Not Just Old Wine in New Bottles: Kentucky Ass\u27n of Health Plans, Inc. v. Miller Bottles a New Test for State Regulation of Insurance

For nearly two decades, the “regulating insurance” aspect of the savings clause was as confusing and convoluted as trying to distinguish between the casks of unlabeled barrels of old wine that all smelled horribly similar. Miller clarified the savings clause analysis by establishing a broad, two-step test for determining if a state law regulates insurance. However, the district courts have been sluggish in recognizing the differences between the tests. The Supreme Court did not even cite to or rely on Miller when it struck down Texas’ patient rights statute on the basis of ERISA preemption in Aetna Health Inc. v. Davila. Nonetheless, Miller is a new blend of wine fermented from a different batch of grapes than those used in the bottling of the casks of old, unlabeled wine barrels that confused everyone, including the Supreme Court. Its two-part test is a “clean break,” and not merely the old McCarran-Ferguson grapes recycled into Miller’s vintage. This Note examines the new test for whether state laws regulate insurance for ERISA purposes and how the Supreme Court’s jurisprudential philosophy toward the savings clause has changed. Part II examines ERISA preemption and its impact on the health care industry. Part III presents the appellate and Supreme Court decisions. Part IV analyzes how Miller changed the analytical framework for the savings clause. Finally, Part V concludes that Miller is not just the old wine test for the regulation of insurance repackaged in new bottles

Four-Wave Mixing and Optical Phase Conjugation in Vertical Cavity Surface Emitting Devices

Four-wave mixing (FWM), a nonlinear optical process, was investigated in resonant cavity light emitting diodes (RCLEDs) and vertical cavity surface emitting lasers (VCSELs) below lasing threshold. These semiconductor photonic devices consisted of an optical gain region of quantum wells sandwiched between two distributed Bragg reflector (DBR) mirrors. Pump and probe lasers were injected into the devices to generate FWM. The dependence of FWM on bias current, pump laser power, and spectral and spatial separation between pump and probe lasers was investigated experimentally. A computer model of FWM based on the wave and carrier density equations was developed and agreed well with experimental results. Conjugate reflectivities of I were obtained in the VCSEL when bias current was below threshold but above transparency. Reasonable conjugate reflectivities were obtained for pump-probe detunings up to 2 GHz in both devices. Noncollinear FWM was performed for the first time in VCSELs or RCLEDs at angles up to 10°. Both experiment and model showed the possibility of generating a strong reflected conjugate signal while minimizing the reflected pump signal. The noncollinear FWM demonstrated the possibility of phase front conjugation for correcting aberrated signals in vertical cavity devices

The Effects of Mandatory and Free College Admission Testing on College Enrollment and Completion

Between the years 2001 and 2015, twenty-three states and the District of Columbia implemented a policy providing mandatory and free college admission exams (ACT or SAT) to all public high school juniors. As such, the policy reduced to zero out of pocket expenses for exam fees, and likely reduced out-of-pocket expenses for exam preparation, because schools might have been induced to provide such a service in-house. The policy also reduced the time cost of test taking because the test is administered during class time and at a student’s school. Because the mandatory exam is administered during the junior year, the policy may also have increased the amount of information a student has about her college prospects earlier on in her decision making process. In this paper I hypothesize that the decreased costs and increased information may induce more students to apply to and enroll in college. I use both college-level longitudinal data (IPEDS) along with cross-sectional student-level data (ACS) to test these predictions. Specifically, I exploit the fact that not all states implemented the policy and that those which did so implemented the policy at different points in time. In the college-level analysis, I find that the average college saw an increase in about 88 enrolled students and 460 applications from the policy without any effect on their graduation rates. In the individual-level analysis, I find that treated individuals have approximately 1.03 times the odds of untreated individuals of attending college. In the appendix I propose a model for the decision to apply, enroll, and complete college

The Effects of Mandatory and Free College Admission Testing on College Enrollment and Completion

Between the years 2001 and 2015, twenty-three states and the District of Columbia implemented a policy providing mandatory and free college admission exams (ACT or SAT) to all public high school juniors. As such, the policy reduced to zero out of pocket expenses for exam fees, and likely reduced out-of-pocket expenses for exam preparation, because schools might have been induced to provide such a service in-house. The policy also reduced the time cost of test taking because the test is administered during class time and at a student’s school. Because the mandatory exam is administered during the junior year, the policy may also have increased the amount of information a student has about her college prospects earlier on in her decision making process. In this paper I hypothesize that the decreased costs and increased information may induce more students to apply to and enroll in college. I use both college-level longitudinal data (IPEDS) along with cross-sectional student-level data (ACS) to test these predictions. Specifically, I exploit the fact that not all states implemented the policy and that those which did so implemented the policy at different points in time. In the college-level analysis, I find that the average college saw an increase in about 88 enrolled students and 460 applications from the policy without any effect on their graduation rates. In the individual-level analysis, I find that treated individuals have approximately 1.03 times the odds of untreated individuals of attending college. In the appendix I propose a model for the decision to apply, enroll, and complete college

An effectiveness analysis of healthcare systems using a systems theoretic approach

<p>Abstract</p> <p>Background</p> <p>The use of accreditation and quality measurement and reporting to improve healthcare quality and patient safety has been widespread across many countries. A review of the literature reveals no association between the accreditation system and the quality measurement and reporting systems, even when hospital compliance with these systems is satisfactory. Improvement of health care outcomes needs to be based on an appreciation of the whole system that contributes to those outcomes. The research literature currently lacks an appropriate analysis and is fragmented among activities. This paper aims to propose an integrated research model of these two systems and to demonstrate the usefulness of the resulting model for strategic research planning.</p> <p>Methods/design</p> <p>To achieve these aims, a systematic integration of the healthcare accreditation and quality measurement/reporting systems is structured hierarchically. A holistic systems relationship model of the administration segment is developed to act as an investigation framework. A literature-based empirical study is used to validate the proposed relationships derived from the model. Australian experiences are used as evidence for the system effectiveness analysis and design base for an adaptive-control study proposal to show the usefulness of the system model for guiding strategic research.</p> <p>Results</p> <p>Three basic relationships were revealed and validated from the research literature. The systemic weaknesses of the accreditation system and quality measurement/reporting system from a system flow perspective were examined. The approach provides a system thinking structure to assist the design of quality improvement strategies. The proposed model discovers a fourth implicit relationship, a feedback between quality performance reporting components and choice of accreditation components that is likely to play an important role in health care outcomes. An example involving accreditation surveyors is developed that provides a systematic search for improving the impact of accreditation on quality of care and hence on the accreditation/performance correlation.</p> <p>Conclusion</p> <p>There is clear value in developing a theoretical systems approach to achieving quality in health care. The introduction of the systematic surveyor-based search for improvements creates an adaptive-control system to optimize health care quality. It is hoped that these outcomes will stimulate further research in the development of strategic planning using systems theoretic approach for the improvement of quality in health care.</p

Search of the Orion spur for continuous gravitational waves using a loosely coherent algorithm on data from LIGO interferometers

We report results of a wideband search for periodic gravitational waves from isolated neutron stars within the Orion spur towards both the inner and outer regions of our Galaxy. As gravitational waves interact very weakly with matter, the search is unimpeded by dust and concentrations of stars. One search disk (A) is 6.87° in diameter and centered on 20h10m54.71s+33°33′25.29′′, and the other (B) is 7.45° in diameter and centered on 8h35m20.61s-46°49′25.151′′. We explored the frequency range of 50-1500 Hz and frequency derivative from 0 to -5×10-9 Hz/s. A multistage, loosely coherent search program allowed probing more deeply than before in these two regions, while increasing coherence length with every stage. Rigorous follow-up parameters have winnowed the initial coincidence set to only 70 candidates, to be examined manually. None of those 70 candidates proved to be consistent with an isolated gravitational-wave emitter, and 95% confidence level upper limits were placed on continuous-wave strain amplitudes. Near 169 Hz we achieve our lowest 95% C.L. upper limit on the worst-case linearly polarized strain amplitude h0 of 6.3×10-25, while at the high end of our frequency range we achieve a worst-case upper limit of 3.4×10-24 for all polarizations and sky locations. © 2016 American Physical Society

A search of the Orion spur for continuous gravitational waves using a "loosely coherent" algorithm on data from LIGO interferometers

We report results of a wideband search for periodic gravitational waves from isolated neutron stars within the Orion spur towards both the inner and outer regions of our Galaxy. As gravitational waves interact very weakly with matter, the search is unimpeded by dust and concentrations of stars. One search disk (A) is $6.87^\circ$ in diameter and centered on $20^\textrm{h}10^\textrm{m}54.71^\textrm{s}+33^\circ33'25.29"$, and the other (B) is $7.45^\circ$ in diameter and centered on $8^\textrm{h}35^\textrm{m}20.61^\textrm{s}-46^\circ49'25.151"$. We explored the frequency range of 50-1500 Hz and frequency derivative from $0$ to $-5\times 10^{-9}$ Hz/s. A multi-stage, loosely coherent search program allowed probing more deeply than before in these two regions, while increasing coherence length with every stage. Rigorous followup parameters have winnowed initial coincidence set to only 70 candidates, to be examined manually. None of those 70 candidates proved to be consistent with an isolated gravitational wave emitter, and 95% confidence level upper limits were placed on continuous-wave strain amplitudes. Near $169$ Hz we achieve our lowest 95% CL upper limit on worst-case linearly polarized strain amplitude $h_0$ of $6.3\times 10^{-25}$, while at the high end of our frequency range we achieve a worst-case upper limit of $3.4\times 10^{-24}$ for all polarizations and sky locations.Comment: Fixed minor typo - duplicate name in the author lis

Search of the Orion spur for continuous gravitational waves using a loosely coherent algorithm on data from LIGO interferometers

We report results of a wideband search for periodic gravitational waves from isolated neutron stars within the Orion spur towards both the inner and outer regions of our Galaxy. As gravitational waves interact very weakly with matter, the search is unimpeded by dust and concentrations of stars. One search disk (A) is 6.87° in diameter and centered on 20[superscript h]10[superscript m]54.71[superscript s] + 33°33[superscript ′]25.29[superscript ′′], and the other (B) is 7.45° in diameter and centered on 8[superscript h]35[superscript m]20.61[superscript s] - 46°49[superscript ′]25.151[superscript ′′]. We explored the frequency range of 50–1500 Hz and frequency derivative from 0 to -5 × 10[superscript -9]  Hz/s. A multistage, loosely coherent search program allowed probing more deeply than before in these two regions, while increasing coherence length with every stage. Rigorous follow-up parameters have winnowed the initial coincidence set to only 70 candidates, to be examined manually. None of those 70 candidates proved to be consistent with an isolated gravitational-wave emitter, and 95% confidence level upper limits were placed on continuous-wave strain amplitudes. Near 169 Hz we achieve our lowest 95% C.L. upper limit on the worst-case linearly polarized strain amplitude h[subscript 0] of 6.3 × 10[superscript -25], while at the high end of our frequency range we achieve a worst-case upper limit of 3.4 × 10[superscript -24] for all polarizations and sky locations.National Science Foundation (U.S.)United States. National Aeronautics and Space AdministrationCarnegie TrustDavid & Lucile Packard FoundationAlfred P. Sloan Foundatio

Search of the Orion spur for continuous gravitational waves using a loosely coherent algorithm on data from LIGO interferometers

We report results of a wideband search for periodic gravitational waves from isolated neutron stars within the Orion spur towards both the inner and outer regions of our Galaxy. As gravitational waves interact very weakly with matter, the search is unimpeded by dust and concentrations of stars. One search disk (A) is 6.87° in diameter and centered on 20[superscript h]10[superscript m]54.71[superscript s] + 33°33[superscript ′]25.29[superscript ′′], and the other (B) is 7.45° in diameter and centered on 8[superscript h]35[superscript m]20.61[superscript s] - 46°49[superscript ′]25.151[superscript ′′]. We explored the frequency range of 50–1500 Hz and frequency derivative from 0 to -5 × 10[superscript -9]  Hz/s. A multistage, loosely coherent search program allowed probing more deeply than before in these two regions, while increasing coherence length with every stage. Rigorous follow-up parameters have winnowed the initial coincidence set to only 70 candidates, to be examined manually. None of those 70 candidates proved to be consistent with an isolated gravitational-wave emitter, and 95% confidence level upper limits were placed on continuous-wave strain amplitudes. Near 169 Hz we achieve our lowest 95% C.L. upper limit on the worst-case linearly polarized strain amplitude h[subscript 0] of 6.3 × 10[superscript -25], while at the high end of our frequency range we achieve a worst-case upper limit of 3.4 × 10[superscript -24] for all polarizations and sky locations.National Science Foundation (U.S.)United States. National Aeronautics and Space AdministrationCarnegie TrustDavid & Lucile Packard FoundationAlfred P. Sloan Foundatio