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spec: In North Dakota , we indicated that the Agency requirement for a dated physician 's signature or initial on a certification was a logical extension of the underlying purpose of the utilization control program . This limit essentially charges agencies with the responsibility of operating within a global budget to provide Medicare covered services . There were so many people coming in and out of there that the traffic was bad , and it was hard to get in and out . “ Users will pay for usage , based on the amount of data coming in and out of NetWeaver , ” Weiss said . " If you have an emergency room it 's kind of like blaming you for people coming in and bleeding to death . Before accepted as final , the preliminary data are verified through comparison between the original form and the computer file contents . In the area of domestic violence , we found serious staff shortages in New York City throughout the HRA centers so that women coming in and presenting the problem were basically told to go someplace else in order to get help . Parents often wonder whether the IEP goals set for their child are realistic or whether too much or too little is being expected . The windows blank and staring with white glass ; the woodwork unadorned and merely painted ; a little stir of feet coming in and garments rustling , the only sound . Based on the goals and objectives of the caucus , what kind of funding needs are there to conduct projects or activities ? It is fortunate that there are many places today that deal strictly with " breast care " in the larger metropolitan areas of the United States . The net effect is that while the percentage of TennCare patients that will be seen at the Medical Center will surely decline , the actual number of people coming in and out of VUMC 's doors is expected to remain relatively unchanged . She copied records of men coming in and out of the war . I did n't want people coming in and staring . Federal authority was established and national finance flourished . The nature of one 's rebirth is determined by the karma resulting from past actions .