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A Wisconsin superintendent is facing six counts of felony false imprisonment after allegedly confining six students to a room and ordering them to strip down to their underwear during a search for vape cartridges, FOX UP reports.

Kelly Casper, superintendent of Suring School District, allegedly directed the students into a small bathroom off the nurses office and told them to remove their clothing as she stood in the doorway, said Oconto County District Attorney Edward Burke Jr. The students were not given a option to leave or contact their parents; the only option was a search by the superintendent or by a police officer, he said.

In Wisconsin, false imprisonment is punishable by up to six years in prison and a $10,000 fine, according to the report.

Some of the parents are also pursuing a civil lawsuit claiming the students Fourth Amendment rights were violated. The amendment protects against unreasonable searches and seizures.

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Superintendent charged after students allegedly ordered to remove clothes during vape search - MLive.com

Providers would do well to think beyond any specific national standard, to more specific details, when considering denial appeals.

A member of a message board I follow, and to which I occasionally contribute, recently posed a question about a denial of coverage based on an alleged failure to meet medical necessity requirements. The admitting diagnosis was metabolic encephalopathy. She did not say (nor, regrettably, did I ask) the principal diagnosis submitted with the claim. The reason given for the denial was that the physician did not document exposure to a toxic element. The patients ammonia levels were high, and ammonia can be a causative factor in metabolic encephalopathy. The patient had Traditional Medicaid.

She asked if toxic exposure was even a factor. I wrote an emphatic no, not based on my own research of a national standard, specifically InterQual, one of the allowed tools for medical necessity evaluation.

I advised that she should appeal on the basis of the totality of the record principle, as stated in Alexander v. Azar, a strategy I have used successfully before a Medicare Administrative Law Judge (ALJ) long before this decision. Slavish adherence to a national standard (i.e. InterQual or MCG) is contrary to sound medical necessity determinations, according to the judges ruling.

How is the totality strategy applicable here?

The denial appears to have been based on InterQuals Toxic Exposure subset. In my opinion, this is an incorrect subset, not applicable to a metabolic disorder. In my search, there was truly no subset directly addressing metabolic encephalopathy, nor one specific to liver disease. Both MCG and InterQual admit to holes, wherein no ORG or subset is useful in determining medical necessity. This Toxic Exposure requirement was an overreach to justify a position.

It is not uncommon for payers to use ORGs or subsets not supported in the record, nor the one reasonably used by the provider to determine medical necessity. Payers also may use the correct ORG or subset, but apply a level-of-care standard for which the plan was not billed. For example, say an acute-stay claim is submitted for care provided on the medical/surgical unit. The criteria applied by the payer is that for intermediate or even critical care. The right criteria were set, but with a manufactured level of care. The inverse is true as well; payers can tend to ignore elements of the criteria set that support inpatient admission so they can justify paying only for observation status.

This payers apparent assertion is not unique. Payers have issued initial denials of coverage based on an admitting diagnosis. These denials are usually issued before coding and billing. Once coded and a proper principal diagnosis is provided, the payer will generally approve the stay. Sometimes the denial is based on insufficient information that, once provided, results in the denial being set aside. But not always. Some will ride that horse all the way off the cliff, never acknowledging their possible error, forcing an appeal to state or federal contractors, where the totality of the record will be considered.

The conclusions of Alexander are, in my opinion, affirmed and expanded upon by Barrows v. Becerra, by the appellate court. The conclusions of the appellate court in Barrows have many layers to peel back, but wading through them reveals that both courts affirm that Medicare beneficiaries have Fourth Amendment standing under the legal theory of property rights. Both deal with hospital and provider admission status decisions essentially coerced to be in compliance with standards set by the Centers for Medicare & Medicaid Services (CMS) and its auditing contractors. Both courts conclude that only the total record can support or refute a claim by the government that inpatient is the wrong status.

Both cases also involve only Traditional Medicare beneficiary rights to due process, but the overriding principle expressed in both is that anything apart from the total record is at least potentially harmful to patients. Arbitrary application of standards, outside an analysis of the complex medical decision-making, is just wrong. Arguably, these conclusions are also applicable to Medicare Advantage plans and Medicaid. I personally can attest to frequent success by challenging payer and government contractor criteria, whether MCG, InterQual, or payer internal proprietary standards, when confronting them with the total record, without reliance on any national standard.

This does not mean you will always be the hands-down winner on appeal. The record has to be, as always, descriptive of why hospital care was necessary. Hospitals sometimes enter into contracts with language that, wittingly or unwittingly, means hospitals waive their rights to disagree with payer internal standards.

But apart from this, the lesson of these court decisions is to never let any standard other than the total record rule final status and/or billing decisions. To do so can cause unwarranted loss of revenue, and worse, have very real, even devastating, effects on your patients.

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Understanding the Totality of the Record - RACmonitor

The story in the Washington Post recounted the experience of a 47-year-old Russian employee of an ice skating rink in a village in the Rostov Oblast region near Russias border with Ukraine.

Moved by Vladimir Putins decision to attack Ukraine, the man wrote an anguished social media post, lamenting the horror and shame of a war that will be catastrophic, according to the article written by the Posts Moscow bureau chief, Robyn Dixon.

The next day, police with weapons showed up at the mans home, arrested him and charged him with showing disrespect for society and the Russian Federation, Dixon reported.

In the United States, such an action goes against the grain of fundamental beliefs and principles. But as the democratic nations of the world galvanize to oppose Russias assault in the Ukraine, anecdotes such as this one help remind us whats at stake when leaders discuss the escalating threats to democracy.

UVA Today checked in with John M. Owen, the Taylor Professor of Politics, to gain perspective and context on the larger struggles around democracy that Russias unprovoked war against Ukraine symbolizes. Owen also is a senior fellow at the Miller Center and a senior fellow at the Institute for Advanced Studies in Culture.

Q. How is Putins attack on Ukraine a threat to democracy globally?

A. Putin is attacking not just the government, military, people and territory of Ukraine, but also Ukrainian democracy.Ukraine has never been a stable constitutional democracy; it is better to say that it is an aspiring democracy.But Putin does not want successful democracies on Russias border, and he is taking aggressive steps to keep constitutional self-government far away.Having democracy next door undermines his own authoritarian regime in Russia.And free-market democracies, at least in Europe, tend to be carriers of American influence and power. It is pretty clear that Putin wants Ukraine to be like neighboring Belarus a pliable authoritarian country.

If Putin succeeds in Ukraine, it certainly will not doom democracy around the world or even in Europe. But we have much research that suggests that domestic regimetypes, including liberal or constitutional democracy, tend to spread and contract in waves over time and geographic space. Political regimes spread through a number of mechanisms. One is by setting a successful example, such as when democracies sustain economic growth and stability. Another is by a kind of osmosis: social contact across borders can have effects.A third is by active promotion, usually by a great power such as what Russia is doing now.A fourth is through contagion, such as happened in the Soviet satellite states of Central Europe in 1989. Finally, international rules and institutions can, depending on their content, favor democracy or authoritarianism. Since World War II, and especially since around 1990, they have favored free-market democracies although they clearly need reform today.

What this all means is that, as President Biden likes to say, democracy and authoritarianism are in a global contest.A Russian victory in Ukraine and I must say that that could well be the outcome, at least in the eastern part of the country could mean a net gain for authoritarianism.It would show that authoritarian states can win in the 21stcentury. It would remove a threat to Russias own authoritarianism and would put an authoritarian country on the border of some young democracies just to the west Poland, Slovakia, Hungary, Romania and Moldova.It would cast doubt on the power of the liberal international rules and institutions that for decades have helped sustain democracy even in our own country.

Q. Freedom of expression including the ability to criticize and protest against the government without fear of punishment is something Americans enjoy and might take for granted. Why is it so important?

A. It is important to note that during wartime, even democracies sometimes restrict speech and other expression that could aid the enemy.But by and large, they try to maintain individual liberties and certainly to restore them once the war is over.

Freedom of expression can be seen as a good thing in itself part of what makes a good life. Political science research also shows that free expression is part of a package of rights and freedoms that tends to give countries a more rational, peaceful and productive foreign policy.When a countrys leadership must tolerate dissenting views, it gets access to more information and the potential for correction.We are hearing that Vladimir Putin is not only suppressing dissent among the Russian public but has isolated himself from dissenting officials.That illustrates the problem: He seems to have made a catastrophic miscalculation in invading Ukraine, and it may be in part because his regime represses speech and protects him from information and opinions he doesnt want to hear.

Q. What other principles of democracy are threatened directly or indirectly by what is happening in Ukraine?

A. The principle of governmental accountability is under attack. Ukraine has held several rounds of free, competitive elections since its independence in 1991. Of course, free elections in Ukraine are a threat to Putin because the resulting government may want to align Ukraine with the West. So Putin almost certainly wants Ukrainian elections to be fixed, with one party certain to win, just as Russian elections have been fixed for more than 20 years.Ukraine also has not exemplified the rule of law very well, but Putin wants to remove any chance of the rule of law taking hold there. All of these institutions free expression, competitive elections, rule of law are linked and mutually reinforcing, of course.

Q. What can people in the United States and other established democracies take from the experiences of those such as the man arrested in Russia for criticizing the assault on Ukraine?

A. Such events drive home to us that individual liberty is a precious achievement that can be taken away or weakened, even in the 21stcentury. Back in the 1990s, many very smart Americans thought that liberal democracy was inevitable that the collapse of Soviet communism meant the End of History.Now we know better. The world has two authoritarian great powers now, and neither is on a path to democracy.As tensions with Russia mount in our own country, one thing to guard against is the tendency to do, in mirror-image fashion, what Russia is doing to censor dissent, particularly dissent that favors Russia. Democracies must remain democratic, even under stress.

Q. Ultimately, will the violence in Ukraine and the larger threats illustrate the fragility of democracy, or could it also strengthen the commitment to its principles in some ways?

A. I think that Europe is already showing us that those two outcomes can go together. Europeans, until last week, have been more accommodating of Russia. Some governments, particularly that of Germany, have maintained that democracies can work with Putin and his regime. They have completely flipped over the past week, and I think that part of the reason why is that Russia today, in the year 2022, really is a menace to democracy in Europe, and that Europe must respond by showing that it is willing to take serious, costly action to defend self-government. Commitment to constitutional democracy has wavered in the United States of late too, and I am hoping that a silver lining to Russias aggression will be our own recommitment to our countrys principles, including free expression. I am just sorry that it might take massive suffering in Ukraine for us to learn this lesson.

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How Russia's Attack on Ukraine Threatens Democracy Everywhere - UVA Today

Even before the current war in Europe was cast as an effort to make the world safe for self-determination, Americans of all political stripes worried about the health of democracy at home.

A collection of World War I photos housed in Kansas City shows, in beautiful black-and-white detail, another time democracy's durability and promise came into question.

For some of the African Americans in the military during what is sometimes referred to as "the war to end all wars," time serving in France prompted a curious revelation.

That was the only time I ever felt like that I was a full-fledged American citizen, Army veteran Robert L. Sweeney said in 1980, decades after the war. Because (the French) treated the Black soldiers just like they treated the white soldiers no difference whatever.

Sweeney was born in Highland, Kansas, and moved to Kansas City after serving in the Armys 92nd Division, one of two segregated divisions during WWI. Like many other Black service members at the time, Sweeney faced discrimination from white American troops.

But, as is depicted in the National WWI Museum and Memorials Make Way for Democracy! exhibit, the Black experience of WWI was complex and multifaceted.

That is part of our job; making sure that the diverse stories of World War I are easily accessible, where people are looking for them, said the museum's curator of education, Lara Vogt, who helped put the exhibit together more than five years ago.

"We really do strive to be talking about Black history in every month of the year," she said.

More than 367,000 African American troops served in the U.S. military during WWI, and their experiences are often left out of the historical narrative, she said.

National WWI Museum and Memorial

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Among the collection are professionally composed portraits and panoramas; candid photos of people relaxing, attending classes, and playing baseball; and animals like horses, cats and dogs there's a lot of pictures of individuals holding animals in World War I, Vogt said.The call to fight for democracy

As the war started, many Black communities debated whether to fight in the service of a country that didnt grant them many basic rights, according to Vogt.

And yet, when war was declared basically on the premise of making the world safe for democracy, you have a community of Black Americans who show this patriotism for a variety of different reasons, Vogt said. Including, they wanted to show they were deserving of that full citizenship that they were not yet receiving inside the United States.

Though African Americans made up only 10% of the countrys population, they comprised 13% of the U.S. armed services during WWI. According to Vogt, 80% of Black troops were assigned a support role in the war, as opposed to a combat role. The rate was 60% for everyone else.

National WWI Museum and Memorial

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Some within the United States military had doubts about African American service members, she said. We know the incredible heroism of the 369th Regiment, which was the longest serving in the front lines of any of the United States military: 191 days. They were also one of the most decorated units in the United States military.

When they returned home from war, African Americans in uniform faced some of the most horrific violence in the countrys history, including whats known as Red Summer, which erupted in 1919 and affected at least 26 cities across the country, according to the museum's website.

At the time, many whites feared the return of tens of thousands of Black veterans, who now had military training. Whites worried these veterans would not resubmit to subjugation in the U.S. The tensions led to mistreatment of and attacks against Black veterans in uniform, a dramatic increase of lynchings from 1918 to 1919, and a revival of the Ku Klux Klan.

But the success of Black Americans in the war also challenged the doctrine of white supremacy, and the shared experiences of Black and white service members helped change attitudes about race.

National WWI Museum and Memorial

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President Harry Trumans 1948 order to desegregate the military was a move that many U.S. military officers were not anticipating, Vogt said.

It was (his) experience in World War I that helped motivate this presidential command, she said.

In an interview recorded in 1980, Army veteran Clay Ryan recalled the unified message soldiers like him heard from "those top-ranking generals and so forth."

"Theyd make speeches from time to time, and they all had the same subject matter, all the time: Make America safe for democracy, said Ryan. I do think that the whole movement was well worth what we went through with.

To preserve and pass down memories and stories like Clays, Vogt said, you cant just depend on history textbooks.

National WWI Museum and Memorial

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Making an online exhibition means that these digitized objects, these artifacts, are available 24 hours a day, seven days a week, anywhere around the world, she said. It captures this moment of their lives, you know? Though it's a short moment a year and a half, maybe, for some of them it's such an impactful moment.

As the fight for democracy once again flares up in the U.S. and abroad, this reexamination of a country uniting around common cause provides some hope.

Make Way for Democracy! is online indefinitely at the National WWI Museum and Memorials website, theworldwar.org.

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Kansas City veterans' WWI fight shows democracy is durable and a work in progress - KCUR

Moscows obsession with Ukraine is not new: Since the 17th century, Ukraine has been an integral part of how Russian rulers have thought about their realm of power, says Stanford historian Norman Naimark.

The more Ukraine continues to establish democratic freedom, rule of law and integration with the West, the more it becomes a threat to Putins sense of Russias mission, according to Stanford historian Norman Naimark. (Image credit: Getty Images)

For centuries, the two entities have had a complicated relationship: Russia sees Ukraine as integral to its empire, while Ukrainians frequently see themselves differently and independent from the common Eastern Slavic heritage they share, says Naimark. Putin wants Ukraine to be integrated into a larger Russian polity, not be an independent sovereign state with a functioning parliamentary system it has today. The more Ukraine, a thriving young democracy, continues to establish democratic freedom, rule of law and integration with the West, the more it becomes a threat to Putins sense of Russias mission.

Naimark, a scholar of Russian and East European history whose current research focuses on Soviet policies and actions in Europe after World War II and on genocide and ethnic cleansing in the 20th century, discusses some of the historical and geopolitical context around Putins fixation on restoring a Eurasian empire.

A number of historical comparisons about the invasion have been made: For example, Britains Prime Minister Boris Johnson said that in terms of scale, it could be the largest conflict Europe has experienced since 1945; others are likening to the start of a new Cold War. And while not quite historical, there are some people, including Representative Michael McCaul, who fear a WWIII. How useful are these comparisons? What historical parallels come to mind for you, if any?

Historical analogies are useful heuristic devices to give us perspective on contemporary events. To some extent, these references to past and future conflicts make sense. We have not seen this kind of major invasion of one country of another in Europe since World War II. Think about older Ukrainians who can remember the invasion of their country by the Nazis in 1941, but also the retaking of their lands by the Red Army in 1944 and the insurgent warfare by underground Ukrainian formations against the Soviets that went on in the west of the country until the late 1940s and early 1950s. This kind of bloody insurgency may emerge again if Ukraine loses this present war and is occupied by troops of the Russian Federation.

The Cold War question is a complicated one since the structured ideological struggle that was so central to the Cold War is not really part of this renewed bellicose hostility between Russia and the United States. That doesnt mean, though, that there arent serious differences between what we might call Putinism and Western values and norms. It is deeply troubling that the antagonisms between Putin and the West have reached such alarming proportions that nuclear strikes are threatened by Moscow and severe sanctions are imposed on the Russians that will clearly damage their economy and their ability to live a normal productive life. In my view, this is a pointless invasion on the part of Moscow, can only damage Russian interests and will sour U.S.-Russian relations for a very long time. Can World War III come from this situation? I really dont think so. Putin has reacted irrationally in moving into Ukraine, to be sure, but NATO has held firm and acted wisely and in concert to protect its eastern flank. I cant imagine Putin would challenge the combined forces of the U.S. and its Allies. He is interested in his Eurasian empire, not world hegemony. Still, there can be nuclear mistakes and miscalculations, and we have to be very careful, in conjunction with the Russians, to make sure that such accidental conflicts dont happen.

In Putins Feb. 22 address, he talked about the historical destiny of Russia. What in particular in Russias history might help people better understand Putin and his motivations and intentions?

There is no Russian empire, to which Putin aspires, without Ukraine. Since the 17th century, Ukraine has always been an integral part of how Russian rulers have thought about their realm of power. This is both conceptual and geostrategic. Stalin ostensibly worried about losing Ukraine in the 1930s to Pilsudskis Poland. Putin does not seek to reconstitute the Soviet Union, as so many commentators have suggested. In fact, he recently denounced Lenin and the Soviet government for having given Ukraine a sense of its statehood. He doesnt admit that Ukrainians have frequently thought of themselves differently than Russians and for many centuries have looked for autonomy within and independence from a larger Russian entity. But Putin simply refuses to recognize that. He is right that Russian and Ukrainian histories have been entangled, but not in the way he asserts.

Relations between Russia and Ukraine have been complicated since the turn of this century by the fact that Putins Russia has moved increasingly in the direction of autocracy, kleptocracy and control over domestic politics and society. Ukraine has become, with lots of bumps on the road and problems with corruption, a thriving young democracy. A Ukraine that is heading towards democratic freedom, the rule of law and integration with the West particularly galls Putin because Ukraine is ethnically Slavic and primarily Orthodox in religion, like Russia. It shares the Russians own Soviet and Imperial past and therefore should be complicit, in Putins view, in Moscows anti-democratic ideology. For Putin, its one thing if Estonia or Latvia has a well-functioning parliamentary democracy. These former Soviet republics that also share common borders with Russia did not have the same integral nexus with the Russia that Putin thinks Ukraine does. Ukrainian democracy is seen as threatening and undermines his sense of the larger Russian mission.

What aspect of Putins obsession with Russias past do you find the most troubling?

Putins version of Russian history is both distorted and pernicious. Alas, given heavy censorship its also the only version of history that is proffered in the Russian media. (Note the closing last December in Russia of the impressive civil society organization, Memorial, which was dedicated to accurately documenting and interpreting the Soviet past.) To be sure, since the late 19th century, there have been Russian nationalist thinkers who, like Putin, extoll the special role of the Russian people, the superior moral quality of Orthodoxy, the justifiable dominance of Russians in Eurasia and the unique place of the Russian collectivity in the world. But there are also plenty of reasonable Russians, who reject this kind of national chauvinism and would like to live normal lives in peace with their neighbors and in a democratic society. This war really hurts these good people. They live under a brutal autocrat, and there is not much they can do to change their countrys policies. They have had to experience Soviet dictatorship and now Putins with the accompanying historical distortions. This is another reason the Ukrainians are fighting so hard: They just dont want to go back to denying their national aspirations and giving up the ability to tell their own story because of Moscows dictates.

Naimark is the Robert & Florence McDonnell Professor of E. European Studies and of German Studies (by courtesy) in the School of Humanities and Sciences. He is also a senior fellow (by courtesy) at the Hoover Institution and at the Freeman Spogli Institute for International Studies (FSI).

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Putin sees Ukrainian democracy as threat that undermines Russia's mission | Stanford News - Stanford University News