In Atlantic Research, the Court noted that the line between the volunteer remediator who has a [section] 107(a)(4)(B) claim and the reimburser
who has only a [section] 113 contribution claim is not so clear and there could be an overlap--a person who has performed remediation and therefore should have a [section] 107(a)(4)(B) claim, but who is not a volunteer and therefore has a [section] 113 contribution claim.
The same employer, with a staff of 10 would pay the state $1,750 a year in the SUI tax system (based on a formula of 2.5 percent tax rate multiplied by a $7,000 taxable wage base pay per employee.) Becoming a reimburser
saves this fictional employer $750 a year.
The following variables formed the equation that met the test of concordance contribution: Admcodtr3 (left-truncated three-digit ICD9-CM code), PFI (the Permanent Facility indicator), Agen (the numeric age in years), Admsource (the Admission source), Expreim1 (the First Expected Principal Reimburser
), and Admtype (the Admission Type).
Others spoke of years of accumulated evidence that supports quality nursing care and urged reimbursers
to move quickly, without calls for more pilot studies to justify nurses as health care providers.
(14) Evaluation may also be carried out by reimbursers
through the process of health technology assessment.
We're just at the beginning, but one thing is certain right now: If the technology allows some of our patients to live happier lives without hypoglycemia, there's something to be said for that, even if the reimbursers
In addition, the Centers for Medicare & Medicaid Services (CMS) as well as all major third-party reimbursers
accept ANCC certification for billing purposes.
This evolution to a more qualified and credentialed professional work force was spurred on by the recent increased influence of managed care, third-party reimbursers
, counselor licensure, and the privatization of the public mental health and substance abuse agencies in this state.
* CMS and the majority of third-party reimbursers
accept ANCC certification.
need different kinds of constructs, different kinds of trials, and different kinds of data to answer their questions, and that's best achieved in the postmarket," Gottlieb explained.
Federally mandated concepts, such as "diagnostic related groups" (Instituted by Medicare as a cost-control measure, they were assigned patients who had been hospitalized and dictated the amount of reimbursement predicated on the simplest treatment of the diagnosis irrespective of the complexity of the individual case.) and the threat of a totally government-controlled universal health care system, pushed providers and reimbursers
into the concept of managed care.
While third party reimbursers
such as Medicare will reimburse acute care for alcoholism in the elderly, private insurance reimbursement for longer term treatment, especially residential treatment in a structured environment, is problematic (Moyers, 2000).
Submission of the patient to mainstream medical practice is assured by the "massiveness of our medical edifices, the aura of high tech, the regiments of health care providers, the intimidation of white coats, the weight of medical statistics, the accumulated experience of physicians, the gods of peer review, and the nods from all-knowing reimbursers
." Ali asks, "What patient has the courage to challenge this?
The second section of the book covers specific topics including common emotional experiences of caregivers, impact on caregivers and their working life, financial burdens of caregiving, and lack of a coordinated, coherent response from third party reimbursers
and providers to the unique troubles faced by caregivers.
ViroLogic is developing novel clinical diagnostic technology to provide patients, physicians, and reimbursers
with useful information to guide therapeutic decisions in the management of viral diseases and cancer.