Medicare program; photocopying reimbursement methodology. Final rule

This final rule increases the rate of reimbursement for expenses incurred by prospective payment system PPS) hospitals for photocopying medical records requested by Quality Improvement Organizations (QIOs), formerly known as Utilization and Quality Control Peer Review Organizations (PROs). We are increasing the rate from 7 cents per page to 12 cents per page to reflect inflationary changes in the labor and supply cost components of the formula. This final rule also provides for the periodic review and adjustment of the per-page reimbursement rate to account for inflation and changes in technology. The methodology for calculating the per-page reimbursement rate will remain unchanged. We are also providing for the payment of the expenses of furnishing photocopies to QIOs, to other providers subject to a PPS (for example, skilled nursing facilities and home health agencies), in accordance with the rules established for reimbursing PPS hospitals for these expenses.     

Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2004 rates. Final rule

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital costs to implement changes arising from our continuing experience with these systems. In addition, in the Addendum to this final rule, we are describing changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 2003. We also are setting forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the IPPS that are paid on a cost basis subject to these limits. Among other changes that we are making are: changes to the classification of cases to the diagnosis-related groups (DRGS); changes to the long-term care (LTC)-DRGs and relative weights; the introduction of updated wage data used to compute the wage index; the approval of new technologies for add-on payments; changes to the policies governing postacute care transfers; payments to hospitals for the direct and indirect costs of graduate medical education; pass-through payments for nursing and allied health education programs; determination of hospital beds and patient days for payment adjustment purposes; and payments to critical access hospitals (CAHs).     

Medicare program; physician fee schedule update for calendar year 1996 and physician volume performance standard rates of increase for federal fiscal year 1996--HCFA. Final notice

This final notice announces the calendar year 1996 updates to the Medicare physician fee schedule and the Federal fiscal year 1996 volume performance standard rates of increase for expenditures for physicians' services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1848 (d) and (f), respectively, of the Social Security Act. The fee schedule update for calendar year 1996 is 3.8 percent for surgical services, -2.3 percent for primary care services, and 0.4 percent for other nonsurgical services. While it does not affect payment for any particular service, there was a 0.8 percent increase in the update for all physicians' services for 1996. The physician volume performance standard rates of increase for Federal fiscal year 1996 are -0.5 percent for surgical services, 9.3 percent for primary care services, 0.6 percent for other nonsurgical services, and a weighted average of 1.8 percent for all physicians' services. In our July 26, 1995 proposed rule concerning revisions to payment policies under the Medicare physician fee schedule for calendar year 1996, we proposed using category-specific volume and intensity growth allowances in calculating the default Medicare Volume Performance Standard (MVPS). We received 20 comments on this proposal. Since this proposal is related to the MVPS and this notice deals with MVPS issues, we are responding to those comments in this notice instead of in the final rule for the fee schedule entitled "Medicare Program; Revisions to Payment Policies and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 1996" published elsewhere in this Federal Register issue.     

违法侦查行为的程序性制裁效果研究——以非法口供排除规则为中心

不断出现的冤案及其背后的违法侦查问题使整个刑事司法的公信力日趋式微。学界和司法部门最高层认识到,只有通过建立非法证据排除规则,剥夺违法侦查者非法取证的利益,才能促使其依法取证。此谓程序性制裁。但是,在目前的机制下,由于我国违法侦查的发现几率极低、无法定罪的成本极小和次级制裁机制的乏力,程序性制裁根本无法成为依法取证的"激励机制"。因此,如果要使程序性制裁的威慑效果发挥作用,必须建立有效的违法侦查行为发现机制,把非法证据排除真正转变为违法侦查的成本,并使法院真正具备作出无罪判决的能力。     

Spouse Abuse by Black and White Offenders in the U.S. Army

Black soldiers are overrepresented in the U.S. Army Central Registry of spouse abuse cases. For each year between 1989 and 1997, the number of black offenders outnumbers white offenders, while the white population outnumbers the black population. When age-specific rates per 1000 were computed, the rates for blacks were greater than those for whites in every age group. The highest rates for both races were in the 18- to 21-year age group. Age-specific rate ratios between blacks and whites for 1997 ranged from 3.4 for the 18- to 21-year-old group to 1.9 for the 42- to 46-year age group. All of the rate ratios except the one for the 42 to 46-year age group were statistically significant. Socioeconomic status (SES) is an unlikely explanation for these findings as SES was reasonably controlled. Culturally specific longitudinal studies are needed to clarify the reasons for differences in black and white spouse abuse incidents.     

服务侵权责任是独立的质量侵权责任

服务侵权责任是一项独立的质量侵权责任。承担服务侵权责任的前提条件是服务存在缺陷,即服务经营者所提供的服务不符合保障人身、财产安全的要求,包括服务设计缺陷、服务指示缺陷和服务过程缺陷。服务侵权责任的归责原则应采取过借推定兼顾公平原则。服务侵权责任与产品责任、建筑侵权责任构成我国“三位一体”的质量侵权责任制度。     

“All the System is Simply a Soap Bubble”: Legal Help-Seeking for Domestic Violence Among Women in Kyrgyzstan

This paper examines limitations in how law enforcement and public health systems respond to domestic violence in Kyrgyzstan. Findings from interviews with domestic violence victims show that these women are subject to ineffectual practices and negative attitudes that tend to minimize domestic abuse and disempower victims. The findings reveal several problematic issues: inconsistencies in the implementation of the law, impunity for abusers because of both personal attitudes and social affinities between the police and abusers, ineffective enforcement of protective orders, and superficial processing of domestic violence cases by the legal system. Additional barriers to help-seeking include a lack of institutional support and guidelines for offering mental health services for victims as well as a scarcity of housing, childcare, and employment opportunities for women seeking to break the cycle of abuse. The findings underscore the need for society-wide changes in attitudes toward domestic violence, stricter mechanisms for enforcing the law, and mandatory training for service providers to facilitate the provision of more accessible and affirmative support to victims.     

香港民事诉讼中的诉讼费担保制度

诉讼费担保制度是普通法系国家的一项民事诉讼规则和制度,它能够解决一些因诉讼费而产生的不公平问题。在诉讼费担保制度的适用情形、担保金命令的申请程序、担保金命令的发出程序、担保金命令的法律效力、担保金的取回程序方面,香港都有比较完善的规定,但也存在一些需要解决的问题。香港诉讼费担保制度的成功之处对于阻止内地民事诉讼中的当事人滥诉行为,会有一定的借鉴意义。     

医疗损害赔偿的相关问题分析与规范化处理

医疗损害赔偿是现阶段医疗纠纷处理中最现实和最敏感的问题,如何公正、合理、有效地处理医疗损害赔偿问题一直被社会公众所关注。本文围绕如何正确理解医疗损害赔偿责任的构成,准确把握法律适用和规范赔偿处理行为等关键性影响因素作出分析和阐述,并力求在法理性与规范性方面为医疗损害赔偿问题的处理提供相关借鉴。     

The Political Rights of Anti-Liberal-Democratic Groups

The purpose of this paper is to consider whether it is permissible for a liberal democratic state to deny anti-liberal-democratic citizens and groups the right to run for parliament. My answer to this question is twofold. On the one hand, I will argue that it is, in principle, permissible for liberal democratic states to deny anti-liberal-democratic citizens and groups the right to run for parliament. On the other hand, I will argue that it is rarely wise (or prudent) for ripe democracies to exclude anti-liberal-democrats from parliamentary elections. There are at least two reasons for this. The first is related to the inherent stability of just institutions. The second is that exclusion can lead to group polarization and enclave deliberation that can engender political extremism and impair processes of interpersonal and intrapersonal deliberation in liberal democracies.     

Competing Risks, Persistence, and Desistance in Analyzing Recidivism

A statistical procedure is developed to analyze recidivism in samples whichare subject to the presence of desisters and to multiple modes ofreconviction. This allows for a more accurate study of individuals'transition and hazard in the type and timing of offenses following aspecific type of conviction. The use of a nonparametric approach forinvestigating failure in the presence of other acting causes is shown;initial estimators of the probabilities of reconviction for different typesof offenses are obtained, and the method can be used both to display thedata and to choose an appropriate parametric family for the survivaltimes. An exponential mixture model for competing risks is presented insuch a way that it allows us to adjust for concomitant variables and toassess their effects on the probabilities both of reconviction forpredetermined types of offenses and desistance and of the hazards ofreconviction; a method for assessing calibration of predicted survivalprobabilities is suggested. A 21-year follow-up of persons convicted ofindecent assault on a female in 1973 illustrates the methods; we find ahigh probability of sexual reconviction for individuals with previoussexual convictions and evidence of diversity and a raised hazard ofreconviction for young chronic offenders.     

环境损害赔偿立法框架和内容的思考

环境损害赔偿立法的必要性由现实社会关系调整的必要性和现行相关立法的不适应性所决定。我国环境损害赔偿立法宜采取实体和程序一体、行政处理与司法处理一体的立法模式,并着重规定环境纠纷处理和环境损害赔偿方面所涉及的一些特殊问题。立法框架和内容主要包括环境损害赔偿的适用条件、环境损害赔偿的范围、环境损害赔偿责任的认定、环境损害赔偿纠纷的行政处理、环境损害赔偿的司法处理等部分。环境损害赔偿立法的难点在于环境行政主管机关处理决定的法律效力问题以及因果关系推定的准确表述问题。     

Integrating the desire–for–control and rational choice in a corporate crime context

The “rational choice” framework, with its focus on risks and rewards, is often used to explain corporate criminality. In this paper, we build on this framework by integrating the notion of “desire‐for‐control.” Although common to many psychologists, the desire‐for‐control, or the general wish to be in control over everyday life events, has not been examined for its relevance in understanding criminal activity generally, or within corporate offending in particular. After demonstrating the importance of desire‐for‐control in the corporate context, we use data from a sample of managers and MBA students to examine the extent to which desire‐for‐control relates to rational‐choice considerations and corporate criminal decision‐making. Results suggest that desire‐for‐control (1) influences the interpretation of rational‐choice considerations and (2) is positively related to corporate criminality even after controlling for a number of important situational‐ and individual‐level factors. Implications for future theoretical and empirical research are addressed.     

从国际实践看国家需要具备的条件

国家需要具备的条件用于区分国家与其他政治实体。从国际实践看,人民、与别的国家进行交往的能力或者进行国际交往的能力、有效的政府、遵守国际法方面的要求、国家的作用、民主和尊重人权方面的要求等国际法学者提出的国家需要具备的条件或者国家资格的标准不是国家需要具备的条件。国家需要具备的条件是定居的居民、领土、政府和独立。     

Standards for protection against radiation; extension of implementation date--NRC. Final rule

The Nuclear Regulatory Commission (NRC) is extending the implementation date for its revised standards for protection against radiation and making a conforming change to its regulation. See SUPPLEMENTARY INFORMATION for specific regulatory parts affected. This rule extends the date by which NRC licensees are required to implement the revised standards for protection against radiation to January 1, 1994. The 1-year extension provides licensees additional time to examine and implement the regulatory guidance developed to support the rule. It also establishes a concurrent implementation date for NRC licensees and Agreement State licensees.     

Schedule for rating disabilities; AL amyloidosis (primary amyloidosis). Final rule

The Department of Veterans Affairs (VA) is amending its Schedule for Rating Disabilities by updating the schedule of ratings for the hemic and lymphatic systems to include AL amyloidosis. This regulatory action is necessary to add AL amyloidosis as one of the disease conditions and establish criteria for disability evaluation to fully implement the decision by the Secretary of Veterans Affairs to grant presumptive service connection based on herbicide exposure for this disease. The intended effects are to provide consistency in disability ratings and to ease tracking of AL amyloidosis for statistical analysis.     

Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 1995 rates--HCFA. Final rule with comment period

We are revising the Medicare hospital inpatient prospective payment systems for operating costs and capital-related costs to implement necessary changes arising from our continuing experience with the system. In addition, in the addendum to this final rule, we are describing changes in the amounts and factors necessary to determine prospective payment rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 1994. We are also setting forth rate-of-increase limits for hospitals and hospital units excluded from the prospective payment systems. Finally, we are revising the criteria used by the Medicare Geographic Classification Review Board (MGCRB) to decide on applications by hospitals for geographic reclassification for prospective payment purposes.     

Relinquishing custody as a requisite for receiving services for children with serious emotional disorders

A review of the literature was conducted to assess the extent and nature of the practice of requiring parents to transfer custody in order to receive public funding for intensive services needed by their child/adolescent who had a serious emotional disorder. The review focused on the legal and policy basis of this practice as well as its social and psychological impact on child and family. We conclude that the practice of transfer of custody as a requirement for receiving financial aid occurs in a majority of states, though the actual extent of this practice is not known. The major factor influencing the use of transfer of custody appears to be the absence of an appropriate and adequate system of services for children and adolescents with serious emotional disorders. We recommend that the practice of requiring custody transfer for the sole purpose of receiving services be abolished and offer several suggestions for improving acess to services.Preparation of this article was supported in part by the National Institute of Mental Health (NIMH) under contract no. 89MF761903. The authors are grateful to John Burke and Kelly Kelleher of the Division of Biometry and Applied Sciences, NIMH for their assistance on this project. Laurie Flynn, Executive Director for the National Alliance for the Mentally Ill, was very helpful during the informative stage of the project. Barbara Friesen, Director of the Research and Training Center at Portland State University, gave us useful guidance throughout the project. We thank Stephen Hill, Consultant to the National Governors' Association, for his help. We are grateful to Amy Hewitt and Carol Ishler for their assistance in preparing this report. We also would like to acknowledge several individuals who assisted us with research reported in this article. We are grateful to Governor Richard F. Celeste of Ohio for his letter of support for the state survey of custody transfer practices. We appreciate the efforts on behalf of this survey by staff from the State of Ohio, particularly Jean Ellen Stevens, Administrative Assistant to the Director of the Department of Mental Health. Margraret McNally assisted in the compilation of data for both surveys.     

Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2003 rates. Final rule

We are revising the Medicare acute care hospital inpatient prospective payment systems for operating and capital costs to implement changes arising from our continuing experience with these systems. In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 2002. We also are setting forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the acute care hospital inpatient prospective payment systems. In addition, we are setting forth changes to other hospital payment policies, which include policies governing: Payments to hospitals for the direct and indirect costs of graduate medical education; pass-through payments for the services of nonphysician anesthetists in some rural hospitals; clinical requirements for swing-bed services in critical access hospitals (CAHs); and requirements and responsibilities related to provider-based entities.