Medicaid program; time limitation on price recalculations and recordkeeping requirements under the drug rebate program. Final rule with comment period

On September 19, 1995, we published a proposed rule in the Federal Register that introduced requirements for States and manufacturers pertaining to the Medicaid drug rebate program. We received several comments from States and manufacturers regarding recordkeeping requirements and drug price recalculations. This final rule with comment period finalizes separately, in an accelerated timeframe, two specific provisions of the September 1995 proposed rule. It establishes new recordkeeping requirements for drug manufacturers under the Medicaid drug rebate program. It also sets forth a 3-year time limitation during which manufacturers must report changes to average manufacturer price and best price for purposes of reporting data to us. In addition, it announces the pressing need for codification of fundamental recordkeeping requirements. Furthermore, it announces our intention to continue to work on finalizing the complete drug rebate regulation for the Medicaid drug rebate program.     

Medicare program; rural health clinics: amendments to participation requirements and payment provisions; and establishment of a quality assessment and performance improvement program. Final rule

This final rule amends Medicare certification and payment requirements for rural health clinics (RHCs) as required by the Balanced Budget Act of 1997 (BBA). It changes the definition of a qualifying rural shortage area in which a Medicare RHC must be located; establishes criteria for identifying RHCs essential to delivery of primary care services that we can continue to approve as Medicare RHCs in areas no longer designated as medically underserved; and limits waivers of certain nonphysician practitioner staffing requirements. This final rule imposes payment limits on provider-based RHCs and prohibits "commingling" (the use of the space, professional staff, equipment, and other resources) of an RHC with another entity. The rule also requires RHCs to establish a quality assessment and performance improvement program that goes beyond current regulations. Finally, this final rule addresses public comments received on the February 28, 2002 proposed rule and makes other revisions for clarity and uniformity and to improve program administration.     

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,Medicaid, and CLIA programs; laboratory requirements relating to quality systems and certain personnel qualifications. Final rule

This final rule revises and responds to comments on certain laboratory requirements issued pursuant to the Clinical Laboratory Improvement Amendments of 1988 (CLIA), Pub. L. 100-578. Specifically, this final rule sets forth requirements for certain quality control (QC) provisions and personnel qualifications; consolidates and reorganizes the requirements for patient test management, QC, and quality assurance; and changes the consensus required for grading proficiency testing challenges. To ensure a smooth transition to the new provisions for directors of high complexity testing who are not board certified (but who have doctoral degrees), we will not be holding facilities out of compliance with the provisions of the rule concerning directors who are not board certified until the effective date of this new rule, to the extent the facilities are otherwise in compliance with the requirements for laboratory directors.     

Medicare and Medicaid programs; fire safety requirements for certain health care facilities. Final rule

This final rule amends the fire safety standards for hospitals, long-term care facilities, intermediate care facilities for the mentally retarded, ambulatory surgery centers, hospices that provide inpatient services, religious nonmedical health care institutions, critical access hospitals, and Programs of All-Inclusive Care for the Elderly facilities. Further, this final rule adopts the 2000 edition of the Life Safety Code and eliminates references in our regulations to all earlier editions.     

Health insurance reform: security standards. Final rule

This final rule adopts standards for the security of electronic protected health information to be implemented by health plans, health care clearinghouses, and certain health care providers. The use of the security standards will improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general by establishing a level of protection for certain electronic health information. This final rule implements some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).     

“两个先锋队”思想是对马克思主义政党性质学说的继承和发展

"两个先锋队"思想是对马克思主义政党性质学说的继承和发展.其继承体现为:坚持了基本原则;继承了动态发展观;是历史经验的科学总结.其发展表现在:新的概括表述;历史经验的新启发;解决了历史性课题;突破了传统框框.文中还从指导思想和价值取向、实践"三个代表"、加强党的自身建设三个方面陈述了在新世纪里如何当好"两个先锋队"问题.     

女性文学批评本土化过程中的语境差异

西方女性主义文学批评进入中国后遇到了完全不同于其理论源头的接受环境。这些接受环境差异包括:一、历史背景的差异,其主要表现为西方女性主义文学批评是先“破”后“立”,而中国本土则是先“立”后“破”;二、意识形态差异,主要表现为西方文化中的民主传统与中国传统文化中的集权思想形成的对照;三、学术背景差异,西方女性主义文学批评是以反拨“新批评”的学术革命开始的,而中国本土则得益于马克思主义的社会历史批评的滋养。这些差异既决定了中国女性主义文学批评的独特面貌,同时又呼唤西方理论本土化研究的新思路。     

对"重典治乱"提高广州市打击刑事犯罪效率和质量的对策思路

当前影响我市打击犯罪质量与效率的因素是转型期社会经济发展和城市建设加快,各种诱发和产生犯罪的负面因素增多,打击犯罪的难度增大;法制工作各有关环节均存在不适应形势要求的情况,影响打击犯罪的力度;公安机关执法整体水平不高、治安控制整体实力不强."重典治乱"是当前社会治安形势的客观要求;提高打击犯罪效率与质量是其关键环节.当前的主要工作思路主动进攻,形成持续"严打"社会声威;快侦快破,提高打击破案时效;最大限度地把警力安排到街面,提高发现抓获现行犯罪的能力.     

一种基于Otsu算法的印章二值化算法

本文提出了一种基于Otsu算法的印章二值化法.该算法通过对算法的改进,考虑了印章图象象素的灰度分布值和它们邻域象素的平均灰度值分布情况.并不是用于整幅印章图象,而是用于分块的印章图象.实验证明,该算法适合印章的二值化处理.