based user fee research website.

DOT National Transportation Integrated Search

2011-01-01

The University Transportation Center for Mobility (UTCM) previously funded several research projects : related to mileage-based user fees (MBUFs). As part of these research efforts a website was developed to : support the planning for the first-ever ...

Removing user fees for basic health services: a pilot study and national roll-out in Afghanistan

PubMed Central

Steinhardt, Laura C; Aman, Iqbal; Pakzad, Iqbalshah; Kumar, Binay; Singh, Lakhwinder P; Peters, David H

2011-01-01

Background User fees for primary care tend to suppress utilization, and many countries are experimenting with fee removal. Studies show that additional inputs are needed after removing fees, although well-documented experiences are lacking. This study presents data on the effects of fee removal on facility quality and utilization in Afghanistan, based on a pilot experiment and subsequent nationwide ban on fees. Methods Data on utilization and observed structural and perceived overall quality of health care were compared from before-and-after facility assessments, patient exit interviews and catchment area household surveys from eight facilities where fees were removed and 14 facilities where fee levels remained constant, as part of a larger health financing pilot study from 2005 to 2007. After a national user fee ban was instituted in 2008, health facility administrative data were analysed to assess subsequent changes in utilization and quality. Results The pilot study analysis indicated that observed and perceived quality increased across facilities but did not differ by fee removal status. Difference-in-difference analysis showed that utilization at facilities previously charging both service and drug fees increased by 400% more after fee removal, prompting additional inputs from service providers, compared with facilities that previously only charged service fees or had no change in fees (P = 0.001). Following the national fee ban, visits for curative care increased significantly (P < 0.001), but institutional deliveries did not. Services typically free before the ban—immunization and antenatal care—had immediate increases in utilization but these were not sustained. Conclusion Both pilot and nationwide data indicated that curative care utilization increased following fee removal, without differential changes in quality. Concerns raised by non-governmental organizations, health workers and community leaders over the effects of lost revenue and increased utilization require continued effort to raise revenues, monitor health worker and patient perceptions, and carefully manage health facility performance. PMID:22027924

47 CFR 1.1116 - General exemptions to charges.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Commission authorization in any other mass media radio service (except the international broadcast (HF) service) private radio service, or common carrier radio communications service otherwise requiring a fee....1116 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule of...

77 FR 518 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

... two monthly login IDs (so, $600 for one), or a fee of $2,400 for a higher- volume user.\\6\\ The NASDAQ... a minimum of two monthly login IDs and does not have a separate fee for a higher-volume user. See.... 78f(b)(4). The proposed changes to increase the fees assessed for CMI Login IDs and FIX Login IDs are...

77 FR 51816 - Notice of Opportunity To Withdraw Abbreviated New Drug Applications To Avoid Backlog Fee Obligations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

...] Notice of Opportunity To Withdraw Abbreviated New Drug Applications To Avoid Backlog Fee Obligations... to avoid paying a fee. The fee in question is a one-time backlog fee that was established through enactment of the Generic Drug User Fee Amendments of 2012 (GDUFA). It will apply to any original ANDA that...

32 CFR 204.9 - Schedule of fees and rates.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Schedule of fees and rates. 204.9 Section 204.9 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS USER FEES § 204.9 Schedule of fees and rates. (a) Schedule of fees and rates. (1) This schedule...

32 CFR 204.5 - Fees.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Fees. 204.5 Section 204.5 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS USER FEES § 204.5 Fees. (a) General. (1) All fees shall be based on full cost to the U.S. Government or market...

25 CFR 700.251 - Fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Fees. 700.251 Section 700.251 Indians THE OFFICE OF... § 700.251 Fees. (a) Services for which fees may be charged. (1) Unless waived pursuant to the provisions of paragraph (c) of this section, user fees shall be charged for document search and duplication...

Payment Reduction and Medicare Private Fee-for-Service Plans

PubMed Central

Frakt, Austin B.; Pizer, Steven D.; Feldman, Roger

2009-01-01

Medicare private fee-for-service (PFFS) plans are paid like other Medicare Advantage (MA) plans but are exempt from many MA requirements. Recently, Congress set average payments well above the costs of traditional fee-for-service (FFS) Medicare, inducing dramatic increases in PFFS plan enrollment. This has significant implications for Medicare's budget, provoking calls for policy change. We predict the effect of proposals to cut PFFS payments on PFFS plan participation and enrollment. We find that small reductions in payment rates would reduce PFFS participation and enrollment; if Congress reduces payments to traditional FFS levels it would cause the vast majority (85 percent) of PFFS plans to exit the market. PMID:19544932

Danish patients are positive towards fees for non-attendance in public hospitals. A qualitative study.

PubMed

Lou, Stina; Frumer, Michal; Olesen, Steen; Nielsen, Agnete Hedemann; Væggemose, Ulla

2016-07-01

Patients' non-attendance is a significant problem in modern healthcare. Non-attendance delays treatment, reduces efficiency and increases healthcare costs. For several years, the introduction of financial incentives such as a non-attendance fee has been discussed in Denmark. Set in the context of a tax-financed, free-for-all healthcare system, the political hesitance to introduce fees relates to concerns that additional fees may be badly received by tax-paying citizens and may undermine the political priority of patient equity. The aim of this qualitative sub-study was to investigate patients' attitudes towards a fee for non-attendance. Six semi-structured focus group interviews were conducted with a total of 44 patients who had been informed about being charged a fee for non-attendance. Data were transcribed verbatim and analysed using a qualitative content analysis. Overall, patients' attitudes towards the non-attendance fee were positive. Non-attendance was viewed as evidence of disregard for the common free-for-all healthcare, and a fee was expected to motivate non-attendees to show up. However, most patients argued that certain groups (e.g. the mentally disabled) should be exempted from the fee. Furthermore, an implementation of fees should be easy to manage administratively and should not increase bureaucracy. In general, patients' attitudes towards implementing non-attendance fees are positive. Danish Regions, Ministry of Health and Central Denmark Region. not relevant.

29 CFR 1949.1 - Policy regarding tuition fees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) OFFICE OF TRAINING AND EDUCATION, OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION OSHA Training... safety and health program. Individuals or organizations wishing to be considered for this exemption shall...

29 CFR 1949.1 - Policy regarding tuition fees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) OFFICE OF TRAINING AND EDUCATION, OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION OSHA Training... safety and health program. Individuals or organizations wishing to be considered for this exemption shall...

76 FR 48189 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... terminal is a basic front- end user interface used by NASDAQ members to connect to, and enter orders in... is necessary for users to enter orders through VTE. The two fees assessed under Rule 7015(h) relate... $100 monthly, and raised the minimum commission fee for users executing orders totaling less than 100...

Abolishing Fees at Health Centers in the Context of Community Case Management of Malaria: What Effects on Treatment-Seeking Practices for Febrile Children in Rural Burkina Faso?

PubMed

Druetz, Thomas; Fregonese, Federica; Bado, Aristide; Millogo, Tieba; Kouanda, Seni; Diabaté, Souleymane; Haddad, Slim

2015-01-01

Burkina Faso started nationwide community case management of malaria (CCMm) in 2010. In 2011, health center user fees for children under five were abolished in some districts. To assess the effects of concurrent implementation of CCMm and user fees abolition on treatment-seeking practices for febrile children. This is a natural experiment conducted in the districts of Kaya (CCMm plus user fees abolition) and Zorgho (CCMm only). Registry data from 2005 to 2014 on visits for malaria were collected from all eight rural health centers in the study area. Annual household surveys were administered during malaria transmission season in 2011 and 2012 in 1,035 randomly selected rural households. Interrupted time series models were fitted for registry data and Fine and Gray's competing risks models for survey data. User fees abolition in Kaya significantly increased health center use by eligible children with malaria (incidence rate ratio for intercept change = 2.1, p <0.001). In 2011, in Kaya, likelihood of health center use for febrile children was three times higher and CHW use three times lower when caregivers knew services were free. Among the 421 children with fever in 2012, the delay before visiting a health center was significantly shorter in Kaya than in Zorgho (1.46 versus 1.79 days, p <0.05). Likelihood of visiting a health center on the first day of fever among households <2.5 km or <5 km from a health center was two and three times higher in Kaya than in Zorgho, respectively (p <0.001). User fees abolition reduced visit delay for febrile children living close to health centers. It also increased demand for and use of health center for children with malaria. Concurrently, demand for CHWs' services diminished. User fees abolition and CCMm should be coordinated to maximize prompt access to treatment in rural areas.

19 CFR 360.106 - Fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

19 CFR 360.106 - Fees.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

19 CFR 360.106 - Fees.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

19 CFR 360.106 - Fees.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

19 CFR 360.106 - Fees.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

From fuel taxes to mileage-based user fees : rationale, technology, and transitional issues.

DOT National Transportation Integrated Search

2011-08-01

Two national commissions established by the U.S. Congress recommend replacing the current system of funding : transportation based on fuel taxes with a new distance-based system of user fees. The State of Oregon has done a : pilot project demonstrati...

Women's experiences and views about costs of seeking malaria chemoprevention and other antenatal services: a qualitative study from two districts in rural Tanzania.

PubMed

Mubyazi, Godfrey M; Bloch, Paul; Magnussen, Pascal; Olsen, Øystein E; Byskov, Jens; Hansen, Kristian S; Bygbjerg, Ib C

2010-02-17

The Tanzanian government recommends women who attend antenatal care (ANC) clinics to accept receiving intermittent preventive treatment against malaria during pregnancy (IPTp) and vouchers for insecticide-treated nets (ITNs) at subsidized prices. Little emphasis has been paid to investigate the ability of pregnant women to access and effectively utilize these services. To describe the experience and perceptions of pregnant women about costs and cost barriers for accessing ANC services with emphasis on IPTp in rural Tanzania. Qualitative data were collected in the districts of Mufindi in Iringa Region and Mkuranga in Coast Region through 1) focus group discussions (FGDs) with pregnant women and mothers to infants and 2) exit-interviews with pregnant women identified at ANC clinics. Data were analyzed manually using qualitative content analysis methodology. FGD participants and interview respondents identified the following key limiting factors for women's use of ANC services: 1) costs in terms of money and time associated with accessing ANC clinics, 2) the presence of more or less official user-fees for some services within the ANC package, and 3) service providers' application of fines, penalties and blame when failing to adhere to service schedules. Interestingly, the time associated with travelling long distances to ANC clinics and ITN retailers and with waiting for services at clinic-level was a major factor of discouragement in the health seeking behaviour of pregnant women because it seriously affected their domestic responsibilities. A variety of resource-related factors were shown to affect the health seeking behaviour of pregnant women in rural Tanzania. Thus, accessibility to ANC services was hampered by direct and indirect costs, travel distances and waiting time. Strengthening of user-fee exemption practices and bringing services closer to the users, for example by promoting community-directed control of selected public health services, including IPTp, are urgently needed measures for increasing equity in health services in Tanzania.

The elimination of healthcare user fees for children under five substantially alleviates the burden on household expenses in Burkina Faso.

PubMed

Abdou Illou, Mahaman Mourtala; Haddad, Slim; Agier, Isabelle; Ridde, Valéry

2015-08-08

Since September 2008, an intervention has made it possible to provide free care to children under five in public health facilities in two districts of Burkina Faso. This study evaluated the intervention's impact on household expenses incurred for services (consultations and medications) to the children targeted. The study is based on a survey of a representative panel of 1,260 households encountered in two waves, one month before and 12 months after the introduction of the intervention. The questions explored the illness episodes of all children under five in the 30 days before each wave. The analysis of health expenses incurred during an illness episode distinguished between total expenses and those incurred in public health facilities (charges for services and medications). Analyses based on multilevel simultaneous equation models were used to estimate the probability of spending and the amount spent, in a context where a large number of observations returned a count of zero. The burden on household expenses was greatly alleviated under the intervention. Average expenditure dropped from US$11 per episode of care to less than US$2 after the intervention was implemented. The risk of incurring an expense at a public health facility was reduced by two-thirds. The facility users' savings were primarily related to medication purchases. In rural areas, where barriers to access health services are more acute, both poor and non-poor families benefited from the intervention. The probability of spending on medications dropped dramatically for both the poor and the non-poor under the exemption (-75% vs.-77%), and the reduction in expenses for medications generated by the intervention was comparable for both groups in relative values (-86% vs.-89%). User fees abolition at the point of service substantially alleviated the burden on household expenses. The intervention benefited both poor and non-poor families and provided financial protection.

Do free caesarean section policies increase inequalities in Benin and Mali?

PubMed

Ravit, Marion; Audibert, Martine; Ridde, Valéry; De Loenzien, Myriam; Schantz, Clémence; Dumont, Alexandre

2018-06-05

Benin and Mali introduced user fee exemption policies focused on caesarean sections (C-sections) in 2005 and 2009, respectively. These policies had a positive impact on access to C-sections and facility based deliveries among all women, but the impact on socioeconomic inequality is still highly uncertain. The objective of this study was to observe whether there was an increase or a decrease in urban/rural and socioeconomic inequalities in access to C-sections and facility based deliveries after the free C-section policy was introduced. We used data from three consecutive Demographic and Health Surveys (DHS): 2001, 2006 and 2011-2012 in Benin and 2001, 2006 and 2012-13 in Mali. We evaluated trends in inequality in terms of two outcomes: C-sections and facility based deliveries. Adjusted odds ratios were used to estimate whether the distributions of C-sections and facility based deliveries favoured the least advantaged categories (rural, non-educated and poorest women) or the most advantaged categories (urban, educated and richest women). Concentration curves were used to observe the degree of wealth-related inequality in access to C-sections and facility based deliveries. We analysed 47,302 childbirths (23,266 in Benin and 24,036 in Mali). In Benin, we found no significant difference in access to C-sections between urban and rural women or between educated and non-educated women. However, the richest women had greater access to C-sections than the poorest women. There was no significant change in these inequalities in terms of access to C-sections and facility based deliveries after introduction of the free C-section policy. In Mali, we found a reduction in education-related inequalities in access to C-sections after implementation of the policy (p-value = 0.043). Inequalities between urban and rural areas had already decreased prior to implementation of the policy, but wealth-related inequalities were still present. Urban/rural and socioeconomic inequalities in C-section access did not change substantially after the countries implemented free C-section policies. User fee exemption is not enough. We recommend switching to mechanisms that combine both a universal approach and targeted action for vulnerable populations to address this issue and ensure equal health care access for all individuals.

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

8 CFR 286.4 - Fee collection responsibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Fee collection responsibility. 286.4 Section 286.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.4 Fee collection responsibility. (a) It is the responsibility of the air or sea carriers...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2012-10-01 2012-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2013-10-01 2013-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2014-10-01 2014-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2011-10-01 2011-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2010-10-01 2010-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Correction AGENCY: Food and Drug Administration, HHS. ACTION: Notice; correction. SUMMARY: The Food and Drug Administration (FDA) is correcting a notice that appeared...

The Free Caesareans Policy in Low-Income Settings: An Interrupted Time Series Analysis in Mali (2003–2012)

PubMed Central

Fournier, Pierre; Dumont, Alexandre; Tourigny, Caroline; Philibert, Aline; Coulibaly, Aliou; Traoré, Mamadou

2014-01-01

Introduction Several countries have instituted fee exemptions for caesareans to reduce maternal and newborn mortality. Objectives To evaluate the effect of fee exemptions for caesareans on population caesarean rates taking into account different levels of accessibility. Methods The observation period was from January 2003 to May 2012 in one Region and covered 11.7 million person-years. Exemption fees for caesareans were adopted on June 26, 2005. Data were obtained from a registration system implemented in 2003 that tracks all obstetrical emergencies and interventions including caesareans. The pre-intervention period was 30 months and the post-intervention period was 83 months. We used an interrupted time series to evaluate the trend before and after the policy adoption and the overall tendency. Findings During the study period, the caesarean rate increased from 0.25 to 1.5% for the entire population. For women living in cities with district hospitals that provided caesareans, the rate increased from 1.7% before the policy was enforced to 5.7% 83 months later. No significant change in trends was observed among women living in villages with a healthcare centre or those in villages with no healthcare facility. For the latter, the caesarean rate increased from 0.4 to 1%. Conclusions After nine years of implementation policy in Mali, the caesarean rate achieved in cities with a district hospital reached the full beneficial effect of this measure, whereas for women living elsewhere this policy did not increase the caesarean rate to a level that could contribute effectively to reduce their risk of maternal death. Only universal access to this essential intervention could reduce the inequities and increase the effectiveness of this policy. PMID:25137072

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

PubMed

2014-09-30

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

Bribery in health care in Uganda.

PubMed

Hunt, Jennifer

2010-09-01

I examine the role of household permanent income in determining who bribes and how much they bribe in health care in Uganda. I find that rich patients are more likely than other patients to bribe in public health care: doubling household expenditure increases the bribery probability by 1.2 percentage points compared to a bribery rate of 17%. The income elasticity of the bribe amount is about 0.37. Bribes in the Ugandan public sector appear to be fees-for-service extorted from the richer patients amongst those exempted by government policy from paying the official fees. Bribes in the private sector appear to be flat-rate fees paid by patients who do not pay official fees. I do not find evidence that the public health care sector is able to price discriminate less effectively than public institutions with less competition from the private sector. Copyright 2010 Elsevier B.V. All rights reserved.

49 CFR 1002.3 - Updating user fees.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

49 CFR 1002.3 - Updating user fees.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

49 CFR 1002.3 - Updating user fees.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

Report on Surface Transportation Board's user fees

DOT National Transportation Integrated Search

1998-11-17

The objective of Inspector Generals's (IG) audit was to evaluate Surface : Transportation Board's (STB) use of fees to fund its operations. To : accomplish this objective, the IG determined whether: (1) STB is assessing : fees for all billable servic...

77 FR 74055 - Notice of Proposed Amendment to Prohibited Transaction Exemption 2006-06 (PTE 2006-06) for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-12

...This document contains a notice of pendency before the Department of Labor (the Department) of a proposed amendment to PTE 2006-06, a prohibited transaction class exemption issued under the Employee Retirement Income Security Act of 1974 (ERISA). Among other things, PTE 2006-06 permits a ``qualified termination administrator'' (QTA) of an individual account plan that has been abandoned by its sponsoring employer to select itself to provide services to the plan in connection with the plan's termination, and to pay itself fees for those services.

9 CFR 130.30 - Hourly rate and minimum user fees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... food testing. (16) Export-related services provided at animal auctions. (17) Various export-related... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Hourly rate and minimum user fees. 130.30 Section 130.30 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT...

76 FR 76738 - Generic Drug User Fee; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public meeting; request for comments. The Food and Drug Administration (FDA) is announcing a public meeting to...

78 FR 78366 - Draft Generic Drug User Fee Act Information Technology Plan; Availability for Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

...] Draft Generic Drug User Fee Act Information Technology Plan; Availability for Comment AGENCY: Food and... the availability for public comment of the draft information technology (IT) plan entitled ``GDUFA Information Technology Plan.'' This plan is intended to provide FDA's approach for enhancing business...

76 FR 58020 - Prescription Drug User Fee Act IV Information Technology Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

...] Prescription Drug User Fee Act IV Information Technology Plan AGENCY: Food and Drug Administration, HHS. ACTION... information technology (IT) plan entitled ``PDUFA IV Information Technology Plan'' (updated plan) to achieve... Information Technology Plan.'' This plan will meet one of the performance goals agreed to under the 2007...

78 FR 78367 - Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

...] Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment AGENCY... announcing the availability for public comment of the draft information technology (IT) plan entitled ``PDUFA V Information Technology Plan.'' This plan is intended to provide FDA's approach for enhancing...

9 CFR 156.7 - User fees under 9 CFR part 130.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-20

... fingerprint-based Criminal History Record Information (CHRI) checks for noncriminal justice purposes. DATES... user fees for authorized agencies requesting noncriminal fingerprint-based CHRI checks at 28 CFR 20.31(e). The FBI will periodically review the process of fingerprint- based CHRI checks to determine the...

12 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... information; processing requests for records under the Freedom of Information Act (5 U.S.C. 552, as amended)(FOIA); FOIA fees; disclosing otherwise exempt information in litigation when FCA is not a party; and... and Banking FARM CREDIT ADMINISTRATION ADMINISTRATIVE PROVISIONS RELEASING INFORMATION Information and...

5 CFR 2604.402 - Business information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Business information. 2604.402 Section... INFORMATION ACT RULES AND SCHEDULE OF FEES FOR THE PRODUCTION OF PUBLIC FINANCIAL DISCLOSURE REPORTS Exemptions Under FOIA § 2604.402 Business information. (a) In general. Business information provided to the...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

Perinatal mortality among infants born during health user-fees (Cash & Carry) and the national health insurance scheme (NHIS) eras in Ghana: a cross-sectional study.

PubMed

Ibrahim, Abdallah; Maya, Ernest T; Donkor, Ernestina; Agyepong, Irene A; Adanu, Richard M

2016-12-08

This research determined the rates of perinatal mortality among infants delivered under Ghana's national health insurance scheme (NHIS) compared to infants delivered under the previous "Cash and Carry" system in Northern Region, especially as the country takes stock of its progress toward meeting the Millennium Development Goals (MDG) 4 and 5. The labor and maternity wards delivery records of infants delivered before and after the implementation of the NHIS in Northern Region were examined. Records of available daily deliveries during the two health systems were extracted. Fisher's exact tests of non-random association were used to examine the bivariate association between categorical independent variables and perinatal mortality. On average, 8% of infants delivered during the health user-fee (Cash & Carry) died compared to about 4% infant deaths during the NHIS delivery fee exemption period in Northern Region, Ghana. There were no remarkable difference in the rate of infant deaths among mothers in almost all age categories in both the Cash and Carry and the NHIS periods except in mothers age 35 years and older. Infants born to multiparous mothers were significantly more likely to die than those born to first time mothers. There were more twin deaths during the Cash and Carry system (p = 0.001) compared to the NHIS system. Deliveries by caesarean section increased from an average of 14% in the "Cash and Carry" era to an average of 20% in the NHIS era. The overall rate of perinatal mortality declined by half (50%) in infants born during the NHIS era compared to the Cash and Carry era. However, caesarean deliveries increased during the NHIS era. These findings suggest that pregnant women in the Northern Region of Ghana were able to access the opportunity to utilize the NHIS for antenatal visits and possibly utilized skilled care at delivery at no cost or very minimal cost to them, which therefore improved Ghana's progress towards meeting the MDG 4, (reducing under-five deaths by two-thirds).

Health worker perspectives on user fee removal in Zambia

PubMed Central

2012-01-01

Background User fees for primary care services were removed in rural districts in Zambia in 2006. Experience from other countries has suggested that health workers play a key role in determining the success of a fee removal policy, but also find the implementation of such a policy challenging. The policy was introduced against a backdrop of a major shortage in qualified health staff. Methods As part of a larger study on the experience and effect of user fee removal in Zambia, a number of case studies at the facility level were conducted. As part of these, quantitative and qualitative data were collected to evaluate health workers’ satisfaction and experiences in charging and non-charging facilities. Results Our findings show that health-care workers have mixed feelings about the policy change and its consequences. We found some evidence that personnel motivation was higher in non-charging facilities compared to facilities still charging. Yet it is unclear whether this effect was due to differences in the user fee policy or to the fact that a lot of staff interviewed in non-charging facilities were working in mission facilities, where we found a significantly higher motivation. Health workers expressed satisfaction with an apparent increase in the number of patients visiting the facilities and the removal of a deterring factor for many needy patients, but also complained about an increased workload. Furthermore, working conditions were said to have worsened, which staff felt was linked to the absence of additional resources to deal with the increased demand or replace the loss of revenue generated by fees. Conclusion These findings highlight the need to pay attention to supply-side measures when removing demand-side barriers such as user fees and in particular to be concerned about the burden that increased demand can place on already over-stretched health workers. PMID:23110690

47 CFR 1.1162 - General exemptions from regulatory fees.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) service), wireless radio service, common carrier radio service, or international radio service requiring... in the wireless radio, common carrier, or international services where such authorization is to be... conjunction with the provision of the EBS. (i) Applications filed in the wireless radio service for the sole...

48 CFR 415.404-4 - Profit.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Termination settlements; and (v) Cost-plus-award-fee contracts; (b) Unless otherwise restricted by contracting... CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 415.404-4 Profit. (a)(1) USDA will use a... negotiation is based on cost analysis. (2) The following types of acquisitions are exempt from the...

32 CFR 811.5 - Customers exempt from fees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE SALES AND SERVICES RELEASE... for official activities. (c) VI records center materials or services furnished according to law or... activities contributing to an Air Force or DoD objective. (e) Nonprofit organizations for public health...

32 CFR 811.5 - Customers exempt from fees.

Code of Federal Regulations, 2012 CFR

2012-07-01

... National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE SALES AND SERVICES RELEASE... for official activities. (c) VI records center materials or services furnished according to law or... activities contributing to an Air Force or DoD objective. (e) Nonprofit organizations for public health...

32 CFR 811.5 - Customers exempt from fees.

Code of Federal Regulations, 2013 CFR

2013-07-01

... National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE SALES AND SERVICES RELEASE... for official activities. (c) VI records center materials or services furnished according to law or... activities contributing to an Air Force or DoD objective. (e) Nonprofit organizations for public health...

32 CFR 811.5 - Customers exempt from fees.

Code of Federal Regulations, 2014 CFR

2014-07-01

... National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE SALES AND SERVICES RELEASE... for official activities. (c) VI records center materials or services furnished according to law or... activities contributing to an Air Force or DoD objective. (e) Nonprofit organizations for public health...

Public Opinion toward User Fees in Public Libraries.

ERIC Educational Resources Information Center

Kinnucan, Mark T.; Estabrook, Leigh; Ferguson, Mark R.

1998-01-01

A reanalysis of data from a national telephone poll (n1181) conducted in 1991 determined that if local libraries faced a fiscal crisis, 47% favored raising taxes, 44% preferred instituting user fees, and 9% advocated reducing services. Frequent library use, urban residence, higher level of education, and greater income were associated with a…

User fees for recreation services on public lands: a national assessment

Treesearch

J. Michael Bowker; H. Ken Cordell; Cassandra Y. Johnson

1999-01-01

A portion of the 1995 National Survey on Recreation and the Environment examined public opinion toward user fees as a means of funding recreation services on public lands, including campgrounds, boat ramps, trails, picnic areas, historic sites, restrooms, parking areas, special exhibits and presentations, visitor centers, and other facilities. Respondents were offered...

9 CFR 130.20 - User fees for endorsing export certificates.

Code of Federal Regulations, 2013 CFR

2013-01-01

... vaccinations are listed in the following table. The user fees apply to each export health certificate 5... health certificates that require the verification of tests or vaccinations are listed in the following... on the number of animals or birds covered by the certificate and the number of tests or vaccinations...

9 CFR 130.20 - User fees for endorsing export certificates.

Code of Federal Regulations, 2012 CFR

2012-01-01

... vaccinations are listed in the following table. The user fees apply to each export health certificate 5... health certificates that require the verification of tests or vaccinations are listed in the following... on the number of animals or birds covered by the certificate and the number of tests or vaccinations...

9 CFR 130.20 - User fees for endorsing export certificates.

Code of Federal Regulations, 2014 CFR

2014-01-01

... vaccinations are listed in the following table. The user fees apply to each export health certificate 5... health certificates that require the verification of tests or vaccinations are listed in the following... on the number of animals or birds covered by the certificate and the number of tests or vaccinations...

9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

Code of Federal Regulations, 2012 CFR

2012-01-01

... slides or plates Slide 49.00 50.00 51.00 53.00 Reference animal tissues for immunohistochemistry Set 171... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false User fees for FADDL veterinary diagnostics. 130.14 Section 130.14 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

Code of Federal Regulations, 2013 CFR

2013-01-01

... slides or plates Slide 49.00 50.00 51.00 53.00 Reference animal tissues for immunohistochemistry Set 171... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false User fees for FADDL veterinary diagnostics. 130.14 Section 130.14 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

Code of Federal Regulations, 2014 CFR

2014-01-01

... slides or plates Slide 49.00 50.00 51.00 53.00 Reference animal tissues for immunohistochemistry Set 171... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false User fees for FADDL veterinary diagnostics. 130.14 Section 130.14 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

75 FR 53702 - Medical Device User Fee Act; Public Meeting; Request for Comments; Amendment of Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. 2010-N-0389] Medical Device User Fee Act; Public Meeting; Request for Comments; Amendment of Notice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing...

75 FR 76472 - Biologics Price Competition and Innovation Act of 2009; Meetings on User Fee Program for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0602] Biologics Price Competition and Innovation Act of 2009; Meetings on User Fee Program for Biosimilar and Interchangeable Biological Product Applications; Request for Notification of Stakeholder Intention To Participate...

78 FR 46962 - Biosimilar User Fee Rates for Fiscal Year 2014

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

...] Biosimilar User Fee Rates for Fiscal Year 2014 AGENCY: Food and Drug Administration, HHS. ACTION: Notice... fiscal year (FY) 2014. The Federal Food, Drug, and Cosmetic Act (the FD&C Act), as amended by the... October 1, 2013, and will remain in effect through September 30, 2014. FOR FURTHER INFORMATION CONTACT...

9 CFR 130.20 - User fees for endorsing export certificates.

Code of Federal Regulations, 2011 CFR

2011-01-01

... vaccinations are listed in the following table. The user fees apply to each export health certificate 5... health certificates that require the verification of tests or vaccinations are listed in the following... on the number of animals or birds covered by the certificate and the number of tests or vaccinations...

77 FR 51814 - Generic Drug User Fee Amendments of 2012; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0882] Generic Drug User Fee Amendments of 2012; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public meeting; request for comments. SUMMARY: The Food and Drug...

78 FR 27113 - Generic Drug User Fee Amendments of 2012; Regulatory Science Initiatives Public Hearing; Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

.... FDA-2013-N-0402] Generic Drug User Fee Amendments of 2012; Regulatory Science Initiatives Public... public meeting that will provide an overview of the current status of the regulatory science initiatives... societies, and other interested stakeholders-- as it fulfills its statutory requirement under the Generic...

78 FR 72016 - User Fees for Processing Installment Agreements and Offers in Compromise

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

... regulations affect taxpayers who wish to pay their federal tax liabilities through installment agreements and... to pay $43 for any new installment agreement, including a direct debit installment agreement. The... do not have the means to pay the user fee, even at the reduced rate. The commenter stated that low...

The impact of user fees on access to health services in low- and middle-income countries.

PubMed

Lagarde, Mylene; Palmer, Natasha

2011-04-13

Following an international push for financing reforms, many low- and middle-income countries introduced user fees to raise additional revenue for health systems. User fees are charges levied at the point of use and are supposed to help reduce 'frivolous' consumption of health services, increase quality of services available and, as a result, increase utilisation of services. To assess the effectiveness of introducing, removing or changing user fees to improve access to care in low-and middle-income countries We searched 25 international databases, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group's Trials Register, CENTRAL, MEDLINE and EMBASE. We also searched the websites and online resources of international agencies, organisations and universities to find relevant grey literature. We conducted the original searches between November 2005 and April 2006 and the updated search in CENTRAL (DVD-ROM 2011, Issue 1); MEDLINE In-Process & Other Non-Indexed Citations, Ovid (January 25, 2011); MEDLINE, Ovid (1948 to January Week 2 2011); EMBASE, Ovid (1980 to 2011 Week 03) and EconLit, CSA Illumina (1969 - present) on the 26th of January 2011. We included randomised controlled trials, interrupted time-series studies and controlled before-and-after studies that reported an objective measure of at least one of the following outcomes: healthcare utilisation, health expenditures, or health outcomes. We re-analysed studies with longitudinal data. We computed price elasticities of demand for health services in controlled before-and-after studies as a standardised measure. Due to the diversity of contexts and outcome measures, we did not perform meta-analysis. Instead, we undertook a narrative summary of evidence. We included 16 studies out of the 243 identified. Most of the included studies showed methodological weaknesses that hamper the strength and reliability of their findings. When fees were introduced or increased, we found the use of health services decreased significantly in most studies. Two studies found increases in health service use when quality improvements were introduced at the same time as user fees. However, these studies have a high risk of bias. We found no evidence of effects on health outcomes or health expenditure. The review suggests that reducing or removing user fees increases the utilisation of certain healthcare services. However, emerging evidence suggests that such a change may have unintended consequences on utilisation of preventive services and service quality. The review also found that introducing or increasing fees can have a negative impact on health services utilisation, although some evidence suggests that when implemented with quality improvements these interventions could be beneficial. Most of the included studies suffered from important methodological weaknesses. More rigorous research is needed to inform debates on the desirability and effects of user fees.

78 FR 28917 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... Change Establishing Non- Display Usage Fees and Amending the Professional End-User Fees for NYSE Arca... Proposed Rule Change The Exchange proposes to establish non-display usage fees and to amend the... Proposed Rule Change 1. Purpose The Exchange proposes to establish non-display usage fees and to amend the...

78 FR 46980 - Prescription Drug User Fee Rates for Fiscal Year 2014

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... 116.333 The FY 2014 application fee is estimated by dividing the average number of full applications... dividing the adjusted total fee revenue to be derived from establishments ($252,342,667) by the estimated... use this number for its FY 2014 estimate. The FY 2014 product fee rate is determined by dividing the...

14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

Code of Federal Regulations, 2010 CFR

2010-01-01

... occupancy fee will be zero. For a postponed or cancelled shared flight, the occupancy fee will be computed... which is less than zero, the occupancy fee will be reset to zero. For a postponed or cancelled shared flight one year or less, but more than six months before launch, the user shall reimburse NASA an...

Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya

PubMed Central

Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

2016-01-01

In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility’s bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers’ motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. Process evaluations tracking (un)intended consequences of interventions can contribute to regional financing and decentralization debates. PMID:25920355

Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.

PubMed

Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

2016-03-01

In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. Process evaluations tracking (un)intended consequences of interventions can contribute to regional financing and decentralization debates. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

42 CFR 7.6 - Exemptions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... BIOLOGICAL STANDARDS AND BIOLOGICAL PREPARATIONS § 7.6 Exemptions. State and local health departments... ministries of health of foreign governments may be exempted from paying user charges, when using biological standards or biological preparations for public health purposes. ...

78 FR 19315 - Exemptions from Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... cross trade occurs. (d) No brokerage commission, fees or other remuneration is paid in connection with a... remuneration directly or indirectly from an ERISA Account in connection with a cross trade involving an ERISA Account (provided that the trustee of an Account may be expected to receive remuneration on foreign...

11 CFR 9405.11 - Miscellaneous fee provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... accrue from the date of the billing. (b) Charges for unsuccessful search. The Commission may assess charges for time spent searching, even if it fails to locate the records or if the records located are determined to be exempt from disclosure. If the Commission estimates that search charges are likely to exceed...

5 CFR 1303.60 - Miscellaneous fee provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... INFORMATION PROVISIONS OF THE ADMINISTRATIVE PROCEDURES ACT Charges for Search and Reproduction § 1303.60... unsuccessful search. OMB may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from disclosure. If OMB estimates that search charges...

11 CFR 9405.11 - Miscellaneous fee provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... accrue from the date of the billing. (b) Charges for unsuccessful search. The Commission may assess charges for time spent searching, even if it fails to locate the records or if the records located are determined to be exempt from disclosure. If the Commission estimates that search charges are likely to exceed...

5 CFR 1303.60 - Miscellaneous fee provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... INFORMATION PROVISIONS OF THE ADMINISTRATIVE PROCEDURES ACT Charges for Search and Reproduction § 1303.60... unsuccessful search. OMB may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from disclosure. If OMB estimates that search charges...

5 CFR 1303.60 - Miscellaneous fee provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... INFORMATION PROVISIONS OF THE ADMINISTRATIVE PROCEDURES ACT Charges for Search and Reproduction § 1303.60... unsuccessful search. OMB may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from disclosure. If OMB estimates that search charges...

11 CFR 9405.11 - Miscellaneous fee provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... accrue from the date of the billing. (b) Charges for unsuccessful search. The Commission may assess charges for time spent searching, even if it fails to locate the records or if the records located are determined to be exempt from disclosure. If the Commission estimates that search charges are likely to exceed...

11 CFR 9405.11 - Miscellaneous fee provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... accrue from the date of the billing. (b) Charges for unsuccessful search. The Commission may assess charges for time spent searching, even if it fails to locate the records or if the records located are determined to be exempt from disclosure. If the Commission estimates that search charges are likely to exceed...

18 CFR 4.300 - Purpose, definitions, and applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) PURPA benefits means benefits under section 210 of the Public Utility Regulatory Policies Act of 1978..., EXEMPTIONS, AND DETERMINATION OF PROJECT COSTS Fees Under Section 30(e) of the Act § 4.300 Purpose... establishes procedures for reimbursing fish and wildlife agencies for costs incurred in connection with...

47 CFR 0.401 - Location of Commission offices.

Code of Federal Regulations, 2012 CFR

2012-10-01

... exemption, waiver or deferral from the fee requirement), should be delivered to one of the following... Commission, P.O. Box IT-70, Gettysburg, PA 17326. (4) The locations of the field offices of the Compliance... boxes for the receipt of different types of applications. It will also establish special post office...

78 FR 48366 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Uniform Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-08

... Organization (HMO) Benefit--Prime Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and... Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their... uniform within the following groups: dependents of active duty members in [[Page 48367

47 CFR 1.1162 - General exemptions from regulatory fees.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the international broadcast (HF) service), wireless radio service, common carrier radio service, or..., E, F, and G of part 74 of this chapter) or stations in the wireless radio, common carrier, or... in the wireless radio service for the sole purpose of modifying an existing authorization (or a...

47 CFR 1.1162 - General exemptions from regulatory fees.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the international broadcast (HF) service), wireless radio service, common carrier radio service, or..., E, F, and G of part 74 of this chapter) or stations in the wireless radio, common carrier, or... in the wireless radio service for the sole purpose of modifying an existing authorization (or a...

47 CFR 1.1162 - General exemptions from regulatory fees.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the international broadcast (HF) service), wireless radio service, common carrier radio service, or..., E, F, and G of part 74 of this chapter) or stations in the wireless radio, common carrier, or... in the wireless radio service for the sole purpose of modifying an existing authorization (or a...

44 CFR 5.46 - Fee schedule.

Code of Federal Regulations, 2010 CFR

2010-10-01

... records responsive to a FOIA request and operator/programmer salary apportionable to the search. FEMA may... are determined to be exempt from disclosure. (c) Duplication costs. (1) For copies of documents... rate prescribed in section 3717 of Title 31 U.S.C. and will accrue from the date of the billing. (e...

44 CFR 5.46 - Fee schedule.

Code of Federal Regulations, 2011 CFR

2011-10-01

... records responsive to a FOIA request and operator/programmer salary apportionable to the search. FEMA may... are determined to be exempt from disclosure. (c) Duplication costs. (1) For copies of documents... rate prescribed in section 3717 of Title 31 U.S.C. and will accrue from the date of the billing. (e...

36 CFR 1250.56 - Fee schedule for NARA operational records.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., the rate is $33 per hour (or fraction thereof) (2) Computer searching. This is the actual cost to NARA of operating the computer and the salary of the operator. When the search is relatively... issues regarding the application of exemptions. (c) Reproduction fees—(1) Self-service photocopying. At...

36 CFR 1250.56 - Fee schedule for NARA operational records.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., the rate is $33 per hour (or fraction thereof) (2) Computer searching. This is the actual cost to NARA of operating the computer and the salary of the operator. When the search is relatively... issues regarding the application of exemptions. (c) Reproduction fees—(1) Self-service photocopying. At...

36 CFR 1250.56 - Fee schedule for NARA operational records.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., the rate is $33 per hour (or fraction thereof) (2) Computer searching. This is the actual cost to NARA of operating the computer and the salary of the operator. When the search is relatively... issues regarding the application of exemptions. (c) Reproduction fees—(1) Self-service photocopying. At...

Working practices and incomes of health workers: evidence from an evaluation of a delivery fee exemption scheme in Ghana

PubMed Central

Witter, Sophie; Kusi, Anthony; Aikins, Moses

2007-01-01

Background This article describes a survey of health workers and traditional birth attendants (TBAs) which was carried out in 2005 in two regions of Ghana. The objective of the survey was to ascertain the impact of the introduction of a delivery fee exemption scheme on both health workers and those providers who were excluded from the scheme (TBAs). This formed part of an overall evaluation of the delivery fee exemption scheme. The results shed light not only on the scheme itself but also on the general productivity of a range of health workers in Ghana. Methods A structured questionnaire was developed, covering individual and household characteristics, working hours and practices, sources of income, and views of the exemptions scheme and general motivation. After field testing, this was administered to 374 respondents in 12 districts of Central and Volta regions. The respondents included doctors, medical assistants (MAs), public and private midwives, nurses, community health nurses (CHNs), and traditional birth attendants, both trained and untrained. Results Health workers were well informed about the delivery fee exemptions scheme and their responses on its impact suggest a realistic view that it was a good scheme, but one that faces serious challenges regarding financial sustainability. Concerning its impact on their morale and working conditions, the responses were broadly neutral. Most public sector workers have seen an increased workload, but counterbalanced by increased pay. TBAs have suffered, in terms of client numbers and income, while the picture for private midwives is mixed. The survey also sheds light on pay and productivity. The respondents report long working hours, with a mean of 54 hours per week for community nurses and up to 129 hours per week for MAs. Weekly reported client loads in the public sector range from a mean of 86 for nurses to 269 for doctors. Over the past two years, reported working hours have been increasing, but so have pay and allowances (for doctors, allowances now make up 66% of their total pay). The lowest paid public health worker now earns almost ten times the average gross national income (GNI) per capita, while the doctors earn 38.5 times GNI per capita. This compares well with average government pay of four times GNI per capita. Comparing pay with outputs, the relatively high number of clients reported by doctors reduces their pay differential, so that the cost per client – $1.09 – is similar to a nurse's (and lower than a private midwife's). Conclusion These findings show that a scheme which increases demand for public health services while also sustaining health worker income and morale, is workable, if well managed, even within the relatively constrained human resources environment of countries like Ghana. This may be linked to the fact that internal comparisons reveal Ghana's health workers to be well paid from public sector sources. PMID:17241454

78 FR 15019 - Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0196] Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice, request for comments. SUMMARY: The Food and...

75 FR 20616 - Information Collection Request to Office of Management and Budget; OMB Control Numbers: 1625-0007...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

... Liquid Chemicals Proposed for Bulk Water Movement; (2) 1625-0074, Direct User Fees for Inspection or... of Intent and Operations Manual; and (5) 1625-0102, National Response Resource Inventory. Before...: The estimated burden has increased from 78 hours to 600 hours a year. 2. Title: Direct User Fees for...

75 FR 39551 - Collection of Information Under Review by Office of Management and Budget; OMB Control Numbers...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

... Liquid Chemicals Proposed for Bulk Water Movement; (2) 1625-0074, Direct User Fees for Inspection or... of Intent and Operations Manual; and (5) 1625-0102, National Response Resource Inventory. Our ICRs...: Direct User Fees for Inspection or Examination of U.S. and Foreign Commercial Vessels. OMB Control Number...

78 FR 65349 - Collection of Information Under Review by Office of Management and Budget

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... following collections of information: 1625-0074, Direct User Fees for Inspection or Examination of U.S. and... Manual. Our ICRs describe the information we seek to collect from the public. Review and comments by OIRA... User Fees for Inspection or Examination of U.S. and Foreign Commercial Vessels. OMB Control Number...

It's Not the Principle, It's the Money of the Thing.

ERIC Educational Resources Information Center

Budd, John M.

1989-01-01

Asserts that, although many arguments in favor of user fees for library services are based on economics, little economic benefit is actually gained by levying charges for some services. A microeconomics model that has been used to demonstrate the benefits of user fees is critiqued, and the issue of accountability is discussed. (23 references) (CLB)

76 FR 67522 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for... scope of potential ``Users'' of its co-location services to include any market participant that requests...

76 FR 67526 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

..., order routing and market data delivery services to their customers while the User is co-located in the... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for...

76 FR 79242 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Approving a Proposed Rule Change Expanding...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

..., order routing and market data delivery services to their customers while the User is co-located in the... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant that Requests to Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

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

76 FR 45814 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0547] Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2012 AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the rates and...

78 FR 28669 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-15

... ``Options Pricing'' section of its fee schedule effective immediately, in order to (i) increase fees for any...'') thresholds. The Exchange offers a bulk-quoting interface which allows Users \\6\\ of BATS Options to submit and... receipt. The bulk-quoting application for BATS Options is a particularly useful feature for Users that...

NBS (National Bureau of Standards) calibration services users guide: Fee schedule

NASA Astrophysics Data System (ADS)

1987-04-01

The physical measurement services of the National Bureau of Standards are designed to help the makers and users of precision instruments achieve the highest possible levels of measurement quality and productivity. The hundreds of individual services found listed in the Fee Schedule constitute the highest-order calibration services available in the United States. These services directly link a customer's precision equipment or transfer standards to national measurement standards. These services are offered to public and private organizations and individuals alike. The Fee Schedule is a supplement to NBS Special Publication 250, Calibration Services Users Guide. These documents are designed to make the task of selecting and ordering an appropriate calibration service as quick and easy as possible.

Techniques for assessing the socio-economic effects of vehicle mileage fees.

DOT National Transportation Integrated Search

2008-06-01

The purpose of this study was to develop tools for assessing the distributional effects of alternative highway user fees for light vehicles : in Oregon. The analysis focused on a change from the current gasoline tax to a VMT fee structure for collect...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-25

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

AdaNET research project

NASA Technical Reports Server (NTRS)

Digman, R. Michael

1988-01-01

The components necessary for the success of the commercialization of an Ada Technology Transition Network are reported in detail. The organizational plan presents the planned structure for services development and technical transition of AdaNET services to potential user communities. The Business Plan is the operational plan for the AdaNET service as a commercial venture. The Technical Plan is the plan from which the AdaNET can be designed including detailed requirements analysis. Also contained is an analysis of user fees and charges, and a proposed user fee schedule.

76 FR 40964 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... Schedule to extend a fee waiver related to the PULSe workstation and to adopt a limited fee waiver for new users of the PULSe workstation. The text of the proposed rule change is available on the Exchange's Web... is to extend a fee waiver related to the PULSe workstation and to adopt a limited fee waiver for new...

78 FR 3900 - Generic Drug User Fee-Active Pharmaceutical Ingredient and Finished Dosage Form Facility Fee...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-17

... facility fee, we divide the $132,945,000 by the total number of facilities (758) which gives us a domestic... domestic API facility fee, we divide the $23,415,000 by the total number of facilities (885) which gives us..., Attention: Government Lockbox 979108, 1005 Convention Plaza, St. Louis, MO 63101. (Note: This U.S. Bank...

Potential revenues from a new day-use fee

Treesearch

Stephen D. Reiling; Hsiang-tai Cheng

1995-01-01

The Corps of Engineers will be implementing a new user fee at day-use areas during the next two years. This paper presents the procedures used to estimate the revenue that the new fee would generate at six Corps projects located across the U.S. The results suggest that revenues will fall well short of the naive projection calculated on the assumption that the new fee...

77 FR 20536 - Exemptions for Security-Based Swaps Issued by Certain Clearing Agencies

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... Markets Trends, Division of Corporation Finance, at (202) 551-3860, U.S. Securities and Exchange... exchange trading due to individual business needs of certain users. Those users should retain the ability... Corporation Finance issued a no-action letter that addressed the availability of these interim exemptions to...

9 CFR 130.11 - User fees for inspecting and approving import/export facilities and establishments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... hourly user fee rate in § 130.30(2) applies to biosecurity level two laboratories. (b) [Reserved] [65 FR... approval) Per year $537.00 $553.00 $570.00 $587.00 $604.00 Inspection for approval of biosecurity level three labs (all inspections related to approving the laboratory for handling one defined set of...

75 FR 33761 - Notice of a New Fee Site; Federal Lands Recreation Enhancement Act (Title VIII, Pub. L. 108-447)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... $5.00 daily user fee or accept the $20 annual user vehicle sticker at the Beck Road Trailhead based... Beck Road Trailhead on the Chequamegon-Nicolet National Forest will provide a much needed trailhead... communities of Drummond, Barnes, Cable, Delta, and Iron River. The funds collected at the Beck Road Trailhead...

The Hidden Costs of a Free Caesarean Section Policy in West Africa (Kayes Region, Mali).

PubMed

Ravit, Marion; Philibert, Aline; Tourigny, Caroline; Traore, Mamadou; Coulibaly, Aliou; Dumont, Alexandre; Fournier, Pierre

2015-08-01

The fee exemption policy for EmONC in Mali aims to lower the financial barrier to care. The objective of the study was to evaluate the direct and indirect expenses associated with caesarean interventions performed in EmONC and the factors associated with these expenses. Data sampling followed the case control approach used in the large project (deceased and near-miss women). Our sample consisted of a total of 190 women who underwent caesarean interventions. Data were collected from the health workers and with a social approach by administering questionnaires to the persons who accompanied the woman. Household socioeconomic status was assessed using a wealth index constructed with a principal component analysis. The factors significantly associated with expenses were determined using multivariate linear regression analyses. Women in the Kayes region spent on average 77,017 FCFA (163 USD) for a caesarean episode in EmONC, of which 70 % was for treatment. Despite the caesarean fee exemption, 91 % of the women still paid for their treatment. The largest treatment-related direct expenses were for prescriptions, transfusion, antibiotics, and antihypertensive medication. Near-misses, women who presented a hemorrhage or an infection, and/or women living in rural areas spent significantly more than the others. Although abolishing fees of EmONC in Mali plays an important role in reducing maternal death by increasing access to caesarean sections, this paper shows that the fee policy did not benefit to all women. There are still barriers to EmONC access for women of the lowest socio-economic group. These included direct expenses for drugs prescription, treatment and indirect expenses for transport and food.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

... Fees for 2013 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing Service... cotton producers for 2013 crop cotton classification services at $2.20 per bale--the same level as in 2012. Revenues resulting from this cotton classing fee and existing reserves are sufficient to cover...

36 CFR 404.9 - Miscellaneous fee provisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... United States Code and will accrue from the date of the billing. (b) Charges for unsuccessful search. ABMC may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from disclosure. If ABMC estimates that search charges are likely to...

36 CFR § 404.9 - Miscellaneous fee provisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... United States Code and will accrue from the date of the billing. (b) Charges for unsuccessful search. ABMC may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from disclosure. If ABMC estimates that search charges are likely to...

36 CFR 404.9 - Miscellaneous fee provisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... United States Code and will accrue from the date of the billing. (b) Charges for unsuccessful search. ABMC may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from disclosure. If ABMC estimates that search charges are likely to...

36 CFR 404.9 - Miscellaneous fee provisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... United States Code and will accrue from the date of the billing. (b) Charges for unsuccessful search. ABMC may assess charges for time spent searching, even if it fails to locate the records or if records located are determined to be exempt from disclosure. If ABMC estimates that search charges are likely to...

10 CFR 1004.7 - Responses by authorizing officials: Form and content.

Code of Federal Regulations, 2010 CFR

2010-01-01

....7 Section 1004.7 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) FREEDOM OF INFORMATION § 1004.7... this Regulation, the Freedom of Information Act, and where the applicable fees are $15 or less or where... denial, containing a reference to the specific exemption under the Freedom of Information Act authorizing...

78 FR 34292 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Uniform Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

... Organization (HMO) Benefit--Prime Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and... Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their... uniform within the following groups: dependents of active duty members in pay grades of E-4 and below...

Alternative Fuels Data Center

Science.gov Websites

Alternative fuel vehicles (AFVs) displaying the proper alternative fuel license plate may use HOV receiving the license plate. This exemption expires September 30, 2019. For more information on fees and eligibility for the AFV license plate, see the Georgia Department of Revenue and the Georgia Department of

78 FR 49478 - National Saltwater Angler Registry Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

... twenty-five dollars ($25.00) for registration of anglers, spear fishers and for-hire fishing vessels to... to twenty-five dollars ($25.00). All persons registering on or after August 1, 2013 will be required to pay that registration fee, unless they are exempt as indigenous people per the provisions of 50...

36 CFR § 1250.56 - Fee schedule for NARA operational records.

Code of Federal Regulations, 2013 CFR

2013-07-01

... professional employee of NARA, the rate is $33 per hour (or fraction thereof) (2) Computer searching. This is the actual cost to NARA of operating the computer and the salary of the operator. When the search is... general legal or policy issues regarding the application of exemptions. (c) Reproduction fees—(1) Self...

17 CFR 240.31 - Section 31 transaction fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of a security future settled by physical delivery) or covered round turn transaction that a covered... resulting from the maturation of a security future settled by physical delivery; and (iv) The trade date.... (6) Covered sale means a sale of a security, other than an exempt sale or a sale of a security future...

78 FR 66746 - Medical Device User Fee and Modernization Act; Notice to Public of Web Site Location of Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-06

...] Medical Device User Fee and Modernization Act; Notice to Public of Web Site Location of Fiscal Year 2014... and Drug Administration (FDA or the Agency) is announcing the Web site location where the Agency will... documents, FDA has committed to updating its Web site in a timely manner to reflect the Agency's review of...

Road user fee task force report to the 72nd Oregon Legislative Assembly on the possible alternatives of the current system of taxing highway use through motor vehicle fuel taxes

DOT National Transportation Integrated Search

2003-03-01

Recognizing that the fuel tax is a declining revenue source for Oregon's road system, the 2001 Oregon Legislative Assembly passed House Bill 3946, mandating the formation of the Road User Fee Task Force with the mission to develop a design for revenu...

User-fee-removal improves equity of children's health care utilization and reduces families' financial burden: evidence from Jamaica.

PubMed

Li, Zhihui; Li, Mingqiang; Fink, Günther; Bourne, Paul; Bärnighausen, Till; Atun, Rifat

2017-06-01

The impact of user-fee policies on the equity of health care utilization and households' financial burdens has remained largely unexplored in Latin American and the Caribbean, as well as in upper-middle-income countries. This paper assesses the short- and long-term impacts of Jamaica's user-fee-removal for children in 2007. This study utilizes 14 rounds of data from the Jamaica Survey of Living Conditions (JSLC) for the periods 1996 to 2012. JSLC is a national household survey, which collects data on health care utilization and among other purposes for planning. Interrupted time series (ITS) analysis was used to examine the immediate impact of the user-fee-removal policy on children's health care utilization and households' financial burdens, as well as the impact in the medium- to long-term. Immediately following the implementation of user-fee-removal, the odds of seeking for health care if the children fell ill in the past 4 weeks increased by 97% (odds ratio 2.0, 95% confidence interval (CI) 1.1 to 3.5, P  = 0.018). In the short-term (2007-2008), health care utilization increased at a faster rate among children not in poverty than children in poverty; while this gap narrowed after 2008. There was minimal difference in health care utilization across wealth groups in the medium- to long-term. The household's financial burden (health expenditure as a share of household's non-food expenditures) reduced by 6 percentage points (95% CI: -11 to -1, P  = 0.020) right after the policy was implemented and kept at a low level. The difference in financial burden between children in poverty and children not in poverty shrunk rapidly after 2007 and remained small in subsequent years. User-fee-removal had a positive impact on promoting health care utilization among children and reducing their household health expenditures in Jamaica. The short-term and the medium- to long-term results have different indications: In the short-term, the policy deteriorated the equity of access to health care for children, while the equity status improved fast in the medium- to long-term.

77 FR 65199 - Generic Drug User Fee-Backlog Fee Rate for Fiscal Year 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-25

... payment to ensure that your backlog fee is fully paid. The account information is as follows: New York... INFORMATION CONTACT: David Miller, Office of Financial Management (HFA-100), Food and Drug Administration, 1350 Piccard Dr., PI50, rm. 210J, Rockville, MD 20850, 301-796-7103. SUPPLEMENTARY INFORMATION: I...

76 FR 39788 - Regulations Governing Fees for Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board 49 CFR Part 1002 [Docket No. EP 542 (Sub... governing user fees for services performed, 49 CFR 1002.2(f), Part V, by lowering the fee for sub-item 56(iv... complaint to the Board. For example, over the past 10 years, our Rail Consumer and Public Assistance unit...

49 CFR 360.5 - Updating user fees.

Code of Federal Regulations, 2014 CFR

2014-10-01

... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent...

8 CFR 286.2 - Fee for arrival of passengers aboard commercial aircraft or commercial vessels.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.2 Fee for arrival of passengers aboard..., per individual is charged and collected by the Commissioner for the immigration inspection of each... Act, per individual, is charged and collected by the Commissioner for the immigration inspection at a...

An evaluability assessment of a West Africa based Non-Governmental Organization's (NGO) progressive evaluation strategy.

PubMed

D'Ostie-Racine, Léna; Dagenais, Christian; Ridde, Valéry

2013-02-01

While program evaluations are increasingly valued by international organizations to inform practices and public policies, actual evaluation use (EU) in such contexts is inconsistent. Moreover, empirical literature on EU in the context of humanitarian Non-Governmental Organizations (NGOs) is very limited. The current article focuses on the evaluability assessment (EA) of a West-Africa based humanitarian NGO's progressive evaluation strategy. Since 2007, the NGO has established an evaluation strategy to inform its maternal and child health care user-fee exemption intervention. Using Wholey's (2004) framework, the current EA enabled us to clarify with the NGO's evaluation partners the intent of their evaluation strategy and to design its program logic model. The EA ascertained the plausibility of the evaluation strategy's objectives, the accessibility of relevant data, and the utility for intended users of evaluating both the evaluation strategy and the conditions that foster EU. Hence, key evaluability conditions for an EU study were assured. This article provides an example of EA procedures when such guidance is scant in the literature. It also offers an opportunity to analyze critically the use of EAs in the context of a humanitarian NGO's collaboration with evaluators and political actors. Copyright © 2012 Elsevier Ltd. All rights reserved.

Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria

PubMed Central

Uzochukwu, Benjamin SC; Onwujekwe, Obinna E

2004-01-01

Background Malaria is one of the leading causes of mortality and morbidity in Nigeria. It is not known how user fees introduced under the Bamako Initiative (BI) system affect healthcare seeking among different socio-economic groups in Nigeria for diagnosis and treatment of malaria. Reliable information is needed to initiate new policy thrusts to protect the poor from the adverse effect of user fees. Methods Structured questionnaires were used to collect information from 1594 female household primary care givers or household head on their socio-economic and demographic status and use of malaria diagnosis and treatment services. Principal components analysis was used to create a socio-economic status index which was decomposed into quartiles and chi-square for trends was used to calculate for any statistical difference. Results The study showed that self diagnosis was the commonest form of diagnosis by the respondents. This was followed by diagnosis through laboratory tests, community health workers, family members and traditional healers. The initial choice of care for malaria was a visit to the patent medicine dealers for most respondents. This was followed by visit to the government hospitals, the BI health centres, traditional medicine healers, private clinics, community health workers and does nothing at home. Furthermore, the private health facilities were the initial choice of treatment for the majority with a decline among those choosing them as a second source of care and an increase in the utilization of public health facilities as a second choice of care. Self diagnosis was practiced more by the poorer households while the least poor used the patent medicine dealers and community health workers less often for diagnosis of malaria. The least poor groups had a higher probability of seeking treatment at the BI health centres (creating equity problem in BI), hospitals, and private clinics and in using laboratory procedures. The least poor also used the patent medicine dealers and community health workers less often for the treatment of malaria. The richer households complained more about poor staff attitude and lack of drugs as their reasons for not attending the BI health centres. The factors that encourage people to use services in BI health centres were availability of good services, proximity of the centres to the homes and polite health workers. Conclusions Factors deterring people from using BI centres should be eliminated. The use of laboratory services for the diagnosis of malaria by the poor should be encouraged through appropriate information, education and communication which at the long run will be more cost effective and cost saving for them while devising means of reducing the equity gap created. This could be done by granting a properly worked out and implemented fee exemptions to the poor or completely abolishing user fees for the diagnosis and treatment of malaria in BI health centres. PMID:15202941

Colorado mileage-based user fee study.

DOT National Transportation Integrated Search

2013-12-01

The Transportation Research Board, Government Accountability Office, and Colorado Transportation : Finance and Implementation Panel (CTFIP) suggested that Colorado pursue fees based on actual travel : as an alternative to the fuel tax. Revenues from ...

Circumventing 'free care' and 'shouting louder': using a health systems approach to study eye health system sustainability in government and mission facilities of north-west Tanzania.

PubMed

Palmer, Jennifer J; Gilbert, Alice; Choy, Michelle; Blanchet, Karl

2016-09-09

Little is known about the contributions of faith-based organisations (FBOs) to health systems in Africa. In the specialist area of eye health, international and domestic Christian FBOs have been important contributors as service providers and donors, but they are also commonly critiqued as having developed eye health systems parallel to government structures which are unsustainable. In this study, we use a health systems approach (quarterly interviews, a participatory sustainability analysis exercise and a social network analysis) to describe the strategies used by eye care practitioners in four hospitals of north-west Tanzania to navigate the government, church mission and donor rules that govern eye services delivery there. Practitioners in this region felt eye care was systemically neglected by government and therefore was 'all under the NGOs', but support from international donors was also precarious. Practitioners therefore adopted four main strategies to improve the sustainability of their services: (1) maintain 'sustainability funds' to retain financial autonomy over income; (2) avoid granting government user fee exemptions to elderly patients who are the majority of service users; (3) expand or contract outreach services as financial circumstances change; and (4) access peer support for problem-solving and advocacy. Mission-based eye teams had greater freedom to increase their income from user fees by not implementing government policies for 'free care'. Teams in all hospitals, however, found similar strategies to manage their programmes even when their management structures were unique, suggesting the importance of informal rules shared through a peer network in governing eye care in this pluralistic health system. Health systems research can generate new evidence on the social dynamics that cross public and private sectors within a local health system. In this area of Tanzania, Christian FBOs' investments are important, not only in terms of the population health outcomes achieved by teams they support, but also in the diversity of organisational models they contribute to in the wider eye health system, which facilitates innovation.

9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

Code of Federal Regulations, 2010 CFR

2010-01-01

... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

78 FR 46977 - Generic Drug User Fee-Abbreviated New Drug Application, Prior Approval Supplement, Drug Master...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... costs to total FDA costs of the review of human generic drug activities for the first 3 of the preceding... review of human generic drug activities. Since the first year of the Generic Drug User Fee Program has... activities other than PC&B (see section 744B(c)(1)(C) of the FD&C Act). Table 3 of this document provides the...

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

Code of Federal Regulations, 2013 CFR

2013-01-01

....00 2.00 Online In-Situ Digital Data 6.00 6.00 Data Poster 18.00 18.00 Shipping Service for orders... * 11.00 Additional National Geophysical Data Center (NGDC) User Fees: Mini Poster 1.00 1.00 Icosahedron... 7,665.00 8,032.00 Data Poster * 18.00 High Definition Geomagnetic Model * 19,997.00 * Reflects a new...

9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

Code of Federal Regulations, 2012 CFR

2012-01-01

... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

Code of Federal Regulations, 2014 CFR

2014-01-01

... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

Code of Federal Regulations, 2013 CFR

2013-01-01

... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

Code of Federal Regulations, 2011 CFR

2011-01-01

... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

National Practitioner Data Bank; change in user fee and elimination of diskette queries--HRSA. Withdrawal.

PubMed

1998-02-13

National Practitioner Data Bank; Change in User Fee and Elimination of Diskette Queries notice, document 98-2637, pages 5811-5812, Volume 63, Number 23, in the issue of Wednesday, February 4, 1998, was published in error and is withdrawn from publication. The correct version of the notice was published on Thursday, January 29, 1998, Document No. 98-2116, Volume 63, Number 19, page 4460.

78 FR 26841 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-08

... Application and Initiation Fees, for a defined period of time, in order that certain market making firms may... Exchange at the request of such traders, unless specifically exempted from such quoting (market-making... on market making firms. The Exchange operates in a highly competitive market, comprised of eleven...

To amend the Immigration and Nationality Act to exempt elementary and secondary schools from the fee imposed on employers filing petitions with respect to non-immigration workers under the H-1B program.

THOMAS, 111th Congress

Rep. Green, Gene [D-TX-29

2009-01-07

House - 02/09/2009 Referred to the Subcommittee on Immigration, Citizenship, Refugees, Border Security, and International Law. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

77 FR 14580 - Order Granting Temporary Exemption of Morningstar Credit Ratings, LLC From the Conflict of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

.... Morningstar traditionally has operated mainly under the ``subscriber-paid'' business model, in which the NRSRO... Realpoint in the spring of 2010, Morningstar began to expand the scope of its business and initiated an... business, in the early stages of its expansion the fees associated with a single issuer-paid engagement...

78 FR 75631 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... such, NASDAQ believes it is appropriate to treat these companies the same as domestic companies for... from most of NASDAQ's corporate governance requirements under Rule 5615(a)(3), a foreign company that... exemption from many of NASDAQ's corporate governance rules. While the proposed $7,500 per year fee would...

76 FR 79233 - Self-Regulatory Organizations; NYSE Amex LLC; Order Approving a Proposed Rule Change Expanding...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant that Requests To Receive Co-Location Services Directly from the Exchange and Amending Its Fee Schedule To Establish a Fee for... co-location services, and to amend its Fee Schedule. The proposed rule change was published for...

The Pricing of Information--A Search-Based Approach to Pricing an Online Search Service.

ERIC Educational Resources Information Center

Boyle, Harry F.

1982-01-01

Describes innovative pricing structure consisting of low connect time fee, print fees, and search fees, offered by Chemical Abstracts Service (CAS) ONLINE--an online searching system used to locate chemical substances. Pricing options considered by CAS, the search-based pricing approach, and users' reactions to pricing structures are noted. (EJS)

7 CFR 504.2 - Fees for deposit and requisition of microbial cultures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Fees for deposit and requisition of microbial cultures... cultures. (a) Depositors of microbial cultures must pay a one-time $500 user fee for each culture deposited on or after November 1, 1983. (b) For cultures deposited on or after November 1, 1983, requesters...

75 FR 81110 - Schedule of Fees for Access to NOAA Environmental Data, Information, and Related Products and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

... Related Products and Services AGENCY: National Environmental Satellite, Data and Information Service..., information, and related products and services to users. NESDIS is revising the fee schedule to ensure that... related products and services. NESDIS is authorized under 15 U.S.C. 1534 to assess fees, up to fair market...

8 CFR 286.8 - Establishment of pilot programs for the charging of a land border fee for inspection services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.8 Establishment of pilot... charge fees for immigration inspection services to be collected by the Commissioner. Individual ports-of... inspection services and to recover the cost of: (a) Hiring additional immigration inspectors, including all...

49 CFR 360.5 - Updating user fees.

Code of Federal Regulations, 2011 CFR

2011-10-01

... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

49 CFR 360.5 - Updating user fees.

Code of Federal Regulations, 2013 CFR

2013-10-01

... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

49 CFR 360.5 - Updating user fees.

Code of Federal Regulations, 2012 CFR

2012-10-01

... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

40 CFR 700.45 - Fee payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... shall be in United States currency and shall be paid by money order, bank draft, wire transfer, Pay.gov... Finance Center, Toxic Substances Control Act User Fees, P.O. Box 979073, St. Louis, MO 63197-9000. (3...

Relationship between pharmaceutical company user fees and drug approvals in Canada and Australia: a hypothesis-generating study.

PubMed

Lexchin, Joel

2006-12-01

Since the early- to mid-1990s, drug companies have paid fees for a variety of activities carried out by the Therapeutic Products Directorate in Canada and the Therapeutic Goods Administration in Australia. To explore whether changes in approval times for new active substances and in the percentage of new drug submissions receiving positive decisions coincided with the level of user fees. Data were collected from a range of Canadian and Australian government publications on the following topics: total funding for and workload of the regulatory agencies, the percentage of income that came from tax revenue and user fees, the percentage of new drug submissions that received a positive decision, and-for Canada only-the percent of submissions that were approved on first review. In both countries, there was a moderate-to-strong positive association between the level of industry funding and the percent of submissions that received a positive decision and a moderate-to-strong (Canada) and moderate (Australia) negative association between the level of industry funding and approval times. Changes observed in both countries are favorable to the pharmaceutical industry. Other than user fees leading to a pro-industry bias in the regulatory authorities, other possible explanations include a more efficient use of resources, a smaller workload (Canada), an improvement in the quality of drug submissions (Canada), and more resources (Australia). Further research strategies are needed to either confirm or refute the hypothesis that the level of industry funding affects decisions made in drug regulatory systems.

Modeling Freight Ocean Rail and Truck Transportation Flows to Support Policy Analyses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gearhart, Jared Lee; Wang, Hao; Nozick, Linda Karen

Freight transportation represents about 9.5% of GDP, is responsible for about 8% of greenhouse gas emissions and supports the import and export of about 3.6 trillion in international trade; hence it is important that our national freight transportation system is designed and operated efficiently and embodies user fees and other policies that balance costs and environmental consequences. Hence, this paper develops a mathematical model to estimate international and domestic freight flows across ocean, rail and truck modes which can be used to study the impacts of changes in our infrastructure as well as the imposition of new user fees andmore » changes in operating policies. This model is applied to two case studies: (1) a disruption of the maritime ports at Los Angeles/Long Beach similar to the impacts that would be felt in an earthquake; and (2) implementation of new user fees at the California ports.« less

Public policies and health systems in Sahelian Africa: theoretical context and empirical specificity

PubMed Central

2015-01-01

This research on user fee removal in three African countries is located at the interface of public policy analysis and health systems research. Public policy analysis has gradually become a vast and multifaceted area of research consisting of a number of perspectives. But the context of public policies in Sahelian Africa has some specific characteristics. They are largely shaped by international institutions and development agencies, on the basis of very common 'one-size-fits-all' models; the practical norms that govern the actual behaviour of employees are far removed from official norms; public goods and services are co-delivered by a string of different actors and institutions, with little coordination between them; the State is widely regarded by the majority of citizens as untrustworthy. In such a context, setting up and implementing health user fee exemptions in Burkina Faso, Mali and Niger was beset by major problems, lack of coherence and bottlenecks that affect public policy-making and implementation in these countries. Health systems research for its part started to gain momentum less than twenty years ago and is becoming a discipline in its own right. But French-speaking African countries scarcely feature in it, and social sciences are not yet fully integrated. This special issue wants to fill the gap. In the Sahel, the bad health indicators reflect a combination of converging factors: lack of health centres, skilled staff, and resources; bad quality of care delivery, corruption, mismanagement; absence of any social security or meaningful commitment to the worst-off; growing competition from drug peddlers on one side, from private clinics on the other. Most reforms of the health system have various 'blind spots'. They do not take in account the daily reality of its functioning, its actual governance, the implicit rationales of the actors involved, and the quality of healthcare provision. In order to document the numerous neglected problems of the health system, a combination of quantitative and qualitative methods is needed to produce evidence. PMID:26559118

Why Did Abolishing Fees Not Increase Public School Enrollment in Kenya? Africa Growth Initiative. Working Paper 4

ERIC Educational Resources Information Center

Bold, Tessa; Kimenyi, Mwangi S.; Mwabu, Germano; Sandefur, Justin

2013-01-01

A large empirical literature has shown that user fees significantly deter public service utilization in developing countries. While most of these results reflect partial equilibrium analysis, we find that the nationwide abolition of public school fees in Kenya in 2003 led to no increase in net public enrollment rates, but rather a dramatic shift…

49 CFR 1002.3 - Updating user fees.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) All updated fees shall be rounded downward in the following manner...

Fees for Library Service: They Are not Inevitable!

ERIC Educational Resources Information Center

Kranich, Nancy

1980-01-01

The interests of libraries and users are best served when library services are provided without fee. Policy makers must be convinced that library services are a combination of public and merit goods deserving governmental funding. (RAA)

Ethical considerations related to participation and partnership: an investigation of stakeholders' perceptions of an action-research project on user fee removal for the poorest in Burkina Faso.

PubMed

Hunt, Matthew R; Gogognon, Patrick; Ridde, Valéry

2014-02-20

Healthcare user fees present an important barrier for accessing services for the poorest (indigents) in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are indigents, and funding and implementing user fee removal. In this paper, we explore stakeholder perceptions of ethical considerations relating to participation and partnership arising in the action-research. We conducted 39 in-depth interviews to examine ethical issues associated with the action-research. Respondents included 14 individuals identified as indigent through the community selection process, seven members of village selection committees, six local healthcare professionals, five members of the management committees of local health clinics, five members of the research team, and four regional or national policy-makers. Using constant comparative techniques, we carried out an inductive thematic analysis of the collected data. The Ouargaye project involved a participatory model, included both implementation and research components, and focused on a vulnerable group within small, rural communities. Stakeholder perceptions and experiences relating to the participatory approach and reliance on multiple partnerships in the project were associated with a range of ethical considerations related to 1) seeking common ground through communication and collaboration, 2) community participation and risk of stigmatization, 3) impacts of local funding of the user fee removal, 4) efforts to promote fairness in the selection of the indigents, and 5) power relations and the development of partnerships. This investigation of the Ouargaye project serves to illuminate the distinctive ethical terrain of a participatory public health action-research project. In carrying out such projects, careful attention and effort is needed to establish and maintain respectful relationships amongst those involved, acknowledge and address differences of power and position, and evaluate burdens and risks for individuals and groups.

Ethical considerations related to participation and partnership: an investigation of stakeholders’ perceptions of an action-research project on user fee removal for the poorest in Burkina Faso

PubMed Central

2014-01-01

Background Healthcare user fees present an important barrier for accessing services for the poorest (indigents) in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are indigents, and funding and implementing user fee removal. In this paper, we explore stakeholder perceptions of ethical considerations relating to participation and partnership arising in the action-research. Methods We conducted 39 in-depth interviews to examine ethical issues associated with the action-research. Respondents included 14 individuals identified as indigent through the community selection process, seven members of village selection committees, six local healthcare professionals, five members of the management committees of local health clinics, five members of the research team, and four regional or national policy-makers. Using constant comparative techniques, we carried out an inductive thematic analysis of the collected data. Results The Ouargaye project involved a participatory model, included both implementation and research components, and focused on a vulnerable group within small, rural communities. Stakeholder perceptions and experiences relating to the participatory approach and reliance on multiple partnerships in the project were associated with a range of ethical considerations related to 1) seeking common ground through communication and collaboration, 2) community participation and risk of stigmatization, 3) impacts of local funding of the user fee removal, 4) efforts to promote fairness in the selection of the indigents, and 5) power relations and the development of partnerships. Conclusions This investigation of the Ouargaye project serves to illuminate the distinctive ethical terrain of a participatory public health action-research project. In carrying out such projects, careful attention and effort is needed to establish and maintain respectful relationships amongst those involved, acknowledge and address differences of power and position, and evaluate burdens and risks for individuals and groups. PMID:24555854

Assessing the elimination of user fees for delivery services in Laos.

PubMed

Boudreaux, Chantelle; Chanthala, Phetdara; Lindelow, Magnus

2014-01-01

A pilot eliminating user fees associated with delivery at the point of services was introduced in two districts of Laos in March 2009. Following two years of implementation, an evaluation was conducted to assess the pilot impact, as well as to document the pilot design and implementation challenges. Study results show that, even in the presence of the substantial access and cultural barriers, user fees associated with delivery at health facilities act as a serious deterrent to care seeking behavior. We find a tripling of facility-based delivery rates in the intervention areas, compared to a 40% increase in the control areas. While findings from the control region suggest that facility-based delivery rates may be on the rise across the country, the substantially higher increase in the pilot areas highlight the impact of financial burden associated with facility-based delivery fees. These fees can play an important role in rapidly increasing the uptake of facility delivery to reach the national targets and, ultimately, to improve maternal and child health outcomes. The pilot achieved important gains while relying heavily on capacity and systems already in place. However, the high cost associated with monitoring and evaluation suggest broad-scale expansion of the pilot activities is likely to necessitate targeted capacity building initiatives, especially in areas with limited district level capacity to manage funds and deliver detailed and timely reports.

Two-Level Verification of Data Integrity for Data Storage in Cloud Computing

NASA Astrophysics Data System (ADS)

Xu, Guangwei; Chen, Chunlin; Wang, Hongya; Zang, Zhuping; Pang, Mugen; Jiang, Ping

Data storage in cloud computing can save capital expenditure and relive burden of storage management for users. As the lose or corruption of files stored may happen, many researchers focus on the verification of data integrity. However, massive users often bring large numbers of verifying tasks for the auditor. Moreover, users also need to pay extra fee for these verifying tasks beyond storage fee. Therefore, we propose a two-level verification of data integrity to alleviate these problems. The key idea is to routinely verify the data integrity by users and arbitrate the challenge between the user and cloud provider by the auditor according to the MACs and ϕ values. The extensive performance simulations show that the proposed scheme obviously decreases auditor's verifying tasks and the ratio of wrong arbitration.

76 FR 35066 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... an Exchange-sponsored terminal (e.g. a Floor Broker Workstation).\\3\\ However, the institution of this... Floor Broker Workstation) will still be exempt from such fees. This change is consistent with the... the objectives of Section 6(b)(4) \\5\\ of the Act in particular, in that it is designed to provide for...

75 FR 61455 - Commission Information Collection Activities (FERC-582); Comment Request; Submitted for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-05

... electronically, access the Commission's website and click on Documents & Filing, E-Filing ( http://www.ferc.gov... and power marketers then must pay the charges within 45 days of the Commission's issuance of the bill... a waiver or exemption of the obligation to pay a fee or an annual charge. Public Comment and FERC...

77 FR 61658 - Idaho Northern & Pacific Railroad Company-Discontinuance of Trackage Rights Exemption-in Canyon...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

... assistance (OFA) under 49 CFR 1152.27(b)(2) to subsidize continued rail service will be due no later than 10... the filing fee, which is currently set at $1,600. See 49 CFR 1002.2(f)(25). All filings in response to...-24796 Filed 10-9-12; 8:45 am] BILLING CODE 4915-01-P ...

17 CFR 275.205-3 - Exemption from the compensation prohibition of section 205(a)(1) for investment advisers.

Code of Federal Regulations, 2014 CFR

2014-04-01

... on the basis of a share of the capital gains upon, or the capital appreciation of, the funds, or any... fee on the basis of a share of capital gains or capital appreciation) will be considered a client for... adviser (other than an employee performing solely clerical, secretarial or administrative functions with...

17 CFR 275.205-3 - Exemption from the compensation prohibition of section 205(a)(1) for investment advisers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... on the basis of a share of the capital gains upon, or the capital appreciation of, the funds, or any... fee on the basis of a share of capital gains or capital appreciation) will be considered a client for... adviser (other than an employee performing solely clerical, secretarial or administrative functions with...

Removing user fees in the health sector: a review of policy processes in six sub-Saharan African countries.

PubMed

Meessen, Bruno; Hercot, David; Noirhomme, Mathieu; Ridde, Valéry; Tibouti, Abdelmajid; Tashobya, Christine Kirunga; Gilson, Lucy

2011-11-01

In recent years, governments of several low-income countries have taken decisive action by removing fully or partially user fees in the health sector. In this study, we review recent reforms in six sub-Saharan African countries: Burkina Faso, Burundi, Ghana, Liberia, Senegal and Uganda. The review describes the processes and strategies through which user fee removal reforms have been implemented and tries to assess them by referring to a good practice hypotheses framework. The analysis shows that African leaders are willing to take strong action to remove financial barriers met by vulnerable groups, especially pregnant women and children. However, due to a lack of consultation and the often unexpected timing of the decision taken by the political authorities, there was insufficient preparation for user fee removal in several countries. This lack of preparation resulted in poor design of the reform and weaknesses in the processes of policy formulation and implementation. Our assessment is that there is now a window of opportunity in many African countries for policy action to address barriers to accessing health care. Mobilizing sufficient financial resources and obtaining long-term commitment are obviously crucial requirements, but design details, the formulation process and implementation plan also need careful thought. We contend that national policy-makers and international agencies could better collaborate in this respect.

75 FR 45632 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... available to you after you submit a cover sheet. Click the ``Pay Now'' button.) On your check, bank draft... 2011, FDA is assuming that the number of applications that will pay fees in FY 2011 will equal the... applications subject to the criteria set forth is section 512(d)(4) of the act which pay half of the full fee...

Potential benefits of mileage-based user fees to the freight industry and industry concerns.

DOT National Transportation Integrated Search

2012-08-01

The concept of funding surface transportation infrastructure through fees charged on miles driven has been : receiving growing attention from transportation professionals and researchers in recent years. Highway funding in : the United States has tra...

49 CFR 385.815 - Exemption for AOBRD users.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the AOBRDs currently in its CMVs or install new devices compliance with § 395.16 of this chapter. (d... to ongoing FMCSA oversight. (e) The exemption granted under this section shall not apply to CMVs...

49 CFR 385.815 - Exemption for AOBRD users.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the AOBRDs currently in its CMVs or install new devices compliance with § 395.16 of this chapter. (d... to ongoing FMCSA oversight. (e) The exemption granted under this section shall not apply to CMVs...

Building a middle-range theory of free public healthcare seeking in sub-Saharan Africa: a realist review.

PubMed

Robert, Emilie; Samb, Oumar Mallé; Marchal, Bruno; Ridde, Valéry

2017-09-01

Realist reviews are a new form of knowledge synthesis aimed at providing middle-range theories (MRTs) that specify how interventions work, for which populations, and under what circumstances. This approach opens the 'black box' of an intervention by showing how it triggers mechanisms in specific contexts to produce outcomes. We conducted a realist review of health user fee exemption policies (UFEPs) in sub-Saharan Africa (SSA). This article presents how we developed both the intervention theory (IT) of UFEPs and a MRT of free public healthcare seeking in SSA, building on Sen's capability approach. Over the course of this iterative process, we explored theoretical writings on healthcare access, services use, and healthcare seeking behaviour. We also analysed empirical studies on UFEPs and healthcare access in free care contexts. According to the IT, free care at the point of delivery is a resource allowing users to make choices about their use of public healthcare services, choices previously not generally available to them. Users' ability to choose to seek free care is influenced by structural, local, and individual conversion factors. We tested this IT on 69 empirical studies selected on the basis of their scientific rigor and relevance to the theory. From that analysis, we formulated a MRT on seeking free public healthcare in SSA. It highlights three key mechanisms in users' choice to seek free public healthcare: trust, risk awareness and acceptability. Contextual elements that influence both users' ability and choice to seek free care include: availability of and control over resources at the individual level; characteristics of users' and providers' communities at the local level; and health system organization, governance and policies at the structural level. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

NGO-provided free HIV treatment and services in Burkina Faso: scarcity, therapeutic rationality and unfair process

PubMed Central

2012-01-01

Until 2010, Burkina Faso was an exception to the international trend of abolishing user fees for antiretroviral treatment (ART). Patients were still expected to pay 1,500F CFA (2 Euros) per month for ART. Nevertheless, many non-governmental organizations (NGOs) exempted patients from payment. The objective of this study was to investigate how NGOs selected the beneficiaries of payment exemptions for government-provided ART and rationed out complementary medical and psychosocial services. For this qualitative study, we conducted 13 individual interviews and three focus group discussions (n = 13 persons) with program staff in nine NGOs (4,000 patients), two NGO coordinating structures and one national program. These encounters were recorded and transcribed, and their content was thematically analyzed. The results were presented to the NGOs for feedback. Results indicate that there are no concrete guidelines for identifying patients warranting payment exemptions. Formerly, ART was scarce in Burkina Faso and the primary criterion for treatment selection was clinical. Our results suggest that this scarcity, mediated by an approach we call sociotherapeutic rationality (i.e. maximization of clinical success), may have led to inequities in the provision of free ART. This approach may be detrimental to assuring equity since the most impoverished lack resources to pay for services that maximize clinical success (e.g. viral load) that would increase their chances of being selected for treatment. However, once selected into treatment, attempts were made to ration-out complementary services more equitably. This study demonstrates the risks entailed by medication scarcity, which presents NGOs and health professionals with impossible choices that run counter to the philosophy of equity in access to treatment. Amid growing concerns of an international funding retreat for ART, it is important to learn from the past in order to better manage the potentially inequitable consequences of ART scarcity. PMID:22394491

NGO-provided free HIV treatment and services in Burkina Faso: scarcity, therapeutic rationality and unfair process.

PubMed

Ridde, Valéry; Somé, Paul Andre; Pirkle, Catherine M

2012-03-06

Until 2010, Burkina Faso was an exception to the international trend of abolishing user fees for antiretroviral treatment (ART). Patients were still expected to pay 1,500F CFA (2 Euros) per month for ART. Nevertheless, many non-governmental organizations (NGOs) exempted patients from payment. The objective of this study was to investigate how NGOs selected the beneficiaries of payment exemptions for government-provided ART and rationed out complementary medical and psychosocial services. For this qualitative study, we conducted 13 individual interviews and three focus group discussions (n = 13 persons) with program staff in nine NGOs (4,000 patients), two NGO coordinating structures and one national program. These encounters were recorded and transcribed, and their content was thematically analyzed. The results were presented to the NGOs for feedback. Results indicate that there are no concrete guidelines for identifying patients warranting payment exemptions. Formerly, ART was scarce in Burkina Faso and the primary criterion for treatment selection was clinical. Our results suggest that this scarcity, mediated by an approach we call sociotherapeutic rationality (i.e. maximization of clinical success), may have led to inequities in the provision of free ART. This approach may be detrimental to assuring equity since the most impoverished lack resources to pay for services that maximize clinical success (e.g. viral load) that would increase their chances of being selected for treatment. However, once selected into treatment, attempts were made to ration-out complementary services more equitably.This study demonstrates the risks entailed by medication scarcity, which presents NGOs and health professionals with impossible choices that run counter to the philosophy of equity in access to treatment. Amid growing concerns of an international funding retreat for ART, it is important to learn from the past in order to better manage the potentially inequitable consequences of ART scarcity.

SUPPORTING CONGRESSIONAL OVERSIGHT: Framework for Considering Budgetary Implications of Selected GAO Work

DTIC Science & Technology

2001-03-01

Certain State Taxes 95 Increase Nuclear Waste Disposal Fees 97 Recover Federal Investment in Successfully Commercialized Technologies 99 Revise the...Motor Fuels 154 Index Excise Tax Bases for Inflation 156 Increase Highway User Fees on Heavy Trucks 158 Impose Pollution Fees and Taxes 160 Appendix...Were Shared 284 Require Corporate Tax Document Matching 286 Improve Administration of the Tax Deduction for Real Estate Taxes 287 Increase Collection

24 CFR 200.934 - User fee system for the technical suitability of products program.

Code of Federal Regulations, 2012 CFR

2012-04-01

... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs... Department. (i) With respect to Mechanical Engineering Bulletins (MEBs), Structural Engineering Bulletins...

24 CFR 200.934 - User fee system for the technical suitability of products program.

Code of Federal Regulations, 2013 CFR

2013-04-01

... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs... Department. (i) With respect to Mechanical Engineering Bulletins (MEBs), Structural Engineering Bulletins...

24 CFR 200.934 - User fee system for the technical suitability of products program.

Code of Federal Regulations, 2014 CFR

2014-04-01

... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs... Department. (i) With respect to Mechanical Engineering Bulletins (MEBs), Structural Engineering Bulletins...

24 CFR 200.934 - User fee system for the technical suitability of products program.

Code of Federal Regulations, 2011 CFR

2011-04-01

... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs... Department. (i) With respect to Mechanical Engineering Bulletins (MEBs), Structural Engineering Bulletins...

78 FR 42998 - CSX Transportation, Inc.-Abandonment Exemption-in Washington County, MD

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-18

... assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a decision.... 1002.2(f)(25). All interested persons should be aware that, following abandonment of rail service and... filing fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer to Docket No. AB...

77 FR 14591 - BNSF Railway Company-Abandonment Exemption-in Page and Fremont Counties, Iowa

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... financial assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a... CFR 1002.2(f)(25). All interested persons should be aware that, following abandonment of rail service... filing fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer to Docket No. AB...

75 FR 22174 - Escanaba & Lake Superior Railroad Company-Abandonment Exemption-in Ontonagon and Houghton...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... financial assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days after service of a... CFR 1002.2(f)(25). All interested persons should be aware that, following abandonment of rail service... fee. See 49 CFR 1002.2(f)(27). All filings in response to this notice must refer to Docket No. AB 415...

76 FR 43743 - Michigan Air-Line Railway Co.-Abandonment Exemption-in Oakland County, MI

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-21

.... Any offer of financial assistance (OFA) under 49 CFR 1152.27(b)(2) will be due no later than 10 days...,500 filing fee. See 49 CFR 1002.2(f)(25). All interested persons should be aware that, following... banking under 49 CFR 1152.29 will be due no later than August 10, 2011. Each trail use request must be...

17 CFR 275.205-3 - Exemption from the compensation prohibition of section 205(a)(1) for investment advisers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... on the basis of a share of the capital gains upon, or the capital appreciation of, the funds, or any... fee on the basis of a share of capital gains or capital appreciation) will be considered a client for... functions with regard to the investment adviser) who, in connection with his or her regular functions or...

17 CFR 275.205-3 - Exemption from the compensation prohibition of section 205(a)(1) for investment advisers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... on the basis of a share of the capital gains upon, or the capital appreciation of, the funds, or any... fee on the basis of a share of capital gains or capital appreciation) will be considered a client for... functions with regard to the investment adviser) who, in connection with his or her regular functions or...

Health Care Financing in Ethiopia: Implications on Access to Essential Medicines.

PubMed

Ali, Eskinder Eshetu

2014-09-01

The Ethiopian health care system is under tremendous reform. One of the issues high on the agenda is health care financing. In an effort to protect citizens from catastrophic effects of the clearly high share of out-of-pocket expenditure, the government is currently working to introduce health insurance. This article aims to highlight the components of the Ethiopian health care financing reform and discuss its implications on access to essential medicines. A desk review of government policy documents and proclamations was done. Moreover, a review of the scientific literature was done via PubMed and search of other local journals not indexed in PubMed. Revenue retention by health facilities, systematizing the fee waiver system, standardizing exemption services, outsourcing of nonclinical services, user fee setting and revision, initiation of compulsory health insurance (community-based health insurance and social health insurance), establishment of a private wing in public hospitals, and health facility autonomy were the main components of the health care financing reform in Ethiopia. Although limited, the evidence shows that there is increased health care utilization, access to medicines, and quality of services as a result of the reforms. Encouraging progress has been made in the implementation of health care financing reforms in Ethiopia. However, there is shortage of evidence on the effect of the health care financing reforms on access to essential medicines in the country. Thus, a clear need exists for well-organized research on the issue. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

EFFECT OF FEES ON WATER SERVICE CUTOFFS AND PAYMENT DELINQUENCIES

EPA Science Inventory

A study was conducted to determine whether increased water and sewer user fees have generated increases in payment delinquencies and service cutoff rates and whether they have created other problems such as increased health hazards. Another objective was to examine the varied use...

Enhancing Kentucky's transportation funding capacity : a review of six innovative financing options.

DOT National Transportation Integrated Search

2005-06-01

Kentucky faces several challenges in meeting the funding needs for its transportation infrastructure. The state currently relies on a revenue stream based on road user taxes and fees. However, the structure of these taxes and fees are such that reven...

19 CFR 24.22 - Fees for certain services.

Code of Federal Regulations, 2014 CFR

2014-04-01

... following address: U.S. Customs and Border Protection, Attn: DTOPS Program Administrator, 6650 Telecom Drive... address: U.S. Customs and Border Protection, Attn: DTOPS Program Administrator, 6650 Telecom Drive, Suite....S. Customs and Border Protection, Revenue Division, Attn: User Fee Team, 6650 Telecom Drive, Suite...

19 CFR 24.22 - Fees for certain services.

Code of Federal Regulations, 2013 CFR

2013-04-01

... following address: U.S. Customs and Border Protection, Attn: DTOPS Program Administrator, 6650 Telecom Drive... address: U.S. Customs and Border Protection, Attn: DTOPS Program Administrator, 6650 Telecom Drive, Suite....S. Customs and Border Protection, Revenue Division, Attn: User Fee Team, 6650 Telecom Drive, Suite...

24 CFR 200.934 - User fee system for the technical suitability of products program.

Code of Federal Regulations, 2010 CFR

2010-04-01

... COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Minimum Property... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs...

Data transmission options for VMT data and fee collection centers.

DOT National Transportation Integrated Search

2002-11-01

The Oregon Road User Fee Task Force (RUFTF) is charged with developing a design for revenue collection for Oregon's roads and highways that will replace the current system for revenue collection for all light vehicles in the state. One option under c...

42 CFR 7.6 - Exemptions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS DISTRIBUTION OF REFERENCE..., governmental institutions (e.g., State hospitals and universities), the World Health Organization, and ministries of health of foreign governments may be exempted from paying user charges, when using biological...

77 FR 1101 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-09

... Login ID and FIX Login ID to $500 per month for regular access and $1000 per month for Sponsored User... a FIX fee of $1200 for a minimum of two monthly login IDs (so, $600 for one), or a fee of $2,400 for... to increase the fees charged for a CMI Login ID and FIX Login ID to $500 per month for regular access...

The Prescription Drug User Fee Act: Cause for Concern?

PubMed

Gabay, Michael

2018-04-01

The Prescription Drug User Fee Act (PDUFA) was originally enacted into law in 1992. PDUFA provides the Food and Drug Administration (FDA) with needed revenue in the form of various fees paid by drug and biologic manufacturers. The FDA utilizes this revenue to streamline the review and approval process for medications. Since the enactment of PDUFA, the median approval time for priority new drug applications and biologics license applications has reduced significantly. The FDA views PDUFA as a successful program that provides a consistent revenue stream to the agency, improves access to medications for patients, and allows industry to have a more predictable product review timeline. However, critics of PDUFA cite concerns including the potential for a lack of FDA independence and medication safety issues involving drugs approved after the existence of PDUFA.

32 CFR 204.6 - Collections.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Collections. 204.6 Section 204.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS USER FEES § 204.6 Collections. (a) Collections of fees will be made in advance or simultaneously with...

44 CFR 5.43 - Waiver or reduction of fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Waiver or reduction of fees. 5.43 Section 5.43 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... requester's and/or intended user's identity and qualifications, expertise in the subject area and ability...

78 FR 40527 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-05

... users using the Co-Lo Console \\4\\ on or after July 1, 2013 through August 31, 2013. The reduced fee... reduction in co-location cabinet fees). \\4\\ The ``Co-Lo Console'' is NASDAQ's web-based ordering tool, and...

Parental Participation Fees in School Expenses in Israel

ERIC Educational Resources Information Center

Shaked, Haim

2016-01-01

Purpose: Many countries throughout the world provide all children with free education. However, sometimes there are user charges in publically funded schools worldwide. The purpose of this paper is to explore parental participation fees in school expenses in Israel, depicting the current situation and analyzing its implications.…

77 FR 29456 - City of Alameda d/b/a Alameda Belt Line Railroad-Abandonment Exemption-in Alameda County, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-17

.../b/a Alameda Belt Line Railroad--Abandonment Exemption--in Alameda County, CA City of Alameda d/b/a Alameda Belt Line Railroad (ABL) has filed a verified notice of exemption under 49 CFR part 1152 subpart F... traffic on the line; (3) no formal complaint filed by a user of rail service on the line (or by a state or...

Radiology practices and their contracts with hospitals, 1989-1990: a representative sample survey.

PubMed

Sunshine, J; Chan, W C; Kassing, P J

1991-12-01

Because of concern about pressures from hospitals for changes in their contracts with radiology practices, the American College of Radiology undertook a stratified sample survey of radiology practices and their contracts with hospitals in late 1989 and early 1990. After three remailings, the survey obtained 904 valid responses for a 64% response rate. It found (weighting data to represent all radiology practices in the nation) that 91% of radiology practices provide services in hospitals. There are contracts at 57% of these hospital sites, and hospitals use tax-exempt bond financing in 54% of the sites with contracts. One year is the most common duration of contracts, and 90 days is the most common cancellation period (89% of contracts can be canceled during the contract's term). Eighty-six percent of contracts are exclusive; 73% are automatically renewable ("evergreen"). Separate billing exists in well over 90% of hospitals with contracts. Two percent of contracts require radiologists to provide equipment; 4% require them to provide support staff. There are fixed-fee arrangements in 9% of contracts and percent compensation arrangements in 3%. Hospitals share in radiologists' fees as a charge for contractual privileges in 5% of contracts. Twenty-seven percent of contracts require hospital approval for radiologists' fee increases; 19% require radiologists to participate with Blue Shield or Medicare. If a contract characteristic is predominant nationally, it is predominant in every region, for solo, small, medium, and large practices, and whether or not hospitals use tax-exempt bond financing. There is, however, some modest variation in frequency of contract provisions. Multivariate analysis shows that most such variation reflects true effects of region and other variables, not statistical artifacts. Region was a statistically significant determinant of 11 of 17 contract characteristics studied. Practice size was a statistically significant determinant of only about half as many characteristics. The survey found some interference in the independence of radiology practices (e.g., required hospital approval of fee increases), questionable clauses (e.g., mandated provision of equipment), and even illegal ones (hospitals charging a fee for contract privileges). Knowledge of the survey findings can make individual radiology practices more effective in negotiations with hospitals and assist the profession in forming a strategy to oppose disadvantageous and illegal provisions.

The sudden removal of user fees: the perspective of a frontline manager in Burundi.

PubMed

Nimpagaritse, Manassé; Bertone, Maria Paola

2011-11-01

In May 2006, the President of Burundi announced the removal of user fees in all health centres and hospitals for children under 5 and women giving birth. As other studies also point out, the policy was adopted extremely suddenly, without much reflection on its ultimate aims and on the operational dimension of its implementation. From the perspective of a frontline manager, this paper provides a descriptive case study of the abolition of user fees in the Muramvya District and a first-hand account of the effects of the sudden reform in the management of a district and a district hospital. The analysis highlights the challenges that the district and hospital teams faced. The main issues were: the reduction of financial flows, which prevented the possibility of investments and caused frequent drugs stock-outs; the reduced quality of the services and the disruption of the referral system; the motivation of the health staff who saw the administrative workload increase (not necessarily because of increased utilization) and faced 'ethical dilemmas' caused by the imprecise targeting of the reform. Undoubtedly, the removal of user fees for certain groups was an equitable and necessary measure in an extremely poor country such as Burundi. However, the suddenness of the decision and the lack of preparation had critical and long-lasting consequences for the entire health system. This analysis, performed from the frontline perspective, clarifies the importance of a rigorous planning of any reform, as well as of involving peripheral actors and understanding the complex challenges that they face.

Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health

PubMed Central

2013-01-01

Background The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs. This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. Methods We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. Results We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. Conclusions The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed. However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose. PMID:24053731

Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health.

PubMed

McPake, Barbara; Witter, Sophie; Ensor, Tim; Fustukian, Suzanne; Newlands, David; Martineau, Tim; Chirwa, Yotamu

2013-09-22

The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs.This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed.However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose.

National Environmental Data Referral Service (NEDRES) User Survey. Final Report.

ERIC Educational Resources Information Center

MAXIMA Corp., Silver Spring, MD.

A survey was conducted to assess environmental data users' interest in a referral system such as the National Environmental Data Referral Service (NEDRES) and to gauge user willingness to participate in a proposed NEDRES network and to comply with a system of NEDRES user fees. Twenty-one organizations were identified and 3,200 individuals were…