Restricted Access and Delays to HCV Treatment Among Medicaid Patients in Louisiana

Background: Many people living with chronic Hepatitis C Virus (HCV) have seen delays in accessing treatment or been denied entirely due to Medicaid restrictions requiring patients to meet certain criteria prior to receiving approval for medication pre-authorization. Methods: This study identified a cohort of Medicaid-insured patients with chronic HCV infection within New Orleans, LA. Patient medical records were reviewed and information regarding HCV care was gathered. This study sought to determine the degree to which HCV care was delayed for this population and describe common reasons for prior-authorization denials for direct-acting antiviral (DAA) medications. Results: For this population of Medicaid-insured patients with HCV RNA assay-confirmed chronic infection, the average number of days it took to reach a specialist was three-times greater than the number of days it took to reach a primary care physician. After attending an appointment with a specialist to seek HCV care, patients experienced wait periods of an average of 150 days before being deemed eligible for treatment per Medicaid requirements. After being deemed eligible for treatment, patients experienced an average wait period of 194.4 days to initiation of treatment, with low fibrosis status being cited as the most common reason for treatment delay. Conclusion: This population of Medicaid-insured patients in New Orleans, LA with chronic HCV infection experienced delays in treatment related to reduced accessibility of a specialist who was eligible to request DAA prior-authorization. Prior-authorization was most frequently denied based on low fibrosis status or recent alcohol/drug use

String-Like Lagrangians from a Generalized Geometry

This note will use Hitchin's generalized geometry and a model of axionic gravity developed by Warren Siegel in the mid-nineties to show that the construction of Lagrangians based on the inner product arising from the pairing of a vector and its dual can lead naturally to the low-energy Lagrangian of the bosonic string.Comment: Conclusions basically unchanged, but presentation streamlined significantly. Published versio

Narrative Quilts and Quilted Narratives: The Art of Faith Ringgold and Alice Walker

There have been two main streams of influence on Chicano artists aside from the obvious one that is the result of their artistic training, education and development in the United States. The primary influence came from Mexico, first during the colonial period in the form of New Spanish art and architecture, and then in modem times provided by the Mexican muralists through their work and their use of pre-Columbian art. The New Spanish materials formed the nucleus for the second stream of influence composed of the various manifestations of religious folk art found primarily in the Southwest

Mortgage Broker Regulations That Matter: Analyzing Earnings, Employment, and Outcomes for Consumers

As the role of mortgage brokers in mortgage origination grew from insignificant in the 1980s to dominant in recent years, questions have arisen about whether its services help or harm consumers. In response, states have increasingly regulated the business, largely by creating and tightening occupational licensing requirements for mortgage brokers. The question of whether increased occupational licensing of mortgage brokers improves consumer outcomes is theoretically ambiguous and has been little studied empirically. This study introduces a new database of mortgage broker licensing requirements and assesses the relationships between these requirements and outcomes in both the labor market for brokers and the consumer market for mortgages. We find that one typical regulation—the requirement in many states that mortgage brokers maintain a surety bond or minimum net worth—has a significant and fairly consistent statistical relationship with both labor and consumer market outcomes. In particular, we find that tighter bonding/net worth requirements are associated with slightly higher broker earnings, fewer brokers, fewer subprime mortgages, higher foreclosure rates, and a greater percentage of high-interest-rate mortgages. Although we do not provide a full causal interpretation of these results, we take seriously the possibility that restrictive bonding requirements for mortgage brokers have unintended negative consequences for many consumers. On balance, our results also seem to support the relevance of theories of occupational licensing that stress the importance of financial entry and exit barriers.

Agri-lending Vision 2020: When Vision and Reality Meet

Agricultural Finance,