Case Report: Conjunctival Infestation with : A Novel Agent of Human Thelaziasis in the United States.

We report a case of thelaziasis in a 26-year-old female, acquired in Oregon. A total of 14 worms were removed from the patient's left eye and were morphologically identified as being . Until now, only two species of have been implicated in causing human disease, in Asia and Europe and occasional reports of from the United States of America.

The Impact of Changes in Medicare's Physician Payment System on Critical Care.

In 2015 President Obama signed the Medicare Access and CHIP Reauthorization Act (MACRA) which repealed the Sustainable Growth Rate (SGR) mechanism for Medicare physician reimbursement and mandated that CMS develop alternative payment methodologies to "reward health care providers for giving better care not more just more care." MACRA makes 3 major changes to Medicare reimbursements: (1) it ends the SGR formula; (2) it establishes a new framework to reward physicians based on performance and health outcomes rather than volume; and (3) it aims to combine existing quality reporting programs into one streamlined system. Beginning in 2019, physicians must enter one of two new tracks for payment: the Merit-based Incentive Payment System (MIPS) or Alternative Payment Models (APMs).