Strategic Chaosity

All day today. Every time I opened a box to put something on a shelf... oooh I want that! oh! that too!
Shiny! Snowmen!Reindeer!Gingerbread Men! Santas! baskets! tins!Cookie exchange stuff!
Good grief what was I thinking? Good thing they pulled me off to work the front.

Man in the Moon
Lit behind cut
( Thought I'd post these before I have to throw them out )

I want to thank all my wonderful f-list for the emails and virtual hugs sent the last few days. I can't say how much you all mean to me, especially now.

We are doing surprisingly well and the arrangements are falling into place and as a simple family who deal with everything through humor we seem to concern and confuse some people. But that is who we are...so was she. So they'll just have to suck it up and understand or not. No apology.
All the business is pretty much dealt with and a Celebration of Life planned.
~Then after all that comes the hard part, the adjustment of living on without her in our lives~

One of her favorite hymns. My Grandmother was a radio gospel singer and she was pretty picky about this song.
This was the best version I could find she would like.

I'm sure this is nothing new, but very cute.
1.) Brush twice a day!



2.) Dress right for the weather.


( 3.) Visit the dentist regularly )

My Mother passed on quietly in her sleep this morning to join my Dad.
Safe Journey Mom. We'll miss you.

Just a silly little picture, because I seem to have lost the one I was working on *phooey

Click to make bigger. May be too grainy for wallpaper.

or crafting for sanity's sake.
What do you do if you can't find a faceplate you like for your cellphone?
Decorate the ones you have.




( NeoVictorian?(ish) The Details )

Made over the last couple of months for various challenges some I forgot to enter, some just fooling around (just to say I made something)

Total Icon Count: 16

Teasers:

( Icons Here! )
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Watching Woodstock with my youngest daughter, she loves it. I knew she'd like Santana, but who knew she'd take a look at Arlo Guthrie and say "He's kinda cute. I remember him!" from Alice's Restaurant she loved that thing.
Can I raise 'em or what?

Is anyone really interested in the continued posting of HR3200 Subtitle by Subtitle?
Is anyone reading it?
Do you want out of the filter if I continue to post?
Do you want to discuss it at all?
Is it what you thought it was?
If I continue to post and use a lj cut do you think anyone will click and read?

Subtitle D--Additional Consumer Protections

SEC. 131. REQUIRING FAIR MARKETING PRACTICES BY HEALTH INSURERS.

The Commissioner shall establish uniform marketing standards that all insured QHBP offering entities shall meet.

SEC. 132. REQUIRING FAIR GRIEVANCE AND APPEALS MECHANISMS.

(a) In General- A QHBP offering entity shall provide for timely grievance and appeals mechanisms that the Commissioner shall establish.

(b) Internal Claims and Appeals Process- Under a qualified health benefits plan the QHBP offering entity shall provide an internal claims and appeals process that initially incorporates the claims and appeals procedures (including urgent claims) set forth at section 2560.503-1 of title 29, Code of Federal Regulations, as published on November 21, 2000 (65 Fed. Reg. 70246) and shall update such process in accordance with any standards that the Commissioner may establish.

(c) External Review Process-

(1) IN GENERAL- The Commissioner shall establish an external review process (including procedures for expedited reviews of urgent claims) that provides for an impartial, independent, and de novo review of denied claims under this division.

(2) REQUIRING FAIR GRIEVANCE AND APPEALS MECHANISMS- A determination made, with respect to a qualified health benefits plan offered by a QHBP offering entity, under the external review process established under this subsection shall be binding on the plan and the entity.

(d) Construction- Nothing in this section shall be construed as affecting the availability of judicial review under State law for adverse decisions under subsection (b) or (c), subject to section 151.

SEC. 133. REQUIRING INFORMATION TRANSPARENCY AND PLAN DISCLOSURE.

(a) Accurate and Timely Disclosure-

(1) IN GENERAL- A qualified health benefits plan shall comply with standards established by the Commissioner for the accurate and timely disclosure of plan documents, plan terms and conditions, claims payment policies and practices, periodic financial disclosure, data on enrollment, data on disenrollment, data on the number of claims denials, data on rating practices, information on cost-sharing and payments with respect to any out-of-network coverage, and other information as determined appropriate by the Commissioner. The Commissioner shall require that such disclosure be provided in plain language.

(2) PLAIN LANGUAGE- In this subsection, the term `plain language' means language that the intended audience, including individuals with limited English proficiency, can readily understand and use because that language is clean, concise, well-organized, and follows other best practices of plain language writing.

(3) GUIDANCE- The Commissioner shall develop and issue guidance on best practices of plain language writing.

(b) Contracting Reimbursement- A qualified health benefits plan shall comply with standards established by the Commissioner to ensure transparency to each health care provider relating to reimbursement arrangements between such plan and such provider.

(c) Advance Notice of Plan Changes- A change in a qualified health benefits plan shall not be made without such reasonable and timely advance notice to enrollees of such change.

SEC. 134. APPLICATION TO QUALIFIED HEALTH BENEFITS PLANS NOT OFFERED THROUGH THE HEALTH INSURANCE EXCHANGE.

The requirements of the previous provisions of this subtitle shall apply to qualified health benefits plans that are not being offered through the Health Insurance Exchange only to the extent specified by the Commissioner.

SEC. 135. TIMELY PAYMENT OF CLAIMS.

A QHBP offering entity shall comply with the requirements of section 1857(f) of the Social Security Act with respect to a qualified health benefits plan it offers in the same manner an Medicare Advantage organization is required to comply with such requirements with respect to a Medicare Advantage plan it offers under part C of Medicare.

SEC. 136. STANDARDIZED RULES FOR COORDINATION AND SUBROGATION OF BENEFITS.

The Commissioner shall establish standards for the coordination and subrogation of benefits and reimbursement of payments in cases involving individuals and multiple plan coverage.

SEC. 137. APPLICATION OF ADMINISTRATIVE SIMPLIFICATION.

A QHBP offering entity is required to comply with standards for electronic financial and administrative transactions under section 1173A of the Social Security Act, added by section 163(a).

After reading Health Care Choices Act Still not sure it's what many people think it is.
I think I broke my brain.

~Went camping at a lake down a road that can only be described as a trail
~Watched loons diving, ducks dabbling and fish jumping.
~It rained buckets(made for wonderful sleep and ended that party by the lake before 1 AM)
~Woke up to a beautiful sunny and very quiet morning.
~People drove up launched their canoes and kayaks and left only their cars behind.
~Friends arrived before noon...end of quiet.
~Realized I'd forgotten to charge camera batteries again.
~Stood on a log out over the water and fished for two hours.
~Remembered why I love my Keene H2 Sandals
~Made lunch of croissants and ham.
~Parked in my camp chair and soaked up the sun like a lizard.
~Best friend's hubby started snoring.
~Fished for another hour on my log. I liked my log.
~Didn't really want to catch anything, no good fish in this lake it's a wild lake.
~Caught sunburn though. Not too bad.
~Decided to stay another night.
~Made dinner with friends.
~Dragged camp chairs down to lake shore.
~Drank hot chocolate.
~Watched loons diving, ducks dabbling and fish jumping.
~Everyone came back, loaded up their boats and left.
~Blessed quiet again.
~Chatted by the lake till about 10pm when bugs got too bad .
~Loons finally started calling after we went in to go to sleep.
~Woke up to a lovely sunny day again.
~Only one tent (blocking my log, oh well) and our two campers in area, nice.
~People drove up launched their canoes and kayaks and left only their cars behind.
~Sat on another fallen tree by the lake shore.
~Watched a couple of boats come in and load up (they'd caught their limit of silver salmon).
~Watched loons diving, ducks dabbling and fish jumping using binoculars this time.
~Packed up camper and gear to go home.
~Went for a drive instead.
~Got home and took much needed bath luckily I didn't drown when I nodded off in the jet tub.
~Iz tired now. But want to go again next week.

Shamelessly Squirreled from betagoddess

Which American accent do you have? Neutral You're not Northern, Southern, or Western, you`re just plain -American-. Your national identity is more important than your local identity, because you don`t really have a local identity. You might be from the region in that map, which is defined by this kind of accent, but you could easily not be. Or maybe you just moved around a lot growing up.

Click Here to Take This Quiz Brought to you by YouThink.com quizzes and personality tests.

From alaska_avo A regional tectonic earthquake occurred at 11:28 AKDT and was felt throughout South Central Alaska. This event is not related to Redoubt. The West Coast and Alaska Tsunami Warning Center has a preliminary magnitude of 5.3 and a location 30 miles southwest of Talkeetna.

Written By Regina Brett, of The Plain Dealer, Cleveland, Ohio


( To celebrate growing older, I once wrote the 45 lessons life taught me. It is the most-requested column I've ever written. So here is the column once more: )

Tim found out his four-wheeler doesn't know how to swim today.*snerk
He really didn't want to tell me but knew I'd ask when they came home a wheeler short.
Glad I'm not the one who had to tow him back. It will be in the shop this week so maybe we can get some yard work done.

Click to enlarge

Making some icons trying to get motivated to finish my SA dues.
Three from a challenge at severalplums I forgot to enter and some Cirque du Soleil.

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