The document provides a side-by-side comparison of major provisions in the House and Senate healthcare reform proposals. Key differences include:
- The Senate bill does not include a public health insurance option but allows for non-profit co-ops
- The individual mandate penalty in the Senate bill is modified to be the lesser of a percentage of income or flat dollar amount
- The Senate bill delays coverage of pre-existing conditions for children until 2014
- Employer requirements and penalties differ between the bills
- Revenue provisions like taxes on insurance plans over a threshold and medical devices are included in the Senate bill but not the House bill
OCR received a breach notice in February 2012 from QCA Health Plan, Inc. of Arkansas reporting that an unencrypted laptop computer containing the ePHI of 148 individuals was stolen from a workforce member’s car. While QCA encrypted their devices following discovery of the breach, OCR’s investigation revealed that QCA failed to comply with multiple requirements of the HIPAA Privacy and Security Rules, beginning from the compliance date of the Security Rule in April 2005 and ending in June 2012. QCA agreed to a $250,000 monetary settlement and is required to provide HHS with an updated risk analysis and corresponding risk management plan that includes specific security measures to reduce the risks to and vulnerabilities of its ePHI. QCA is also required to retrain its workforce and document its ongoing compliance efforts.
The Health Care and Education Affordability Reconciliation Act of 2010 was recently passed by the House and will be signed into law 03/30/2010. NAHU (National Association for Health Underwriters) published a comprehensive timeline of the changes coming over the next few years. Please contact me with any questions.
The Terrorism Risk Insurance Act (TRIA) tries to prevent double payments of policyholder and claimant losses under multiple federal disaster relief programs. When Treasury implemented TRIA’s double payment rules more than 15 years ago it assumed future disaster relief programs would look a lot like those previously rolled out for hurricanes, floods and earthquakes.
COVID-19 has shaken that assumption.
OCR received a breach notice in February 2012 from QCA Health Plan, Inc. of Arkansas reporting that an unencrypted laptop computer containing the ePHI of 148 individuals was stolen from a workforce member’s car. While QCA encrypted their devices following discovery of the breach, OCR’s investigation revealed that QCA failed to comply with multiple requirements of the HIPAA Privacy and Security Rules, beginning from the compliance date of the Security Rule in April 2005 and ending in June 2012. QCA agreed to a $250,000 monetary settlement and is required to provide HHS with an updated risk analysis and corresponding risk management plan that includes specific security measures to reduce the risks to and vulnerabilities of its ePHI. QCA is also required to retrain its workforce and document its ongoing compliance efforts.
The Health Care and Education Affordability Reconciliation Act of 2010 was recently passed by the House and will be signed into law 03/30/2010. NAHU (National Association for Health Underwriters) published a comprehensive timeline of the changes coming over the next few years. Please contact me with any questions.
The Terrorism Risk Insurance Act (TRIA) tries to prevent double payments of policyholder and claimant losses under multiple federal disaster relief programs. When Treasury implemented TRIA’s double payment rules more than 15 years ago it assumed future disaster relief programs would look a lot like those previously rolled out for hurricanes, floods and earthquakes.
COVID-19 has shaken that assumption.
Catholic Health Care Services Resolution Agreement and Corrective Action PlanAlex Slaney
Catholic Health Care Services of the Archdiocese of Philadelphia settlement, Resolution Agreement and Corrective Action Plan as a result of violating the HIPAA Security Rule for ePHI
Raleigh Orthopedic RA and CAP April 2016Alex Slaney
Resolution Agreement and CAP put in place after Raleigh Orthopedic violated The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule
Parkview Health System, Inc. (Parkview) has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule with the Department of Health and Human Services (HHS) Office for Civil Rights (OCR). Parkview will pay $800,000 and adopt a corrective action plan to correct deficiencies in its HIPAA compliance program.
On February 4, 2011, Pam Silberman, president & CEO of North Carolina Institute of Medicine, made this presentation to Chamber members about federal health reform.
Louisiana Citizens Property Insurance Company is the state’s residual market providing property insurance to homeowners and businesses that have been unable to procure insurance in the private market. Louisiana Citizens came out of the 2005 hurricane season nearly $1 billion in debt from Hurricane Katrina and Rita losses.
As reflected in the attached graphic, Louisiana Citizens appears to have transformed itself into a leaner, financially disciplined, and well governed organization. While it has yet to publish estimated losses from Hurricane Ida, there appears little chance of a similar financial hole opening in Louisiana Citizens’ balance sheet this year.
A graphic overview of this article is available here.
What’s in Your Rule Book? A Common Sense Approach to Plan Documentation.CBIZ, Inc.
Two recent eligibility opportunities, one created as a result of a US Supreme Court decision and the other enacted by law, are a wake-up call for plan sponsors of welfare and pension benefit plans to review and update, as appropriate, the terms of their plans. As is well known by now, the Supreme Court’s ruling in United States v. Windsor1 extended federal tax and benefit rights to couples in a same-sex marriage. In addition, the Affordable Care Act (ACA) incents employers to extend
eligibility to their workforce or risk an excise tax penalty. Plan sponsors should review their plan documents in light of these recent developments to ensure that the plan language is current and compliant.
Learn how you can successfully navigate the Affordable Care Act, "Obama Care".
This easy to read outline will benefit your family and business.
Call (816-224-9466) for more information today.
Catholic Health Care Services Resolution Agreement and Corrective Action PlanAlex Slaney
Catholic Health Care Services of the Archdiocese of Philadelphia settlement, Resolution Agreement and Corrective Action Plan as a result of violating the HIPAA Security Rule for ePHI
Raleigh Orthopedic RA and CAP April 2016Alex Slaney
Resolution Agreement and CAP put in place after Raleigh Orthopedic violated The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule
Parkview Health System, Inc. (Parkview) has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule with the Department of Health and Human Services (HHS) Office for Civil Rights (OCR). Parkview will pay $800,000 and adopt a corrective action plan to correct deficiencies in its HIPAA compliance program.
On February 4, 2011, Pam Silberman, president & CEO of North Carolina Institute of Medicine, made this presentation to Chamber members about federal health reform.
Louisiana Citizens Property Insurance Company is the state’s residual market providing property insurance to homeowners and businesses that have been unable to procure insurance in the private market. Louisiana Citizens came out of the 2005 hurricane season nearly $1 billion in debt from Hurricane Katrina and Rita losses.
As reflected in the attached graphic, Louisiana Citizens appears to have transformed itself into a leaner, financially disciplined, and well governed organization. While it has yet to publish estimated losses from Hurricane Ida, there appears little chance of a similar financial hole opening in Louisiana Citizens’ balance sheet this year.
A graphic overview of this article is available here.
What’s in Your Rule Book? A Common Sense Approach to Plan Documentation.CBIZ, Inc.
Two recent eligibility opportunities, one created as a result of a US Supreme Court decision and the other enacted by law, are a wake-up call for plan sponsors of welfare and pension benefit plans to review and update, as appropriate, the terms of their plans. As is well known by now, the Supreme Court’s ruling in United States v. Windsor1 extended federal tax and benefit rights to couples in a same-sex marriage. In addition, the Affordable Care Act (ACA) incents employers to extend
eligibility to their workforce or risk an excise tax penalty. Plan sponsors should review their plan documents in light of these recent developments to ensure that the plan language is current and compliant.
Learn how you can successfully navigate the Affordable Care Act, "Obama Care".
This easy to read outline will benefit your family and business.
Call (816-224-9466) for more information today.
Last Friday, March 23, marked the two-year anniversary of the passage of the Affordable Care Act (ACA). While this week the Supreme Court heard arguments on challenges to the health care law, a number of ACA’s provisions are already making an impact on the business of health care and individual consumers.
Chapter 10
Health Reform in the United States
Chapter OverviewDiscusses the history of health reform in the United States and details the key provisions of the Affordable Care Act (ACA)Focuses on:Previous attempts at national health reformWhy health reform is difficult to achieveThe passage and provisions of the ACA
*
Health ReformThere have been numerous health reform attempts in the United States.Prior to 2010, all attempts at national health reform to create universal or near-universal coverage have failedSome successes at the state level
Health Reform—Difficulty of Reform in the United StatesIndividualistic cultureDislike of big governmentLack of consensus Federal system rules and structure make it difficult to achieve major reformStates generally home to social welfare issuesPowerful interest groups against national health reformPath dependency
Health Reform—Key Failed Attempts at National Health Reform1912 Progressive Party candidate Teddy Roosevelt supported social insurance platform that included health insurance1915 American Association for Labor Legislation proposal for working-class health insurancePresident Truman supported national health reform upon taking office, won re-election on national health insurance platform in 1948President Nixon: initial health reform proposal in 1969 and revised proposal in 1972President Clinton Health Security Act in 1993
*
The Affordable Care Act
(1 of 3)Why did the ACA pass when so many prior attempts had failed?Commitment and leadershipLearned lessons from past failuresPolitical pragmatism
The Affordable Care Act
(2 of 3)Individual mandate—most people have to purchase health insurance or pay a penalty starting in 2014Exemptions for certain populations and based on affordabilityPenalty for individual mandate repealed in 2017 Tax Cut and Jobs ActControversyToo much government interference in private lives?Constitutional?
The Affordable Care Act
(3 of 3)State Health Insurance ExchangesAmerican Health Benefit Exchanges for individualsSmall Business Health Options program for small businessesEffectively ended in 2018; may be revisedMust offer essential health benefits (abortion compromise)Four cost levels for plans based on actuarial value
ACA: Premium and Cost Sharing SubsidiesPremium tax credits available for individuals who purchase insurance in an exchange and have income between 133% and 400% of povertyCost-sharing subsidies available for individuals who purchase insurance in an exchange and have income up to 250% of povertyTo qualify, must be a U.S. citizen or legal resident, not eligible for any type of public insurance, and not have access to employer-sponsored insurance
*
ACA: Employer MandateIn 2014, employers with 50 or more employees must provide affordable health insurance or pay a penalty.Insurance is affordable if it has an actuarial value of at least 60% or is not more than 9.5% of an employee’s income.Penalty is per employee after first 30 emplo ...
HEALTH INSURANCE PROVIDED BY GOVERNMENT VS PRIVATE SECTOR IN INDIAVedica Sethi
Healthcare is significant for each individual on the planet, on account of this each nation should focus on wellbeing, because of increment pace of sickness and ailments.
In India medical coverage part is an undiscovered market, still it has crying needs. There is colossal potential for this part. The medical coverage suppliers are not satisfying this interest. After 1999 the privatization of protection area, the protection segment has developed in past decade. By and by there are 25 medical coverage suppliers, in that four are with open area and twenty one private medical coverage suppliers. The piece of the overall industry of open segment is 60 rates while the rest with other private players.
This paper inspects the present status of medical coverage in India, advancement in health care coverage area and difficulties looked by it. It additionally investigates the job of both open and private medical coverage players to arrive at most extreme inclusion in health care coverage.
Health Reform Bulletin 133 | Executive Order Directing Modifications to the A...CBIZ, Inc.
An Executive Order, signed on October 12, 2017, promotes modifications of certain aspects of the Affordable Care Act (ACA) (also see press statement). In a nutshell, this Executive Order directs the ACA’s governing agencies (Health and Human Services/Labor/Treasury) to address three
elements: formation of association health plans, expansion of short-term, limited-duration insurance, and expanding the rules to allow individual premium to be reimbursed through health reimbursement arrangements (HRAs). Briefly, this Executive Order directs the governing agencies to
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
House Senate HC Reform Bill Comparison Update Dec 30
1. Side-by-Side Comparison of House and Senate
Healthcare Reform Proposals
Updated 12/30/09
On November 7, 2009, the U.S. House of Representatives passed the Affordable Health Care for
America Act (HR 3962). On November 21, the Senate’s proposal for healthcare reform, the
Patient Protection and Affordable Care Act, was introduced on the Senate floor in the nature of a
substitute amendment to a House-passed bill: HR 3590. Following Senate floor debate, Majority
Leader Harry Reid released the Manager’s Amendment to HR 3590, which essentially provided
an updated version of the Senate healthcare reform bill. On December 24, the Senate passed the
Patient Protection and Affordable Care Act. The following chart provides a side-by-side
comparison of the major market reform, mental health and addiction provisions of the proposals
being considered in Congress. Please Note: Updates made to the Senate healthcare reform bill
through the Manager’s Amendment (MA) are in red text.
House Bill: Senate Bill:
Affordable Health Care The Patient Protection
for America Act and Affordable Care Act
(HR 3962) (HR 3590)
INSURANCE MARKET REFORMS
High Risk Pool Sec. 101: Beginning Jan, 1, 2010, Sec. 1101: Enacts a temporary
creates a temporary insurance insurance program for those who
program for those who have been have been uninsured for at least 6
uninsured for at least 6 months or months and has a pre-existing
due to pre-existing conditions. condition. Funding capped at $5M –
Funding capped at $5M – program program will terminate when the
will exist until funding runs out or American Health Benefit Exchanges
when the Health Insurance are operational in 2014.
Exchange is functional.
Pre-Existing Sec. 106: Pre-existing condition Sec. 2704: No group or individual
Conditions exclusions entirely prohibited plan may discriminate against pre-
beginning in 2013. Prior to that date, existing conditions or against those
shortens the time that plans can look that have been sick in the past
back for a pre-existing condition (Begins in 2014, when Exchanges
from 6 months to 30 days and become operational).
shortens time plans may exclude MA: Immediately applies ban on
coverage of certain benefits pre-existing condition exclusion to
generally from 12 months to 3 children.
1
2. months (Begins Jan 1, 2010).
HR 3962 (House bill) HR 3590 (Senate bill)
Coverage of Sec. 105: Young adults covered Sec. 2714: Young adults permitted
Young Adults through parents’ health insurance to remain on their parents’ health
through age 26. (Begins Jan 1, 2010) insurance until age 26 (Begins 6
months after enactment).
Sec. 2004: Allows all young adults
below age 25 who were formerly in
foster care to be eligible for
Medicaid and all its benefits,
including EPSDT.
Lifetime and Sec. 109: Prohibits use of lifetime Sec. 2711: Prohibits all plans from
Annual Limits limits. (Begins Jan 1, 2010) establishing lifetime or unreasonable
annual limits on benefits (Begins 6
months after enactment).
MA: Clarifies that beginning in
2014, annual limits on essential
benefits will be prohibited. Prior to
2014, the Secretary of HHS will
establish restrictions on health
insurers’ ability to apply annual
limits. The prohibition on annual
limits does not apply to services that
are not part of the essential benefits
package.
Mental Health & Sec. 214: Applies 2008 Wellstone- Sec. 1311(j) and 1562(c)(4): Applies
Addiction Parity Domenici MH/SA parity law to the mental health and substance abuse
individual and small group market parity to all insurance plans
Public Health Sec. 321: Requires the creation of a Sec. 1322: Allows for the creation of
Insurance Option public health insurance option as a non-profit, member-run co-operative
plan choice within the Exchange. It health insurance programs.
participates on a level playing field Sec. 1323: Requires the creation of a
and must abide by all rules that public health insurance option
apply to private plans. (Begins in (called a “community health
2013) insurance option”), but allows states
Sec. 323: Secretary of HHS to pass a law to opt out of
negotiates payments for providers, participating.
items and services (inc. prescription Sec. 1324: Requires co-ops and the
drugs). public option to abide by all federal
and state laws that apply to private
insurers.
MA: Eliminates the public health
insurance option from the bill
Individual Sec. 401: Requires that either an Sec. 1501(5000A): Requires
Responsibility individual has insurance or pays a individuals to maintain minimum
2.5% tax; based on modified essential coverage beginning in
2
3. adjusted gross income. (Amount of 2014 or pay a penalty of $95 in
Individual tax defined in Sec. 501) 2014, $350 in 2015, $750 in 2016
Responsibility Sec. 501: Allows for hardship and indexed thereafter. Penalties are
(cont.) exemption. reduced by half for those under age
18. Exemptions will be made for
those who can’t afford coverage,
those under 100% of poverty, Indian
tribes, and those who were
uninsured for less than 3 months in a
year.
MA: Modifies the penalties for
failure to maintain coverage:
individuals must pay the lesser of: 1)
the national average premium for the
“bronze” level of coverage in the
exchange; or 2) a monthly penalty
based on a percentage of income or
a flat dollar amount.
HR 3962 (House bill) HR 3590 (Senate bill)
Employer Sec. 411: Beginning in 2014, if an Sec. 1513: Requires employers with
Responsibility employee chooses an insurance plan more than 50 full time employees
offered through the Exchange rather who do not offer coverage and who
than a plan offered by the employer, have one or more employees
the employer must make a receiving premium assistance to
contribution to the Exchange. make a payment of $750 per
Sec. 512: For employers who don’t employee. For employers with 50 or
offer coverage, establishes a payroll more FTEs who offer insurance but
tax of 8% of the wages of its have at least one employee receiving
employees. Small employers with premium assistance, the employer
annual payroll of $500,000 are must pay the lesser of $3,000 for
exempt. Payroll tax phases in for each employee receiving assistance
small employers with annual payroll or $750 for all full time employees.
from $500,000-$750,000. MA: Imposes a $600 fine on large
employers who require employees to
be on a waiting list for longer than 2
months before they become eligible
for employer-sponsored coverage.
Revenue Sec. 551: Establishes a 5.4% tax on Sec. 9001: Levies an excise tax of
modified adjusted gross income in 40% on insurance companies and
excess of $1M for joint tax returns plan administrators for any health
($500,000 for other tax returns). coverage plan that is above the
Sec. 552: 2.5% excise tax on threshold of $8,500 for single
medical devices sold for use in the coverage and $23,000 for family
U.S. coverage. The tax would apply to
the amount of the premium in excess
of the threshold. Other revenue
3
4. provisions include an annual flat fee
Revenue (cont.) on the health insurance, pharmaceu-
tical & medical device sectors.
MA: Clarifies that non-profit health
insurance plans are exempt from the
annual flat fee.
HR 3962 (House bill) HR 3590 (Senate bill)
Community Living Sec. 2581: Establishes a new, Sec. 8002: Establishes a new,
Assistance voluntary, public long-term care voluntary, public long-term care
Services and insurance program for the purchase insurance program for the purchase
Supports (CLASS of community living assistance of community living assistance
Program) services and supports by individuals services and supports by individuals
with functional limitations. Provides with functional limitations.
cash benefit that is not less than an Provides cash benefit that is not less
avg. of $50/day. than an avg. of $50/day.
Community-Based Sec. 2534: Establishes a new [None.]
Collaborative Care program to support community- MA: Establishes a new program to
Networks based collaborative care networks – support community-based
a consortium of health care collaborative care networks – a
providers offering coordinated & consortium of health care providers
integrated health services for low- offering coordinated & integrated
income populations or medically- health services for low-income
underserved communities. populations or medically-
underserved communities.
HEALTH INSURANCE EXCHANGES
Individual/Small Sec. 301: Establishes the Health Sec. 1311: Requires the Secretary of
Group Market for Insurance Exchange which HHS to award grants (available until
Health Insurance facilitates the offering of health 2015) to States to establish
Plans (Exchanges) insurance choices, including a public American Health Benefit Exchanges
plan option. (See Public Health by 2014.
Insurance Option) Sec. 1321: Requires the Secretary to
set standards for the Exchanges,
qualified health plans, reinsurance,
and risk adjustment. If the Secretary
determines before 2013 that a State
won’t have an operational Exchange
by 2014, the Secretary is authorized
to operate an Exchange in that State.
MA: Requires at least two multi-
state qualified health plans to be
offered through each State Exchange
Eligibility for Sec. 302: Beginning in Year 1 Sec. 1312: Allows small employers
Participation in the (defined in Sec. 100 (c) as 2013), and any individual who is lawfully
4
5. Exchange individuals without insurance and residing within a State and who is
Eligibility for small employers with 25 or fewer not incarcerated to participate in a
Participation employees are allowed to participate State’s Exchange. Beginning in
(cont.) in the Exchange. In 2014, employers 2017, large employers may
with 50 or fewer employees can participate as well.
participate and in 2015, employers
with 100 and fewer employees may
participate with the ultimate goal of
eventually allowing all employers to
participate. **Medicaid-eligible
individuals will be enrolled in
Medicaid, not the Exchange.
HR 3962 (House bill) HR 3590 (Senate bill)
Outreach & Sec. 305: Requires the Health Sec. 2201: Allows individuals to
Enrollment Efforts Choices Commissioner (who apply for and enroll in Medicaid,
oversees the Exchange) to conduct CHIP, or the exchange through a
outreach and enrollment activities to state-run website.
ensure timely enrollment, including
outreach to individuals with mental
illness or cognitive impairments.
Essential Benefits Sec. 222: Defines the services that Sec. 1302: Defines the services that
Package (For Plans must be offered by all plans within must be offered by all plans within
in the Exchanges) the Exchange. Includes the Exchange. Includes
rehabilitative and habilitative rehabilitative and habilitative
Essential Benefits services; mental health and services; mental health and
Package (cont.) substance use disorder services, substance use disorder services,
including behavioral health including behavioral health
treatments. Requires that the treatments.
Secretary of HHS consider adding Sec. 1311: Allows states to require
domestic violence counseling to benefits in addition to the essential
behavioral health or primary care health benefits.
visits.
Cost-Sharing in the Sec. 222: Annual cost-sharing Sec. 1302: Annual cost-sharing
Exchange cannot exceed $5,000 for an cannot exceed $5,000 for an
individual and $10,000 for a family. individual and $10,000 for a family.
These limits include the cost of These limits do not include the cost
premiums. of premiums. Prohibits deductibles
greater than $2,000 for individuals
and $4,000 for families enrolled in
employer-sponsored plans.
Benefit Package Sec. 303: Plans must offer at least Sec. 1302: Differences between the
Levels one basic plan in each service area types of plans are the levels of cost
they operate and have a choice to sharing required: Bronze (plan must
offer one enhanced and one pay for 60% of costs), Silver (70%),
premium plan. Differences between Gold (80%), and Platinum (90). In
the three plan types are the levels of addition, a catastrophic plan may be
5
6. cost-sharing required, not the offered to individuals under age 30
Benefit Package benefits covered. Variation in cost- or individuals exempted from the
Levels (cont.) sharing between plans cannot mandate because of a hardship
exceed 10%. Also creates a 4th plan waiver. The catastrophic plan must
tier: “premium-plus”: plans may cover essential health benefits and at
offer non-covered benefits at an least 3 primary care visits but may
additional cost to the consumer. require higher cost sharing.
States may apply state benefit
mandates to all Exchange
participating plans.
HR 3962 (House bill) HR 3590 (Senate bill)
State Flexibility Sec. 308: Permits states to offer their
Sec. 1332: Beginning in 2017, gives
own Exchange or join with a group States the right to apply for a waiver
of states to create their own for up to 5 years of requirements
exchange. relating to the Exchanges, qualified
health plans, and cost-sharing
requirements. States must show that
waivers will provide coverage that is
at least as comprehensive and
affordable to at least a comparable
number of residents as the Exchange
would provide and must also show
that the waiver would not increase
the Federal deficit.
Sec. 1333: By July 1, 2013, requires
the Secretary to issue regulations for
interstate health care choice
compacts (which can begin in 2016).
Under these compacts, qualified
health plans can be offered in all
participating States but insurers
would still be subject to each State’s
consumer protection and other laws.
Affordability Sec. 341: Creates affordability Sec. 1401(36B): Creates premium
Credits for credits for people with incomes up assistance credits for people with
Exchange- to 400% of poverty. For 2013-2014, incomes up to 400% of poverty. For
Participating Plans credits can only be used to purchase individuals or families at 100% of
the Basic plan, after which they can poverty, the credits cover premium
be used to purchase other plans. costs that exceed 2% of income.
Sec. 343: At 133% of poverty, Premium assistance credits are
credits will cover premium costs that calculated on a sliding scale,
exceed 1.5% of the individual’s or phasing out at 400% of poverty,
family’s income. Premium credits where they cover premium costs that
are calculated on a sliding scale, exceed 9.8% of the individual’s or
phasing out at 400% of poverty, family’s income.
where they cover costs exceeding Sec. 1402: The standard cap on out-
6
7. 12% of the individual’s or family’s of-pocket payments is $5,950 for
Affordability income. Caps on out-of-pocket individuals and $11,900 for families.
Credits (cont.) payments for those receiving credits For those receiving credits, the caps
range from $500 for an individual on out-of-pocket spending are
and $1000 for a family at the lowest reduced to one third of the standard
income tier to $5000 for an level for those between 100-200% of
individual and $10,000 for a family poverty, one half of the standard
at highest income tier. level for those between 200-300% of
poverty, and two thirds of the
standard level for those between
300-400% of poverty.
MEDICAID/CHIP
HR 3962 (House bill) HR 3590 (Senate bill)
Medicaid Sec. 1701: Requires states to cover Sec. 2001: Requires states to cover
Expansion children, parents, individuals with all non-elderly, non-pregnant
Medicaid disabilities, and non-disabled individuals who are not entitled to
Expansion (cont.) childless adults under age 65 who Medicare up to 133% of poverty
are not eligible for Medicare and beginning in 2014. From 2014 to
who have incomes at or below 150% 2016, the federal government will
of FPL. For individuals that fall into pay 100% of the cost of covering
these categories and with incomes newly eligible individuals. From
between the levels in effect in the 2017 to 2019, federal support is
state as of June 16, 2009 and 150% phased down, and from 2019
of FPL, the federal gov’t would pay onward, states will receive an
100% of the costs of Medicaid FMAP increase of 32.3 percentage
coverage in 2013 and 2014 and 91% points for covering these
in 2015 and beyond. individuals. States must maintain
Sec. 1703: Prohibits states from the same income eligibility levels
adopting eligibility standards, through 2013, but may be exempt if
methodologies, or procedures in they are experiencing a budget
their Medicaid programs that are deficit. For children, states must
more restrictive than those in effect maintain current eligibility levels
as of June 16, 2009. through Sept. 2019.
MA: States may opt to implement
these eligibility levels beginning in
Apr. 1, 2010.
CHIP Sec. 1703: Prohibits states from Sec. 2101: Requires states to
adopting eligibility standards, maintain current eligibility levels for
methodologies, or procedures in CHIP through Sept. 2019. From
their CHIP programs that are more 2014 to 2019, states will receive a
restrictive than those in effect as of 23 percentage point increase in the
June 16, 2009. This maintenance of CHIP match rate. There is no
eligibility ends upon expiration of provision to reauthorize CHIP after
7
8. the CHIP program on Dec. 31, 2013. 2019.
CHIP (cont.) MA: Extends funding for CHIP
through 2015.
HR 3962 (House bill) HR 3590 (Senate bill)
Medicaid Medical Sec. 1722: Establishes a 5-year pilot Sec. 2703: Provides states the option
Home Pilot program to test the medical home of enrolling Medicaid beneficiaries
concept with Medicaid beneficiaries. with chronic conditions, including
Specifically names the inclusion of serious and persistent mental illness,
medically fragile children and high- into a health home. Grants of up to
risk pregnant women. The federal $25 million are provided for
government would match the costs planning and implementing the pilot
of community care workers at 90% projects.
for the first 2 years and 75% for the
next 3 years. The total funding
provided for this project is $1.235B.
Therapeutic Foster Sec. 1727: Clarifies that federal [None.]
Care Medicaid law does not prohibit State
Medicaid programs from covering
TFC for children in out-of-home
placements.
Suspension of Sec. 1729: Requires States to [None.]
Medicaid suspend, not terminate, eligibility
Eligibility for for beneficiaries under age 19 who
Justice-Involved are incarcerated in a public
Youth institution during period of
incarceration.
Medicaid Sec. 1730A: Allows State Medicaid Sec. 2706: Establishes a
Accountable Care programs to pilot one or more of the demonstration project that allows
Organization Pilot models used in the Medicare qualified pediatric providers to be
Program Accountable Care Organization Pilot recognized and receive payments as
Program established in HR. 3962. ACOs under Medicaid. ACOs that
Admin costs would be matched at meet quality standards and provide
90% in the first 2 years and 75% in services at a lower cost can share in
the last 5 years. the savings that result.
Extension of Sec. 1749: Extends the Medicaid [None.]
Medicaid FMAP FMAP increase originally
Increase authorized in the American
Recovery & Reinvestment Act
through June 2011.
Medicaid Sec. 1787: Requires HHS to Sec. 2707: Requires HHS to
Emergency establish a 3-year Medicaid establish a 3-year Medicaid
Psychiatric demonstration project to reimburse demonstration project to reimburse
Demonstration certain institutions for mental certain institutions for mental
Project disease for services provided to disease for services provided to
Medicaid beneficiaries between the Medicaid beneficiaries between the
8
9. ages of 21 and 65 who are in need of ages of 21 and 65 who are in need of
Medicaid medical assistance to stabilize an medical assistance to stabilize an
Emergency emergency psychiatric condition. emergency psychiatric condition.
Services (cont.) Provides $75 million for the Provides $75 million for the
demonstration project. demonstration project.
HR 3962 (House bill) HR 3590 (Senate bill)
Community [None.] Sec. 2401. Establishes an optional
Services Medicaid benefit through which
states could offer community-based
attendant services and supports to
Medicaid beneficiaries who would
otherwise require the level of care
offered in a hospital, nursing
facility, or intermediate care facility
for the mentally retarded.
Sec. 2402: Removes barriers to
providing HCBS by giving states the
option to provide more types of
HCBS through a state plan
amendment to individuals with
higher levels of need, rather than
through a waiver, and to extend full
Medicaid benefits to individuals
receiving HCBS under a state plan
amendment.
MEDICARE
Medicare Part D Sec. 1181: Eliminates the Part D Sec. 3301: Requires drug
coverage gap – or donut hole – manufacturers to provide a 50%
beginning with a $500 reduction in discount to Part D beneficiaries for
2010 and completing phase out by brand-name drugs and biologics
2019. purchased in the donut hole
Sec. 1182: Provides discounts of beginning July 1, 2010.
50% to brand-name drugs offered in Sec. 3305: Requires HHS to
the donut hole (Beginning in 2010). transmit formulary and coverage
Sec. 1185: Prevents Part D plans information to Low-Income Subsidy
from making any formulary changes (LIS) beneficiaries who have been
that reduce coverage (inc. increased automatically reassigned to new Part
cost-sharing) in any way once the D plans.
plan marketing period begins. Sec. 3307: Codifies the current six
Sec. 1202: Eliminates cost-sharing classes of clinical concern.
for ppl receiving care under a HCBS Sec. 3309: Eliminates cost sharing
waiver who would otherwise require for beneficiaries receiving care
institutional care. under a HCBS program who would
9
10. otherwise require institutional care.
HR 3962 (House bill) HR 3590 (Senate bill)
Specialized Sec. 1177: Extends the Special Sec. 3205: Extends the Special
Medicare Needs Plan (SNP) program through Needs Plan (SNP) program through
Advantage Plans 2012, and extends certain fully 2013 and requires SNPs to be
for Special Needs integrated dual eligible SNPs approved by the National
Individuals through 2015. Also extends the Committee for Quality Assurance.
moratorium on service area Allows HHS to apply a frailty
expansion for dual eligible SNPs payment adjustment to fully-
that do not meet certain integrated, dual-eligible SNPs that
requirements until 2012. enroll frail populations. Requires
Sec. 1178: Extends SNPs that serve HHS to transition beneficiaries
residents in continuing care enrolled in SNPs that do not meet
retirement communities through statutory target definitions. Requires
2012. dual-eligible SNPs to contract with
state Medicaid programs beginning
in 2013. Requires an evaluation of
Medicare Advantage risk adjustment
for chronically ill populations.
Medicare Sec. 1301: Creates a $20M pilot Sec. 3022: Allows ACOs that meet
Accountable Care program that supports an alternative quality of care targets and reduce
Organizations payment model within fee-for- costs to share in a portion of their
service Medicare to reward savings to the Medicare program.
physician-led organizations that take
responsibility for the costs and
quality of care received by their
patients over time. ACOs can
include groups of physicians
organized around a common
delivery system, an independent
practice association, a group
practice, or other practice
organizations. Nothing in this
provision prohibits the inclusion of
other provider types or health
organizations. ACOs that achieve
quality and cost benchmarks are
rewarded with a share of
programmatic savings. (Begins Jan.
1, 2012)
Medicare Medical Sec. 1302: Expands pre-existing Sec. 3502: Creates a program to
Home Pilot Medicare medical home demo and establish and fund the development
Program allots approx. $1.8B for the pilot of community health teams to
programs. support the development of medical
homes by increasing access to
comprehensive, community based,
10
11. coordinated care.
HR 3962 (House bill) HR 3590 (Senate bill)
Medicare Payment Sec. 1308: Adds state-licensed or [None.]
for LMFT/LPC certified MFTs and LPCs as
Services Medicare providers and pays them at
the same rate as social workers.
WORKFORCE
Co-location of [None.] Sec. 5604: Authorizes $50 million in
Primary and grants for coordinated and integrated
Specialty Care in services through the co-location of
Community-Based primary and specialty care in
Mental Health community-based mental and
Settings behavioral health settings.
National Health Sec. 2201: Increases loan repayment Sec. 5208: Provides specific funding
Service Corps benefits for each Corps member to a amounts for the National Health
max of $50,000/year. Allows Service Corps, increasing funding
fulfillment of Corps service from $320,461,632 in 2010 to
obligation through part-time service $1,154,510,336 in 2016, and
and clinical teaching (for up to 20% adjusted each year thereafter “by the
of the period of obligated service). product of ‘‘(A) one plus the
Sec. 2202: Authorizes an add’l average percentage increase in the
$1.8B between FY2011-FY2015) to costs of health professions education
the NHSC. during the prior fiscal year; and (B)
one plus the average percentage
change in the number of individuals
residing in health professions
shortage areas designated under
section 333 during the prior fiscal
year, relative to the number of
individuals residing in such areas
during the previous fiscal year.’’
Training for Sec. 2522: Establishes a new Sec. 5306: Awards grants to schools
Behavioral Health training program for mental and for the development, expansion, or
Professionals behavioral health professionals enhancement of training programs in
(including those specializing in social work, graduate psychology,
substance abuse counseling and professional training in child and
addiction medicine) to promote adolescent mental health, and pre-
interdisciplinary training and service or in-service training to
coordination of the delivery of paraprofessionals in child and
health care. Authorizes $60M for adolescent mental health.
each of FY2011-FY2015 to carry
out the program. Requires that no
less than 15% of funds to be used
11
12. for training programs in psychology.
HR 3962 (House bill) HR 3590 (Senate bill)
Training Activities Sec. 2527: Establishes a new $17M [None.]
Related to Autism program to support training
and Other activities to address the unmet needs
Developmental of kids and adults with autism and
Disabilities related DDs.
Indian Health – Sec. 125: Allows the Secretary of [None.]
Behavioral Health HHS to enter into contracts and/or
Training make grants to tribal colleges to
establish demonstration programs
developing educational curricula for
substance abuse counseling.
Sec. 126: Improves access to
behavioral health services through
training and education programs.
Indian Health – Secs. 701- 715: Requires that the [None.]
Behavioral Health Secretary of HHS implements
Treatment, various treatment and prevention
Prevention, and strategies and pilot programs and
Education authorizes an annual appropriation
of such sums as necessary.
Loan repayment [None.] Sec. 5203. Establishes and funds a
for pediatric Pediatric Specialty Loan Repayment
mental health Program for individuals employed in
specialists in health professional shortage area or
underserved areas medically underserved area for at
least 2 years, who provide pediatric
medical subspecialty, pediatric
surgical specialty, or child and
adolescent mental and behavioral
health care, including SA prevention
and treatment services.”
Educating Primary [None.] Sec. 5405: Establishes a Primary
Care Providers Care Extension Program to educate
about Mental primary care providers about
Health preventive medicine, chronic disease
management, mental and behavioral
health services (including substance
abuse prevention and treatment
services), and evidence-based and
evidence-informed therapies and
techniques.
MISCELLANEOUS
12
13. HR 3962 (House bill) HR 3590 (Senate bill)
340B Program Sec. 2501: Expands the 340 Drug Sec. 7101: Extension of 340B drug
Discount Program to other entities, pricing does not include community
including those that provide mental health or addictions centers.
community mental health or
addictions services.
Federally- Sec. 2513: Sets forth criteria for the [None.]
Qualified certification of FQBHCs and
Behavioral Health recognizes the role of such centers
Centers as safety net providers for
individuals with behavioral, mental
health, and substance use disorders.
Community [None.] Sec. 4201: Authorizes competitive
Transformation grants to eligible entities for
Grants programs that promote individual &
community health & prevent the
incidence of chronic disease, incl.
programs to prevent or reduce the
incidence of mental illness.
Grant Program to [None.] Please Note: ENHANCED MA: Allows the Secretary of HHS
Establish National Act introduced in House as a stand- to provide grants to institutions of
Centers of alone bill (HR 4204). higher education or a public/private
Excellence for research institution to establish
Depression national centers of excellence in
(ENHANCED depression. These grantees will
Act) engage in activities related to the
treatment of depression. Priority is
given to applicants who, among
other things, have a demonstrated
capacity to establish relationships
with CMHCs and other community
providers.
13