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Dental benefits under Medicaid.: An article from: Pediatric News

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This digital document is an article from Pediatric News, published by Thomson Gale on June 1, 2007. The length of the article is 839 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.

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Title: Dental benefits under Medicaid.(Health P… More >>

Dental benefits under Medicaid.: An article from: Pediatric News

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Keep Diabetes Under Control And Live Healthy Life

Diabetes is a condition in which body either does not produce enough, or doesn’t respond properly to insulin, a hormone produced in the pancreas. Insulin enables cells to absorb glucose and turn it into energy. This causes glucose to add and build up in the blood (hyperglycemia), leading to various potential complications.

Diagnosing diabetes is vital not only to manage their condition for the long term, but also to ensure that you do not end the suffering of some of the effects of this terrible disease, which can lead to blindness and amputation to name a few. Now, although the opening line may seem a bit scary let me put in place, saying that although there is no cure for diabetes, the lifestyle and health care remedy this condition can be kept under control very well so even if you have that you should be able to live a life almost as if he were not there.

Before we get to diagnose diabetes, I first must point out; there are two types of diabetes. Type 1, which is often found in young people and is possibly more of a hereditary condition, and type 2. Type 2 is likely to become an epidemic, since it is often self-inflicted condition that is caused by poor food choices that often lead to obesity and this is strongly linked to type 2 diabetes, and say its close epidemic due to the alarming rate at which obesity is growing.

The first steps to diagnose diabetes are the attention to signs such as frequent urination (especially at night), extreme thirst, unexplained weight loss and blurred vision. If you notice these signs, then you should see a doctor immediately so they can start testing to see if you have diabetes.

The tests are generally blood or urine tests to measure glucose in the body. The reason for this is to check the insulin resistance, as this may eventually lead to impaired glucose tolerance, and stop doing their job is to strictly monitor the amount of sugar in the blood and keep it within a range narrow. Resistance occurs when there is plenty of insulin from the pancreas so (it is functioning normally and doing too much insulin), but the body’s cells are resistant to its action reflected in the level of blood sugar being too high.

The good news out of all this is that if you are diagnosed with diabetes, you can control it with natural remedies. However, you probably want to keep your blood sugar level as normal as possible, and this is covered by the life changes to play. The main cause of excess blood sugar is refined white flour and white sugar. Our bodies are not accustomed to them in the way they are, but why we end up with it for so long is because we never put them in our bodies at the rate we do now. With cakes and white bread and sugar in plenty going on all (including frozen foods), then you have to be more vigilant than ever about what you eat to keep your diabetes under control and live a healthy life.

Remedies to control diabetes problem:

Add starchy foods such as dried beans and bean soups and casseroles to increase intake of starch in food, because it will have a positive effect on the level of blood sugar.

Eat plenty of fruit and vegetables for soluble fiber helps reduce diabetic complications and for the absorption of glucose in the intestine.

Control your weight for type 2 diabetes it particularly important because extra body fat causes the body to have difficulty making and using insulin. Low fat recipes help you to lose weight and control weight, if you lose a few pounds, you may even be able to reduce medication.

About Author
Find more information on remedies for diabetes and treatment of diabetes problem. Also get more information on gestational diabetes in women.

Banish Dark Circles Under Eyes

At some point in our lives we all experience dark circles and puffiness around the eye area. Dark circles and puffiness adds unwanted age to our appearance. There are many factors that contribute to dark circles under the eyes. Below are the most common causes.

Genetics – If your parents have or had dark areas around and/or under the eyes, chances are you are predisposed to inherit this condition. Furthermore, if your family members suffer from puffiness and bags under the eyes chances are you will inherit this trait.

Medications – Any medicine that causes the blood vessels to dilate will produce dark circles under and around the eye area. The skin under and around the eye is very thin and thus the veins will show through producing a dark area.

Allergies – Hay fever, asthma or other allergies that causes watery and itching eyes can produce dark areas under the eyes. Allergy sufferers have a tendency to rub away their itchy watery eyes thus damaging the blood vessels below the very thin skin of the eye area which causes the veins to show through.

Nutrition – Maintaining a well balanced diet with proper nutrition and being fully hydrated affects the appearance of your skin. Your skin needs its vitamins to stay healthy just as the rest of the body.

Lack of Sleep and Fatigue – Sleep is your body’s rejuvenation mechanism. Lack of sleep shows through in the eye area such as dark circles under eyes, puffiness and bags under the eyes. Has anyone ever said to you “you look tired today”? The appearance of your eyes and the surrounding area are the first to show tell tale signs of not enough sleep.

Hormones – Changes in hormones from menstruation, menopause or from medicines that influence hormones can change your skin tone and texture. Again, blood dilatation which causes veins to enlarge will show through under the very thin skin in the eye area leaving dark areas.

Aging – The eye area is the first to show signs of aging with wrinkles, sagging skin and thinning skin. The disappearance of fat pads which sits directly below the eyes causes shadows to reflect off the hollows of the eyes darkening the area below the eyes. Additionally lack of elasticity and lack of moisture will darken the eye area.

The eye area needs special treatment to ward off signs of aging and dark circles. There are many products on the market that address the needs of the eye area. Additionally, there are many home made recipes to decrease the appearance and/or eliminate dark circles under the eyes. Below are homemade recipes specifically for the eye area.

Almond Oil – Easily absorbed into the skin and is an excellent emollient with nourishing properties. Almond oil promotes soft and smooth skin. Also used in massage therapy for its hydrating properties. Note: People who are allergic to it, or have nut allergies should avoid almonds and almond oil. Massage around eye area gently without stretching the skin for two weeks and see the improvement.

Tea – A cold compress of rosemary. Excellent for its antioxidant properties, and secondly has a remarkable stimulating effect on the skin. Mix 1/2 cup cup fresh rosemary and a quart of water to a boil and steep for 20 minutes, strain and then chill.Place cloth in liquid, wring out and place on eyes for 15 to 20 minutes, once a day or as needed. Note: rosemary essential oil has a highly stimulating action and may not be suitable for people with epilepsy or high blood pressure. The essential oil should also not be used during pregnancy.

Tea – A cold compress of Chamomile. Chamomile tones all types of complexions. The anti-inflammatory effect of the essential oil applied topically improves skin regeneration, and a cold compress does wonders for puffy eyes. Chamomile is used in facial steams to reduce puffiness and cleanse the pores of the skin. Steep tea bags and chill. Place cotton balls in liquid and apply to dark circles leaving on 10 to 15 minutes. Note: Handling fresh chamomile plants may cause dermatitis in some individuals. It should not to be used when using anti-coagulant drugs. Please note that the essential oil is said to stimulate the uterus and should be used with care in pregnancy. Allergic reactions may occur – normally people allergic to daisies.

Lemon/Tomato Paste: 1 tsp. of tomato juice, 1/2 tsp. lemon juice, a pinch of turmeric powder and 1 tsp. of flour. Apply around the eyes and leave on for 10 minutes. Rinse thoroughly. The lemon refreshes and stimulates white corpuscles. Additionally, lemon is a bleaching agent for skin.

Above are just a few simple steps to eliminate dark circles under eyes. Another alternative is to invest in a good concealer to lighten up the eye area.

Carol Belanger PhotoAbout Author
Carol Belanger, author of 300+ Skin Care Recipes
For wonderful homemade skin care recipes, including body scrubs, facial peels and masks, etc., visit Complete Skin Care Therapy

Does Your Practice Qualify as a Group Practice Under Federal Stark Law

The Federal Stark law prohibits physicians from referring Medicare/Medicaid beneficiaries to an entity in which they (or an immediate family member) have a financial relationship for designated health services (“DHS”), unless an exception applies. DHS include: clinical lab; physical therapy; occupational therapy; radiology (including, MRI, CAT scans, and ultrasounds); radiation therapy and supplies; DME and supplies; parenteral and enteral nutrients, equipment and supplies; prosthetics, orthotics, and prosthetic devices and supplies; home health services; outpatient prescription drugs; and inpatient and outpatient hospitalization services. In addition, physicians should also be mindful that the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule to amend the Stark regulations effective January 1, 2006 to include diagnostic and therapeutic nuclear medicine, including PET scans, to the list of DHS.

Physicians must keep in mind that they cannot ignore Stark, as nearly every financial relationship between physicians and entities that furnish designated health services (“DHS”) implicate the law. Violations of the Stark law have substantial consequences for all parties involved, regardless of the intent of the parties. Sanctions include denial of payment for DHS claims, civil monetary penalties ($15,000 for each claim submitted plus two times the reimbursement claimed), and exclusion from Medicare and Medicaid. In addition, parties who enter into circumvention schemes are subject to a civil monetary penalty of up to $100,000 per scheme.

Group practices are well advised to document their compliance with Stark. Documentation supporting compliance is particularly important in today’s health care environment, which has had an increase in Federal False Claims litigation and investigations stemming from Qui Tam whistleblowers utilizing technical violations of the Stark law as a predicate for False Claims Act violations.

Application of Stark in the Group Practice Setting

Many common financial relationships can trigger the need for a Stark analysis. This article, however, will focus on Stark’s applicability in the group practice context as Stark applies to referrals of DHS within a group practice. For example, if a physician practice provides services such as physical therapy, clinical lab, x-rays, and/or ultrasounds, within the practice, Stark will be implicated. Once the prohibition is triggered, the relationship(s) must then fall within a Stark exception.

The in-office ancillary services exception has been arguably the single most important exception in the Stark law. This exception is designed to protect the in-office provision of certain DHS that are genuinely ancillary to the medical services provided by the practice. In order for a physician practice that provides DHS to protect its referrals under the in-office ancillary services exception, the physicians must first qualify for the group practice definition. The group practice definition is not an exception to Stark in and of itself, but any “group” of physicians that want to take advantage of the in-office ancillary services exception must be structured to meet the group practice definition.

The Group Practice Definition

Under Stark, a group practice is a physician practice that meets the following conditions:

Single Legal Entity.

The group practice must consist of a single legal entity operating primarily for the purpose of being a physician group practice in any organizational form recognized by the State in which the group practice achieves its legal status.

Physicians.

The group practice must have at least two physicians who are members of the group (whether employees, or direct or indirect owners). Stark defines a member of the group as a direct or indirect owner of a group practice (including a physician whose interest is held by his or her individual professional corporation or by another entity), a physician employee of the group practice, a locum tenens physician, or an on-call physician while the physician is providing on call services for members of the practice. An independent contractor is not a member of the group.

Range of Care.

Each physician who is a member of the group, must furnish substantially the full range of patient care services that the physician routinely furnishes, including medical care, consultation, diagnosis, and treatment, through the joint use of shared office space, facilities, equipment, and personnel.

Services Furnished by Group Practice Members.

Substantially all of the patient care services of the physicians who are members of the group (that is, at least 75% of the total patient care services of the group practice members) must be furnished through the group and billed under a billing number assigned to the group, and the amounts received must be treated as receipts of the group. Patient care services must be measured by one of the following:

  • The total time each member spends on patient care services documented by any reasonable means (for example, time cards and appointment schedules.)
  • Any alternative measure that is reasonable, fixed in advance of the performance of the services being measured, uniformly applied over time, verifiable, and documented.

Distribution of Expenses and Income.

The overhead expenses of, and income from, the practice must be distributed according to methods that are determined before the receipt of payment for the services giving rise to the overhead expense or producing the income.

Unified Business.

The group practice must be a unified business having at least the following features:

Centralized decision making by a body representative of the group practice that maintains effective control over the group’s assets and liabilities; and

Consolidated billing, accounting, and financial reporting.

Volume or Value of Referrals.

No physician who is member of the group practice directly or indirectly receives compensation based on the volume or value of referrals except as provided under the specialty rules for productivity and profit shares.

Physician-Patient Encounters.

Members of the group must personally conduct no less than 75 percent of the physician-patient encounters of the group practice.

Special Rules for Productivity Bonuses and Profit Shares

The special rules for productivity bonuses and profit shares allow a physician who is in the group practice to be paid a share of overall profits of the group or a productivity bonus based on services that he/she has personally performed (including services “incident to” those personally performed services), provided that the share or bonus is not determined in any manner that is directly related to the volume or value of referrals of DHS by the physician. CMS now takes the position that diagnostic-testing services cannot be billed as “incident to” but practices that provide physical therapy can, however, bill physical therapy services as “incident to” services (provided that all of the “incident to” requirements are met).

The Stark regulations specifically set forth examples of formulas that will be deemed not to relate directly to the volume or value of referrals. For example, a group’s profits will be deemed not to relate directly to the volume or value of referrals if revenues derived from DHS are distributed based on the distribution of the group practice’s revenue attributed to services that are not DHS payable by any Federal health care program or private payer.

Documentation of Compliance

Group practices that choose to take advantage of the special treatment that the Stark law affords them must be prepared to demonstrate compliance with the regulations. In this regard, if requested by the Secretary, group practices are required to provide documentation of the total time each member spends on patient care services, and to maintain documentation supporting compliance with the “substantially all” test. The “substantially all” test is intended to guarantee that the group practice members are providing a substantial amount of their services through the group. Groups can document compliance by any reasonable means, including without limitation, time cards, appointment schedules, personal diaries, or other reasonable means that are fixed in advance of the performance of the services being measured, uniformly applied over time, and verifiable. Groups are also required to document, in writing, a new member’s employment with, or ownership or investment in, the group practice before the new relationship commences.

The In-Office Ancillary Services Exception

In order for a group of physicians to provide DHS within the practice, including without limitation, clinical laboratory, physical therapy, x-rays, and ultrasounds, the group must first meet all of the requirements of the group practice definition. If the group practice definition is met, the group is then eligible to utilize the in-office ancillary services exception to protect its in-office DHS referrals. The in-office ancillary exception exempts services personally provided by the referring physician, a physician who is a member of the same group practice as the referring physician, an individual that is supervised by the referring physician, or if the referring physician is in a group practice, by another physician in the group practice, provided that the supervision complies with all of the Medicare payment and coverage rules for the services. In addition, the exception contains a location and a billing requirement.

Conclusion

This article is intended as only a brief summary of the Stark II Phase II Final Regulations in connection with the in-office provision of DHS within the group practice context. Physicians and groups that provide DHS should also be mindful that many other common financial relationships may also trigger Stark, including, without limitation, (1) lease agreements for space and equipment; (2) medical director agreements; and (3) physician employment contracts with group practices and hospitals.

http://www.racattorneys.com

Andrew Wachler PhotoAbout Author
Wachler & Associates, P.C., is a law firm providing healthcare legal services to healthcare providers, suppliers and entities nationwide. Since 1980, the attorneys of Wachler & Associates, P.C., have successfully defended thousands of Medicare, Medicaid and other third party payor audits.

Steps To Remove Dark Circles Under Your Eyes

Removing dark circles is not a difficult job when you consider the right guide. However, you can also treat this problem yourself and all that you have to do is to follow certain steps.

The main causes of dark circles are as follows:

How we look and how we feel will be greatly influenced by lack of sleep. The sleeping hours and quality of rest that we get is directly connected to our health.

In most of the cases, age is the main factor that contributes heavily to the cause of puffy eyes and dark circles. The skin that we find under our eyes will be thinner. As our age is counting, the skin starts to become thinner.

If you fail to balance the proper nutrition, then it may be also one of the main causes for dark circle and puffiness problems. The health problems that we face due to lack of nutrition will also play an important role in this case.

Remove dark circles and enjoy the benefits:

You have to remove dark circles under eyes to enjoy many benefits as follows:

First benefit is that it will give an entire new and beautiful look to your face. Secondly, it will boost up your self-confidence whenever you are facing anyone. Apart from this, you will also enjoy some more benefits on your day-to-day basis as well.

Easy steps for removing dark circles:

Many steps will help you to get rid of dark circle under eyes. However, the following content is to let you know some of those best steps.

Sleep and take rest for maximum possible hours. You can also check out for the new anti wrinkle pillow. Always try to use the fresh ones when it comes to daily utilities such as blankets, sheets, pajamas etc. Always have a fixed time to go to bed and also to wake up. When you follow these simple steps, you will surely get a positive outlook.

Although you cannot get younger, but on following certain steps, you can definitely look younger. Adjusting your skin care regimen will be one good example for those steps. Always an aged one needs more help compared to a teenager. An aged one should always look for increasing the thickness of the under eye skin. The health of the blood vessel will be well supported on achieving the thickness.

Removing dark circles and puffiness under eyes can also be easily achieved just by using some specialized health products such as anti aging skin care products; dark circles under eyes cream, effective skin exfoliate etc. Apart from these, for increasing your under eye skin thickness and removing dark circles and puffiness, you can also prefer compounds like HALOXYL and EYELISS. Although these are not the only ingredients available, it has been advised to prefer these as they have proved with good results. Nevertheless, one advice for you to get rid of these problems is balancing your good nutrition and good regular quality sleep as prevention is better than cure.

About Author
This article is written by Pankaj K. Kumar, who is a consultant expert providing advises to Remove Dark Circles Under Eyes and puffiness under eyes. If you really want to get rid of dark circles please visit: http://www.itsfitlife.com/dark-circles-under-eyes-cream/.

Steps To Remove Dark Circles Under Your Eyes

Removing dark circles is not a difficult job when you consider the right guide. However, you can also treat this problem yourself and all that you have to do is to follow certain steps.

The main causes of dark circles are as follows:

How we look and how we feel will be greatly influenced by lack of sleep. The sleeping hours and quality of rest that we get is directly connected to our health.

In most of the cases, age is the main factor that contributes heavily to the cause of puffy eyes and dark circles. The skin that we find under our eyes will be thinner. As our age is counting, the skin starts to become thinner.

If you fail to balance the proper nutrition, then it may be also one of the main causes for dark circle and puffiness problems. The health problems that we face due to lack of nutrition will also play an important role in this case.

Remove dark circles and enjoy the benefits:

You have to remove dark circles under eyes to enjoy many benefits as follows:

First benefit is that it will give an entire new and beautiful look to your face. Secondly, it will boost up your self-confidence whenever you are facing anyone. Apart from this, you will also enjoy some more benefits on your day-to-day basis as well.

Easy steps for removing dark circles:

Many steps will help you to get rid of dark circle under eyes. However, the following content is to let you know some of those best steps.

Sleep and take rest for maximum possible hours. You can also check out for the new anti wrinkle pillow. Always try to use the fresh ones when it comes to daily utilities such as blankets, sheets, pajamas etc. Always have a fixed time to go to bed and also to wake up. When you follow these simple steps, you will surely get a positive outlook.

Although you cannot get younger, but on following certain steps, you can definitely look younger. Adjusting your skin care regimen will be one good example for those steps. Always an aged one needs more help compared to a teenager. An aged one should always look for increasing the thickness of the under eye skin. The health of the blood vessel will be well supported on achieving the thickness.

Removing dark circles and puffiness under eyes can also be easily achieved just by using some specialized health products such as anti aging skin care products; dark circles under eyes cream, effective skin exfoliate etc. Apart from these, for increasing your under eye skin thickness and removing dark circles and puffiness, you can also prefer compounds like HALOXYL and EYELISS. Although these are not the only ingredients available, it has been advised to prefer these as they have proved with good results. Nevertheless, one advice for you to get rid of these problems is balancing your good nutrition and good regular quality sleep as prevention is better than cure.

About Author
This article is written by Pankaj K. Kumar, who is a consultant expert providing advises to Remove Dark Circles Under Eyes and puffiness under eyes. If you really want to get rid of dark circles please visit: http://www.itsfitlife.com/dark-circles-under-eyes-cream/.

How to Remove Dark Circles Under Your Eyes

Dark circles under the eyes are very common, though no less detested by anyone plagued by them. They tend to make a person look tired and run-down, and sometimes older than their natural age.

There are plenty of ways to remove dark circles under eyes effectively.

Improve Nutrition

Eating healthy is not only important for your overall nutrition but also for your eyes. If you eat plenty of vegetables and fruits, which are rich in beta carotene, then you will be promoting healthier eyes. Yes, carrots really do help your eyesight. Carrots, spinach, papaya and mango are all excellent fruits and vegetables for this purpose.

Slices of cucumber or potato can be used to reduce circles around the eyes. Close your eyes and cover your eyelids with a thin slice for up to twenty minutes. This soothes tired eyes and increases the circulation to the skin around the eyes.

If possible, use an eye cream that is also proven to remove fine lines, wrinkles, puffiness, swelling, and dryness. These added benefits can take your youthful, vibrant appearance to new heights!

Black Tea bags make for a great eye remedy. The black tea will help tighten the skin around your eyes, and it gives the eyes themselves a nice glow. Just brew yourself a cup of black tea and then use the teabag on your eyes. Don’t burn yourself, but put it on there as hot as you can comfortably stand it.

Heredity can be a monster of an obstacle! But there are ways to sidestep heredity. A major dietary overhaul like the one mentioned above is HUGE, but there are some great fatty-acid rich topicals and eye creams that can also help you tremendously.

Rose Water: It has an excellent relaxing and rejuvenating property. Rose water can effectively reduce discoloration under your eyes. To treat under eye discoloration, soak a cotton ball in 5 drops of rose water. Apply it on closed eyes for nearly 15 minutes.

Listen, we need sleep for a reason and if you go to bed at a decent hour every night, you could get rid of the dark circles under the eyes. The better you sleep, the better your circulation is throughout the day. If you’re overworked, stressed out, or have insomnia, it’s always recommended to see the family physician and let them help you get more rest.

Stop smoking: Smoking can damage your skin and destroy some vitamins present in your body. It can also dehydrate your skin when combined with the intake of coffee and high-caffeine drinks. In order to get rid of under eye discoloration, you must quit the habit of smoking.

One of the oddest solutions to removing the Dark Circles Under Eyes is to freeze cotton balls. Sometimes the area underneath your eyes will tense up because of stress, which contributes to discoloration. You can relax the area by wiping a cotton ball under each eye. Granted, it will be a little cold, but the end result could help you get somewhat of a reduction.

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