4,547 research outputs found

    Assessing the Effects of Medicaid Documentation Requirements on Health Centers and Their Patients: Results of a Second Wave Survey

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    This report represents a second wave follow-up to a first wave study whose purpose was to measure the effects of the Deficit Reduction Act\u27s citizenship documentation requirements on health centers and their patients. The earlier study, conducted six months after implementation, found that the law had a widespread impact, including delayed applications, interrupted enrollment, disruptions in care, and at least anecdotal evidence of a growth in the number of uninsured patients as a result of the denial or loss of Medicaid coverage. This second wave survey underscores the existence of serious, ongoing problems more than a year after implementation. Specifically, the second wave survey finds that: Three-quarters of all health centers continue to experience significant problems with citizenship documentation barriers for one or more patient groups; among health centers experiencing problems, the situation appears to be worsening rather than lessening on key measures. Documentation requirements appear to have particularly affected several specific patient categories, including pregnant women, children, patients new to the service area, and newborns. About one-third of health centers report a longer and more difficult application and enrollment process. Nearly one-half of health centers continue to report that Medicaid application and enrollment disruptions and delays continue to affect their ability to arrange for specialty care and many affected centers report increased costs associated with helping patients with application and enrollment problems. Although regulatory changes issued in 2007 were intended to address the problem, a significant number of health centers continue to report enrollment delays affecting newborns. Despite the fact that the DRA did not modify the State Children’s Health Insurance Program (SCHIP) when administered as a separate program, fully one-third of health centers located in states with separate SCHIP programs, and 45 percent of respondents in states with combination programs (Medicaid expansions plus a separate SCHIP expansion), reported that citizenship documentation requirements are being applied to SCHIP applicants as well. These findings suggest that changes implemented in the final rules have done little to ease burdens associated with the DRA’s citizenship documentation requirements, and that the law\u27s greatest impact is falling on low income children and pregnant women and the health care providers that serve them

    High Resolution Study of Magnetic Ordering at Absolute Zero

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    High fidelity pressure measurements in the zero temperature limit provide a unique opportunity to study the behavior of strongly interacting, itinerant electrons with coupled spin and charge degrees of freedom. Approaching the exactitude that has become the hallmark of experiments on classical critical phenomena, we characterize the quantum critical behavior of the model, elemental antiferromagnet chromium, lightly doped with vanadium. We resolve the sharp doubling of the Hall coefficient at the quantum critical point and trace the dominating effects of quantum fluctuations up to surprisingly high temperatures.Comment: 5 pages, 4 figure

    Giant magnetothermopower associated with large magnetoresistance in Ag_(2−δ)Te

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    We have probed the temperature and magnetic-field dependence of the thermopower and resistance of a p-type silverchalcogenide,Ag_(2−δ)Te. The application of a magnetic field causes not only a large magnetoresistance but also a giant magnetothermopower effect. The maximum change of thermopower is as high as 470 μV/K in a 7 T magnetic field. Both the magnetoresistance and the magnetothermopower show a pronounced peak and nearly linear behavior near the sign change of the thermopower. Bandcrossing and quantum confinement due to disorder appear to play key roles in the heightened response to field

    State Benefit Design Choices under SCHIP - Implications for Pediatric Health Care

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    This policy brief1 is the second in a series of reports focusing on the design of state SCHIP programs as they near full implementation. It examines the extent to which state agencies adopt conventional insurance norms or adhere to special principles of Medicaid coverage design for children in designing separately administered (or freestanding) SCHIP programs. The issue of coverage design is particularly relevant for children with low prevalence conditions and special health care needs. Increasingly, conventional insurance uses standardized coverage norms to limit coverage and treatment. These standardized norms take the form of across-the-board treatments and exclusions, limited definitions of medical necessity, and the use of irrebuttable, standardized treatment guidelines in determining when covered treatments will be available. All of these practices are impermissible under Medicaid, which uses exceptionally broad preventive standards to determine coverage of children; such standards favor coverage of children with low prevalence problems

    Liability Protections for Emergency Volunteer Health Practitioners and Entities

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    Twenty-four states and D.C. have statutes that extend some level of immunity to groups and/or organizations providing charitable, emergency, or disaster relief services, although these laws varied greatly among states

    Band-gap tuning and linear magnetoresistance in the silver chalcogenides

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    Optimally doped silver selenide and silver telluride exhibit linear positive magnetoresistance over decades in magnetic field and on a scale comparable to the colossal magnetoresistance compounds. We use hydrostatic pressure to smoothly alter the band structure of Ag-rich and Ag-deficient samples of semiconducting Ag_(2±δ)Te of fixed stoichiometry and disorder. We find that the magnetoresistance spikes and the linear field dependence emerges when the bands cross and the Hall coefficient changes sign

    Conductivity Cusp in a Disordered Metal

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    A tendency toward a cusp at zero temperature in the electrical conductivity of Si crystals doped with P is observed. It is found that, within the metallic state, decreasing P concentration enhances the cusp and then rapidly changes its sign as a pseudogap opens. Such a cusp has been predicted for a disordered metal in which Coulomb interactions dominate the scattering

    Coverage of obesity treatment: A state-by-state analysis of Medicaid and state insurance laws

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    Objectives. We determined whether state Medicaid programs cover recommended treatments for adult and pediatric obesity and to what extent states regulate the treatment and coverage of obesity by private insurers. Methods. We conducted a state-by-state document review of Medicaid manuals and private insurance laws and regulations. Results. Eight state Medicaid programs appear to cover all recommended obesity treatment modalities for adults. Only 10 states appear to reimburse for obesity-related treatment in children. In the small-group insurance market, 35 states expressly allow obesity to be used for rate adjustments, while 10 states do so in the individual market. Two states expressly allow obesity to be used in eligibility decisions in the individual market. Five states provide for coverage of one or more treatments for obesity in both small-group and individual markets. Conclusions. Very few states ensure coverage of recommended treatments for adult and pediatric obesity through Medicaid or private insurance. Most states allow obesity to be used to adjust rates in the small-group and individual markets and to deny coverage in the individual market
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