Making sense of referral fee statutes

State and federal prohibitions of referral fees have long plagued the health care sector because their broadly worded provisions threaten established and socially valuable business arrangements. Congress has recently instructed the Department of Health and Human Services to issue regulations that clarify the scope of the most threatening of these prohibitions, the Medicare and Medicaid felony referral fee statute. This article examines three possible analytical models for imposing a limiting construction on referral fee statutes by testing the models against three beneficial practices that the statute jeopardizes: physician recruitment, fee discounting, and efficiency bonuses. The article recommends primary reliance on an earned/unearned analysis that detects a prohibited referral fee by asking whether the fee is fully earned by legitimate, nonreferral services.     

FIELD NETWORK RESEARCH IN POLICY EVALUATION

The field-network evaluation studies (FNES) approach to policy evaluation research seeks to overcome deficiencies of small-sample case study method and of the large-sample survey research approach. Methodologically, FNES uses many of the familiar techniques of both these approaches interviews, data collection and analysis, limited sampling, field observation, and document analysis. The crucial difference is sample size. The FNES approach using a middle-range sample of 50 to 60 research sites has the advantages of the case study method in being able to provide an in depth account of a program and how it operates, and is sufficiently flexible to permit a shift in the analytical framework as the research proceeds thus overcoming the inflexibility of the instruments of survey research.
Seven major studies employing the FNES approach have been carried out or are underway in the United States of America. The principal components of the methodology are a network of university-based field associates and a central management group. The field associates collect the information and the data using a uniform analytical framework and reporting form. The central staff aggregates these analyses into a single report that cuts across the sample. This approach and the use of a middle-range sample make it possible to draw generalizable conclusions based on the national experience, and also provide sufficient detail to differentiate policy impacts among the sample jurisdictions.     

REVIEWS

Beyond Complacency; Administrative Law (Fifth Edition). By H. W. R. Wade. Principles of Public International Law. Third Edition. By Ian Brownlie. An Introduction to the Principles of Morals and Legislation. Jeremy Bentham. Edited by J. H. Burns and H. L. A. Hart. Courts, Prosecution, and Conviction. By M. McConville and J. Baldwin. Making Good: Prisons, Punishment and Beyond. By Martin Wright.     

The Role of Policy Brokers: The Case of Biotechnology in Kenya

Debates about biotechnology continue to be polarized despite its potential to improve the living standards of the poor in Sub‐Saharan Africa. In the backdrop of this polarized scenario, this paper asked, is there a place for brokers in bringing about a productive debate that is pro‐development? The paper argued that if potential intermediaries are analyzed from the perspective of understanding their role and stakeholding in the regulatory change process, this may help breakout the current polarized anti‐ and pro‐biotechnology debates and thereby focus on how to enable productive biotechnology development. Informed by insights from innovation brokering, the functions of brokers in biotechnology regulation are analyzed through the lens of organizations involved in agricultural biotechnology debates in Kenya. The analysis found that policy brokering function attracts varying opportunities and challenges appropriate for informing relevant policy. The paper drew lessons from Kenya's experience to inform a productive policy brokering model for biotechnology regulation.     

Reducing Adverse Childhood Experiences (ACE) by Building Community Capacity: A Summary of Washington Family Policy Council Research Findings

Community capacity for organization and collaboration has been shown to be a powerful tool for improving the health and well-being of communities. Since 1994 the Washington State Family Policy Council has supported the development of community capacity in 42 community public health and safety networks. Community networks bring local communities together to restructure natural supports and local resources to meet the needs of families and children, and increase cross-system coordination and flexible funding streams to improve local services and policy. In this study, researchers sought to demonstrate the strong impact of the community networks' capacity to interrupt health and social problems. Findings suggest that community networks reduce health and safety problems for the entire community population. Further, community networks with high community capacity reduced adverse childhood experiences (ACE) in young adults ages 18-34.     

‘No toques mi pelo’ (don’t touch my hair): decoding Afro-Cuban identity politics through hair

ABSTRACT

People across the African Diaspora have developed a complex socio-visual-language system of hair as a means of self-expression; however, the decades of economic sanctions in Cuba generated a unique political dynamic that has shaped concepts of self-image and cultural expressions. Sixteen Afro-Cuban women were interviewed about the cultural significance of their hair using The Guided Hair Autobiography methodology. Participant themes included aesthetic pride and confidence, hair bullying and embarrassment, and hair damage and distress. A Cuban cultural critique underlines how Afro-Cuban women have been socialized to have a bias towards straightened long hair over tightly coiled hair textures. These findings suggest that despite the ‘raceless’ political revolutionary spirit infused into Cuban cultural ideology, people of African descent process racial politics and identity through hair.     

Using PMCT of Individuals of Known Age to Test the Suchey–Brooks Method of Aging in Victoria,Australia

The estimation of an individual's age at death plays a critical role in the investigation of unidentified human remains. The Suchey–Brooks method, which involves the analysis of degenerative morphological changes in the pubic symphysis, is currently widely used to estimate age in adults. This study tested the applicability of the Suchey–Brooks method on a contemporary adult Australian (Victorian) subpopulation by observing three‐dimensional volume‐rendered postmortem computed tomographic (PMCT) reconstructions of the pubic symphysis of 204 individuals aged 15–100 years. Results showed the method was reliable for females (85% correct allocations) but not for males (67% correct allocations). It is therefore recommended that extreme caution be used when applying the Suchey–Brooks method for estimating age at death of an individual in this subpopulation from PMCT images. The results suggest further investigation into alternate age estimation methods is required.