Medicare program; withdrawal of coverage of certain investigational intraocular lenses.--HCFA. Final notice

This notice announces the withdrawal of Medicare coverage for certain investigational intraocular lenses (IOLs). Medicare coverage of IOLs that have received approval by the Food and Drug Administration (FDA) will continue to be covered by Medicare, as well as certain other IOLs that are awaiting FDA approval.     

Medicare program; adjustment in payment amounts for new technology intraocular lenses furnished by ambulatory surgical centers. Department of Health and Human Services (HHS), Health Care Financing Administration (HCFA). Final rule

This final rule establishes a process under which interested parties may request a review of whether the current Medicare payment amount for intraocular lenses furnished by participating ambulatory surgical centers is appropriate for a class of new technology intraocular lenses. This rule implements section 141(b) of the Social Security Act Amendments of 1994, which requires us to develop and implement this process. This rule also serves as the initial notice to those wishing to submit requests for review of the appropriateness of the payment amount with respect to a particular intraocular lens, in accordance with section 416.195 of this rule.     

The Argument of Rightness as an Element of the Discretionary Power of the Administrative Judge

The article concerns the situation of the judicial application of the law where the entity applying the law refers in a decision-making process to moral principles. The decision should be based on the directives of interpretation, which indicate the need for such a determination of the meaning of the applicable norms so that it remains in harmony with commonly accepted moral rules of the society. The equity (understood as rightness) has one more purpose; namely, it allows for the process of decision-making—and not just for the process of unifying the decisions—since the mere rule does not specify the algorithm of undertaking them. This rule thus assumes that it will be further specified by phronesis judge who in a given situation will determine—for the purposes of a particular decision—a hierarchy between the criteria of substantive justice “embedded” in this rule. The reference to equity (rightness) stands for the concretization of an unspecified general rule. We deal here with an indefinite general rule, the application of which is facilitated by a reference to rightness.

     

中西方法治意识生成因素的比较

西方的法治意识是基于西方的文化传统所内生的一种社会思想意识,是西方社会经济、文化自然演进的结果.而中国的法治意识是在对西方法治的传入与"移植"过程中,在外力的作用下逐步形成的.考察西方法治的发展历史,我们发现,法治是西方社会发展和社会进步的一个理性选择,是融合了社会文化和经济因素的产物.与法治相适应的法治意识的培育,是法治得以实现的基础.在培育我国公民法治意识的过程中,需要运用比较研究的方法对中西方法治意识的生成因素做深入的分析和法理思考,从而获得有益的启示.     

中国的法治进程与公众参与——以网民参与法律事件对法治建设的影响为例

中国走的是一条政府主导型的法治化发展道路,即在政府主导下强制性地完成社会制度变迁。在这一过程中,中国社会的法治发展条件也发生了根本性的变化。社会自身的发展、经济和社会生活的需要、公众的参与正在成为法治发展的动力。本文以时间为序,把中国的法治进程划分为初始起步阶段、加速发展阶段和平稳发展阶段,并以公众中极具代表性的网民群体作为分析范本,以当前网民参与法律事件为例,结合目前我国所处的法治阶段,分析了网民参与法律事件的性质和特征,以期进一步探讨中国法治进程和公众参与之间的互动意义。     

百年法治进程的基本逻辑与执政党角色——纪念中国共产党成立100周年和“依法治国”方略提出24周年

中国共产党领导的中国特色社会主义法治事业是人类历史上前所未有的伟大法治工程,中国共产党的领导是中国特色社会主义法治的最本质特征。中国法治进程近代发端的特殊性在于其被动性和外在强制性,中国法治现代化面对的基本难题是其所遭遇的"矛盾的现代性":一方面必须彻底反帝反封建以实现民族独立,另一方面必须学习并移植西方先进的法律制度和生产方式以实现现代化,这就决定了中国走向现代法治之路的曲折性。新中国建政之初颁布的《中国人民政治协商会议共同纲领》不仅起到了临时宪法的作用,还是当代中国法治体系的"基础规范",它内在蕴含着"法治国家"的必然性。新中国法治建设在经历一定时期的挫折之后,得益于中国共产党从革命党到执政党的转型和正确领导,终于走上依法治国、建设社会主义法治国家之正途,开创了全面依法治国的全新局面,形成了指导中国特色社会主义法治建设的"习近平法治思想",向着"法治中国"战略目标不断胜利推进。所有这些伟大成就的取得,归功于执政党之于中国法治建设所承担的领导者、设计者和推动者的伟大角色,亦归因于法治建设进程中执政党对建构理性和经验理性方法论的兼重与融合。     

Medicare program; prior determination for certain items and services. Final rule

This final rule establishes a process for Medicare contractors to provide eligible participating physicians and beneficiaries with a determination of coverage relating to medical necessity for certain physicians' services before the services are furnished. This rule is intended to afford the physician and beneficiary the opportunity to know the financial liability for a service before expenses are incurred. This final rule establishes reasonable limits on physicians' services for which a prior determination of coverage may be requested and discusses generally our plans for establishing the procedures by which those determinations may be obtained. This rule also responds to public comments on the August 30, 2005 proposed rule.     

Registration of food facilities under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. Final rule

The Food and Drug Administration (FDA) is issuing a final regulation that confirms the interim final rule entitled "Registration of Food Facilities Under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002" (68 FR 58894, October 10, 2003 (interim final rule) as corrected by a technical amendment (69 FR 29428, May 24, 2004), and responds to comments submitted in response to the request for comments in the interim final rule. This final rule affirms the interim final rule's requirement that domestic and foreign facilities that manufacture/process, pack, or hold food for human or animal consumption in the United States be registered with FDA by December 12, 2003. The interim final rule implemented the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act), which requires domestic and foreign facilities to be registered with FDA by December 12, 2003. This final rule does not make any changes to the regulatory requirements established by the interim final rule.     

Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule

This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.     

Medicare program; establishment of an expedited review process for Medicare beneficiaries enrolled in health maintenance organizations, competitive medical plans, and health care prepayment plans--HCFA. Final rule with comment period

This final rule with comment period establishes a new administrative review requirement for Medicare beneficiaries enrolled in health maintenance organizations (HMOs), competitive medical plans (CMPs), and health care prepayment plans (HCPPs). This rule implements section 1876(c)(5) of the Social Security Act, which specifies the appeal and grievance rights for Medicare enrollees in HMOs and CMPs. This rule requires that an HMO, CMP, or HCPP establish and maintain, as part of the health plan's appeals procedures, an expedited process for making organization determinations and reconsidered determinations when an adverse determination could seriously jeopardize the life or health of the enrollee or the enrollee's ability to regain maximum function. This rule also revises the definition of appealable determinations to clarify that it includes a decision to discontinue services.     

考夫曼类推理论论略

传统上类推仅仅是法律适用的补充性技术，而考夫曼①在诠释学的关照下主张所有的法律适用都是类推的过程。没有完全相同的案件，法律适用就是规范与事实不断逼近的过程，只有在规范与事实的对应中才有真实的法。类推的过程可以通过考察规范与事实的共有意义、回归立法目的和判断相似性等方式来操作，从而实现类推从本体论到方法论的转换。     

Medicare and Medicaid programs: changes affecting hospital and critical access hospital conditions of participation: telemedicine credentialing and privileging. Final rule

This final rule will revise the conditions of participation (CoPs) for both hospitals and critical access hospitals (CAHs). The final rule will implement a new credentialing and privileging process for physicians and practitioners providing telemedicine services. Currently, a hospital or CAH receiving telemedicine services must go through a burdensome credentialing and privileging process for each physician and practitioner who will be providing telemedicine services to its patients. This final rule will remove this undue hardship and financial burden.     

法治认同培育的理性逻辑

法治认同作为社会认同的一种,需要社会公众在社会交往和社会实践中形成对于法治的理性认知和情感,并把这种理性认知和情感转化为自身的行为选择和具体行动。在这一过程中,理性的社会群际关系是培育法治认同的社会心理基础,人们对法治整体化范畴的认知和社会性自我归类意识的培育是当代中国社会法治认同培育的关键所在,培育人们的法治认知、法治情感、法治思维与法治观念和理性的法治行动,是当代中国社会法治认同培育的实践展开方式。     

论合宪性解释方法

虽然合宪性解释方法在概念上会存在些许差别,但其所遵循的合宪性推定逻辑是相通的,即都体现了司法权对立法权的谦抑。合宪性解释方法中所含括的单纯解释规则,如果不与冲突规则在学理上加以区分,则很容易对合宪性解释产生认识上的偏差。目前合宪性解释方法所模本的欧陆经验,从源流上来说,最早其实可溯及至早期美国合宪性推定的理论与实践,并与回避宪法方法一脉相承。通过合宪性推定可以发现,合宪性解释方法可以从宪法方法与法律方法两个层面展开。把握其内在理路及权力逻辑,方可使其具有本土可能性。     

Medicare program; application of inherent reasonableness payment policy to Medicare Part B services (other than physician services). Final rule

This final rule finalizes the process that was set forth in an interim final rule published on December 13, 2002, for establishing a realistic and equitable payment amount for Medicare Part B services (other than physicians' services) when the existing payment amounts are inherently unreasonable because they are either grossly excessive or grossly deficient. This process does not apply to services paid under a prospective payment system, such as outpatient hospital services or home health services. The December 2002 interim final rule also described the factors we (or our carriers) will consider and the procedures we will follow in establishing realistic and equitable payment amounts for Medicare Part B services. In addition, this final rule responds to public comments we received on two provisions in the December 13, 2002 interim final rule relating to how we define grossly excessive or deficient payment amounts and to the criteria for using valid and reliable data in applying the inherent reasonableness authority.     

Social Network Analysis and the Diffusion of the Strict Liability Rule for Manufacturing Defects, 1963–87

This article reports the results of a study that uses social network analysis to compare the persuasiveness of legal precedents in the diffusion of the strict liability rule for manufacturing defects. This new study tests which legal precedents were most influential and also whether certain state judicial variables influenced the diffusion process. The results are striking. The federal circuit regions appear to define an important reference group in the diffusion process, and social network effects dominate economic and political variables. In addition, the de facto separation of powers in the enactment of new state legislation appears to influence courts' propensities to adopt the strict liability rule. When the executive and legislative branches were controlled by the same political party, regardless of whether it was Republican or Democratic, state courts were more inclined to adopt the strict liability rule.     

从经验到法则:经验在事实认定过程中的引入与规制

从事实认定制度发展的历程来看,经验法则是为将经验引入事实认定过程中并对其加以有效控制的一种独特机制。这种机制在大陆法系和英美法系有着不同的表述形式和内在制约机制。在我国,经验法则和法律推定是将经验引入事实认定过程的两种不同机制,它们在立法和司法实践中都存在某种程度的失控状态。这种失控状态的产生源于其内在制约机制的缺陷。只有从制约机制入手才能有效保障经验在事实认定过程得到恰当的运用。     

当代中国法治话语体系的构建

近十余年来,社会各方面对中国法治的应有形态及理想图景认识出现了一定分歧。形成这种分歧的实质原因是,在"什么是法治"的问题上,人们更多地受到西方自由主义法治理论的影响。自由主义法治理论所建构的法治模式以及所描绘的法治的某些特征,一定程度上已成为人们对于法治的深刻记忆,并成为认知和评判我国法治现实的依据。为此,应当在充分揭示和深刻认知自由主义法治理论乖谬的基础上,加强我国法治意识形态的自主化建设,以社会主义法治理念为基础构建中国特色法治话语体系。在此过程中,应注重社会主义法治理念与法学传统理论及知识谱系的对接,把社会主义法治理念转化或体现为具体的法律思想、法学理论、法律原理、法律文化、法律知识以及法律思维,藉以确立社会主义法治理念作为我国法治的"元理论"和"元知识"的权威地位。     

从经验到法则:经验在事实认定过程中的引入与规制

从事实认定制度发展的历程来看,经验法则是为将经验引入事实认定过程中并对其加以有效控制的一种独特机制.这种机制在大陆法系和英美法系有着不同的表述形式和内在制约机制.在我国,经验法则和法律推定是将经验引入事实认定过程的两种不同机制,它们在立法和司法实践中都存在某种程度的失控状态.这种失控状态的产生源于其内在制约机制的缺陷....