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The article focuses on Public Health and Law in the U.S. Topics include unlawful government regulations that threaten health, issue of Title X "gag" rule by american president Trump, and use of extraordinary equity power by states, professional societies, and nonprofit health care providers to stop Title X.

The article reports on the assessing the reproductive health damage. Topics discussed the steps towards reproductive health protections for American women and their families; mentions the aim of undermining women's access to health care in 2020 and focuses the abortion rights; and highlights the reproductive health policy during 2018 which represents the number of abortion restrictions.

The article talks about the misconception about poor working-age adults in the U.S. and their health care, including the national attitude toward the poor. Topics discussed include the health care reforms brought by the Affordable Care Act's (ACA); the efforts to remove Medicaid expansion in several U.S. states; and the need to improve government assistance to health care of the poor.

The article offers information on efforts of the U.S. government to improve the community health and to provide comprehensive, high-quality primary health care in urban and rural communities through funding. Topics discussed include building of community health centers program; children to substance abuse treatment for communities ravaged by the opioid epidemic and home and community-based care for the frail elderly; and health centers use grants to care for the uninsured and underinsured.

The article informs that the 50th anniversary of Medicaid's special early and periodic screening diagnosis and treatment (EPSDT) benefit establishes a coverage standard for the nation's poorest children that has no parallel in other forms of health insurance. It is noted that firms employing a predominantly low-income workforce are significantly less likely to offer health insurance.

The article informs about the increasing cases of deaths related to firearms among children in the U.S. and recommendations given by American Academy of Pediatrics (AAP) to pediatricians for preventing the same. Topics include to Wollschlaeger v. Governor, State of Florida court case related to Firearm Owners' Privacy Act (FOPA); examining governmental laws aimed at regulating medical practice; and passing of FOPA by Florida legislature in response to six complaints about gun ownership.

The article discusses approval of contraceptive methods provided by the Affordable Care Act (ACA) by the U.S. Food and Drug Administration (FDA). Topics discussed include information on the U.S. Religious Freedom Restoration Act (RFRC) which contains plans sponsored by religious organizations and nonprofit organizations; elimination of the ACA by the U.S. President Donald Trump; and policies to be made in the U.S. regarding contraceptive coverage.

The author discusses the future of Child Health Policy as to the 50th anniversary in 2017 of the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) or Special Children's Benefit of Medicaid. She agrees that the government should prioritize modernization of federal policies on EPSDT to improve pediatric practice of Medicaid since its last 1989 updates. Also discussed are the 1967 Social Security Amendments on adding children's coverage and work of Title V agencies on healthcare needs.

The author discusses implementation of the Section 1557 related to the Affordable Care Act (ACA). Topics discussed include association of civil rights law with health care system by description of the U.S. Civil Rights Act of 1964, observation of discrimination in medical expense coverage through health insurance, implementation of cost sharing strategies along with discriminatory marketing practices by health agencies and recommendations for civil rights connection with health insurance.

The author looks at some developments concerning community benefit spending practices of tax-exempt hospitals in the U.S. She says the Internal Revenue Service (IRS) has recognized that hospitals can qualify as tax-exempt charities since 1956. She cites that there is an intensifying focus on the social determinants of health. She mentions policy shifts under the Affordable Care Act (ACA).

The article discusses the role of the U.S. Supreme Court on the future of reproductive health rights among Americans. It traces the Court's involvement with reproductive health based on the constitutional right to marital privacy over issues of contraceptive use or access to abortion. It explains the federal laws that barred public funding for abortion and the enactment of state laws over abortion access, limitations, and restrictions.

CONTEXT The confidentiality of family planning services remains a high priority to adolescents, but barriers to implementing confidentiality and privacy practices exist in settings designed for teenagers who are medically underserved, including federally qualified health centers ( FQHCs). METHODS A sample of 423 FQHCs surveyed in 2011 provided information on their use of five selected privacy and confidentiality practices, which were examined separately and combined into an index. Regression modeling was used to assess whether various state policies and organizational characteristics were associated with FQHCs' scores on the index. In-depth case studies of six FQHCs were conducted to provide additional contextual information. RESULTS Among FQHCs reporting on confidentiality, most reported providing written or verbal information regarding adolescents' rights to confidential care (81%) and limiting access to family planning and medical records to protect adolescents' confidentiality (84%). Far fewer reported maintaining separate medical records for family planning (10%), using a security block on electronic medical records to prevent disclosures (43%) or using separate contact information for communications regarding family planning services (50%). Index scores were higher among FQHCs that received Title X funding than among those that did not (coefficient, 0.70) and among FQHCs with the largest patient volumes than among those with the smallest caseloads (0.43). Case studies highlighted how a lack of guidelines and providers' confusion over relevant laws present a challenge in offering confidential care to adolescents. CONCLUSIONS The organizational practices used to ensure adolescent family planning confidentiality in FQHCs are varied across organizations. [ABSTRACT FROM AUTHOR]

The article discusses the U.S. Supreme Court case Gobeille v. Liberty Mutual Insurance Company, which will test whether self-insuring employers can refuse to comply with state all-payer claims reporting laws. It mentions that Affordable Care Act (ACA) has no role in all-payer claims reporting systems established by states. It also reveals preemption provision made into Employee Retirement Income Security Act (ERISA) by the U.S. Congress.

The article focuses on U.S.degrading health insurance conditions. Topics discussed includes a survey on health reform implementation by Commonwealth Fund's Biennial Health Insurance Survey and the Kaiser Family Foundation, under insured full year coverage, rising deductibles as a factor in under insurance, financial exposure created by high deductibles, protection against high medical costs by insurance coverage, outlandish health care costs, rising insurance premiums.

The article discuses the role of the U.S. Congress and Republican party members in proposing health care reforms. Topics discussed include court decisions regarding the ban on Affordable Care Act (ACA) premium tax subsidies, role of federal government in providing premium subsidies under state-based exchange, and private insurance reform plans.

The article discusses the future of subsidies in the federal health insurance exchange in the U.S. Topics discussed include implementation of the Affordable Care Act (ACT) as reminder of judiciary decisions to the U.S. health policy, the importance of establishing exchange to protect people against the loss of premium subsidies and the U.S. Supreme Court to hear four cases related to whether ACA permits people who buy health insurance through federal Exchange.

The article focuses on the issue of the performance of the U.S. Affordable Care Act (ACA) for children as of September 2014. Topics discussed include the mandatory eligibility standard for children aged 18 under the ACA, design flaws in the ACA and influence of the Children's Health Insurance Program (CHIP) on the ACA.

The author reflects on the arguments between arts and crafts company Hobby Lobby Corp. and wood furniture manufacturer Conestoga Wood Specialties regarding the Religious Freedom Restoration Act (RFRA), an act which allows corporations to deny employees benefits to which they are entitled. Topics discussed include the laws which serves as backdrop of the arguments including the Affordable Care Act (ACA), and the views regarding the extension of the Court on the RFRA's protection to corporation.

U.S. health policy is engaged in a struggle over access to health information, in particular, the conditions under which information should be accessible for research when appropriate privacy protections and security safeguards are in place. The expanded use of health information—an inevitable step in an information age—is widely considered be essential to health system reform. Models exist for the creation of data-sharing arrangements that promote proper use of information in a safe and secure environment and with attention to ethical standards. Data stewardship is a concept with deep roots in the science and practice of data collection, sharing, and analysis. Reflecting the values of fair information practice, data stewardship denotes an approach to the management of data, particularly data that can identify individuals. The concept of a data steward is intended to convey a fiduciary (or trust) level of responsibility toward the data. Data governance is the process by which responsibilities of stewardship are conceptualized and carried out. As the concept of health information data stewardship advances in a technology-enabled environment, the question is whether legal barriers to data access and use will begin to give way. One possible answer may lie in defining the public interest in certain data uses, tying provider participation in federal health programs to the release of all-payer data to recognized data stewardship entities for aggregation and management, and enabling such entities to foster and enable the creation of knowledge through research. [ABSTRACT FROM AUTHOR]

BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors frequently result in dermatologic toxicities,including rash, xerosis, pruritus, and paronychia. Although the frequency and severity of these events have beendescribed, their effect on health-related quality of life (QoL) remains poorly understood. By using a dermatology-specific questionnaire, the authors examined the effect of these toxicities on QoL. METHODS: Patients completed theSkindex-16, a questionnaire that measures the effects on 3 domains of QoL: symptoms, emotions, and functioning.The severity of dermatologic toxicities was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0 (NCI-CTCAE). Correlations of dermatology QoL scores with NCI-CTCAE grade,skin phototype (SPT), sex, age, type of EGFR inhibitor, and cancer type were investigated. RESULTS: Concordantwith greater severity of rash grade, there was an increase in median scores for symptoms (P = .0006), emotions (P <.0001), function (P = .001), and overall score (P < .0001). There was an inverse correlation between age and emotions(r = -0.26; P = .03) and overall score (r = -0.25; P = .04). There was a significant difference between patients aged50 years and patients aged >50 years with regard to symptoms (P = .02), emotions (P = .03), functioning (P =.04), and overall score (P = .02). There were no significant differences between QoL and SPT, sex, treatment type, orcancer type (P > .05). CONCLUSIONS: Toxicities, including rash, xerosis, paronychia, and pruritus, adversely affectedQoL, and rash was associated with a QoL greater decrease. Younger patients reported lower overall QoL than olderpatients who had the same toxicities. The current results support using the NCI-CTCAE as a correlative tool for measuring the effects of rash on dermatology-specific QoL. [ABSTRACT FROM AUTHOR]

The population pharmacokinetics of mycophenolic acid (MPA) and its phenolic (MPAG) and acyl (AcMPAG) glucuronide metabolites were studied in patients taking enteric-coated mycophenolate sodium. Plasma samples (n = 232), obtained from 18 renal transplant recipients, were analyzed for MPA, MPAG, and AcMPAG using a validated high-performance liquid chromatography/ultraviolet assay. Population pharmacokinetic analysis was performed using NONMEM. The pharmacokinetics of MPA were best described by a 2-compartment model, with MPAG and AcMPAG produced from the central compartment and with enterohepatic recirculation of MPA via these 2 metabolites. Population mean estimates for MPA were apparent clearance (CL/F) of 10.6 L/h (interindividual variability [IIV] = 21.4%) and apparent volume of distribution of the central compartment (V1/F) of 25.9 L (IIV = 87.8%). Mean elimination rate constants of MPAG and AcMPAG were 0.323 h[sup[sup[sup-1]]] (IIV = 29.1%) and 0.206 h[sup[sup[sup-1]]] (IIV = 48.8%), respectively. The mean fraction of MPA converted to MPAG and AcMPAG, normalized by their volumes of distribution (FM[subAG] and FM[subAC], respectively), was also estimated. The elimination rate constant for MPAG and FM[subAC] was influenced by glomerular filtration rate in patients with renal impairment. The visual predictive check, based on 100 simulated data sets each for MPA, MPAG, and AcMPAG, found that the final pharmacokinetic model adequately predicts the observed concentrations of all 3 species. [ABSTRACT FROM AUTHOR]

Background: Recent changes to Medicaid policy may have unintended consequences in the education system. This study estimated the potential financial impact of the Deficit Reduction Act (DRA) on school districts by calculating Medicaid-reimbursed behavioral health care expenditures for school-aged children in general and children in special education in particular. Methods: Medicaid claims and special education records of youth ages 6 to 18 years in Philadelphia, PA, were merged for calendar year 2002. Behavioral health care volume, type, and expenditures were compared between Medicaid-enrolled children receiving and not receiving special education. Results: Significant overlap existed among the 126,533 children who were either Medicaid enrolled (114,257) or received special education (27,620). Medicaid-reimbursed behavioral health care was used by 21% of children receiving special education (37% of those Medicaid enrolled) and 15% of other Medicaid-enrolled children. Total expenditures were $197.8 million, 40% of which was spent on the 5728 children in special education and 60% of which was spent on 15,092 other children. Conclusions: Medicaid-reimbursed behavioral health services disproportionately support special education students, with expenditures equivalent to 4% of Philadelphia’s $2 billion education budget. The results suggest that special education programs depend on Medicaid-reimbursed services, the financing of which the DRA may jeopardize. [ABSTRACT FROM AUTHOR]

Policy Points In a recently commissioned report on solutions for eliminating racial and ethnic health care inequities entitled Ending Unequal Treatment, the National Academies of Sciences, Engineering, and Medicine found a health workforce that is representative of the communities it serves is essential for health care equity. The Supreme Court decision to ban race‐conscious admission constraints pathways toward health workforce representativeness and equity. This paper draws on the National Academies report's findings that health care workforce representativeness improves care quality, population health, and equity to discuss policy and programmatic options for various participants to promote health workforce representativeness in the context of race‐conscious admissions bans. In a recently commissioned report on solutions for eliminating racial and ethnic health care inequities entitled Ending Unequal Treatment, the National Academies of Sciences, Engineering, and Medicine found a health workforce that is representative of the communities it serves is essential for health care equity. The Supreme Court decision to ban race‐conscious admission constraints pathways toward health workforce representativeness and equity. This paper draws on the National Academies report's findings that health care workforce representativeness improves care quality, population health, and equity to discuss policy and programmatic options for various participants to promote health workforce representativeness in the context of race‐conscious admissions bans. [ABSTRACT FROM AUTHOR]

ABSTRACT: Economically disadvantaged rural families, like their urban counterparts, face significant difficulties obtaining adequate maternity and infant health care resulting, in part, from an unequal distribution of resources as well as economic and racial barriers to health care nationwide. Rural women and infants must contend with additional access problems that reflect the inherent constraints of rural existence as well as specific state policies that exacerbate the barriers associated with isolation. This article provides an overview of the availability and accessibility of maternal and infant health services in nonmetropolitan America and identifies policy reforms to improve access to care. [ABSTRACT FROM AUTHOR]

Public program reforms in the 1980s have substantially increased the numbers of poor pregnant women potentially eligible for Medicaid coverage. Structural deficiencies in the Medicaid program, together with inadequate arrangements in managed-care plans, however, have not led to generally acceptable levels of maternity care. Demonstration projects indicate that Medicaid can be modified cost effectively to underwrite early, continuous, and comprehensive care delivery. Recommendations are suggested for eligibility guarantees, enrollment safeguards, benefit and treatment protocols, provider recruitment, quality control, and sufficient payment rates to overcome barriers to adequate levels of maternal health care. [ABSTRACT FROM AUTHOR]

Discusses the nature of behavioral health contracting in the U.S. Emergence of managed care organizations that offer enrolled members specified health care; Creation of virtual health systems through subcontracts; Consideration of the legal basis of health care.

In this article the author discusses the U.S. Supreme Court case National Federation of Independent Business v. Sebelius. Topics include the shared responsibility provision of the U.S. Patient Protection and Affordable Care Act (ACA), the debate over whether the U.S. Congress has the power to impose mandatory conditions of participation on state Medicaid programs, and the implications of the Medicaid ruling on future congressional efforts to modify spending clause statutes.

Comments on the findings of a study which examined the use of healthcare by homeless persons. Significance of the study for policymakers; Implications of the findings of the study for Medicare agencies; Low-level funding for the Homeless and Health Centers as a cause for concern.

Context Methods Findings Conclusions Policy Points Maternal health is influenced by the quality and accessibility of care before, during, and after pregnancy. Nationwide, Medicaid covers nearly one in two births and uses managed care as a central means for carrying out these responsibilities. Thus, managed care plays a fundamental role in assuring timely, equitable, quality care and improving maternal health outcomes. A close review of managed care contracts makes evident that the absence of a national set of maternal health standards has caused challenges in setting expectations for managed care performance. State Medicaid agencies adopt a variety of approaches and underlying philosophies for contracting. Maternal health is influenced by the quality and accessibility of care before, during, and after pregnancy. Nationwide, Medicaid covers nearly one in two births and uses managed care as a central means for carrying out these responsibilities. Thus, managed care plays a fundamental role in assuring timely, equitable, quality care and improving maternal health outcomes. A close review of managed care contracts makes evident that the absence of a national set of maternal health standards has caused challenges in setting expectations for managed care performance. State Medicaid agencies adopt a variety of approaches and underlying philosophies for contracting. Managed care is how Medicaid agencies principally furnish maternity care. For this reason, the contracts that Medicaid agencies enter into with managed care organizations have attracted strong interest as a means of improving maternal health access, quality, and equity. However, limited research has documented the extent to which states use these agreements to set binding expectations across the maternal health continuum and how states approach the task of maternal health contracting.To explore maternal health contracting within Medicaid Managed Care, this study took a three‐phase, sequential approach: (1) an extensive literature review to identify clinical guidelines and expert recommendations regarding maternal health “best practices” for people with elevated health and social needs, (2) a review of the managed care contracts in use across 40 states and Washington, DC, to determine the extent to which they incorporate these best practices, and (3) interviews conducted with four state Medicaid agencies to better understand how states approach maternal health when developing their contracts.The evidence on maternal health best practices reveals nearly 60 “best practices,” although the literature review also underscored the extent to which these recommendations are fragmented across numerous professional bodies and government agencies and are thus difficult for Medicaid agencies to ascertain. The contracts themselves reflect an approach to the maternal health continuum in a fragmented and incomplete way. Thematic analysis of interviews with state Medicaid agencies revealed three key approaches to contracting for maternity care: an “organic” approach, an “intentional” approach, and an approach “grounded” in state strategy.The absence of comprehensive, integrated guidelines reflecting the full maternal health continuum likely complicates the contracting task and contributes to incomplete, ambiguous contracts. A major step would be the development of a “best practices tool” that helps state Medicaid agencies translate evidence into comprehensive, clear contracting expectations. [ABSTRACT FROM AUTHOR]