58 lines
3.4 KiB
Markdown
58 lines
3.4 KiB
Markdown
# Palliative RFI Finishing Pass — Run Record (2026-08-20)
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> Not a forward plan — the run record of the "full analysis and full
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> documentation" pass that closed out P42/P43's open analysis items.
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> Forward work remaining for P44 is listed at the end.
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**Goal:** Every open analysis input for the P44 comment (due 2026-09-12,
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docket closes 2026-09-14) either done or running to completion; documentation
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current (notebook, tracker, spec, memory).
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## What was done
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- [x] **Stage-3 PRISMA eligibility + extraction launched** (rig 4090,
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`qwen2.5:14b-ctx32k` created via Ollama /api/create; `stack prisma eligible
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palliative-rfi --max-chars 60000`; chained `extract`). Two fixes en route:
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`--max-chars` cap so bounded-context models keep the criteria in window, and
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a deterministic `uncertain / unavailable-fulltext` path for items with no
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retrieved full text (they also tripped the qwen/Ollama empty-response quirk;
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the eligibility prompt got the same one-sentence-system restructure that
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fixed screening). Log: `.state/prisma-stage3.log`.
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- [x] **#649 closed** — § II.E close read; pincite analysis in
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`docs/spec/2026-08-20-cy2027-iie-crossread-palliative-rfi.md`, condensed as
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notebook Section 6. Headline: II.E proposes nothing; the only operative text
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is II.D's G2211 changes; three CMS concessions anchor part (d).
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- [x] **#648 closed** — claims utilization methodology exhibit (notebook
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Section 5) over the synthetic Tuva CCLF (962 beneficiaries, 2016-2018):
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ACP/CCM/TCM/Home-E/M sparse but concentrated in serious illness (75-91% of
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users), CCM reaching ~1/7 of the 611 seriously-ill; PCM/APCM structurally
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absent (post-window codes). Scope-disclosed as methodology, not empirics.
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- [x] **#644 closed** — sixth cited source captured: MLN909188 (June 2025)
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CCM/PCM/APCM coding booklet, bib `PV8APQ4A`, synced to Zotero
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(`--tag source:rfi-cited`).
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- [x] **#645 closed** — sibling rules: FY2027 Hospice NPRM is 2026-06604 at
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91 FR 17338 (the rule's "90 FR 17360" cite is a volume typo), ESRD is
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2026-12925 at 91 FR 38784. Both created as bib rule items (KUZC5FN2,
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IGXTEJU3), fr-grabbed (322 ¶/42 pp; 887 ¶/87 pp), fr-jump verified.
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- [x] **#663 implemented** — `stack comments extract-ocr` (RapidOCR ONNX,
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pip-only; PDFs rasterized via PyMuPDF), TDD'd, smoke-verified; full run over
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2,738 queued comments launched, chained with a palliative re-sweep. Log:
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`.state/comments/ocr.log`.
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- [x] Notebook updated: Sections 5 (claims) and 6 (II.E) added, Provenance →
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Section 7 with today's pipeline lines, stage-3 methods disclosure current.
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Headless nb_integration: pass.
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## Still open / running when this record was written
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- Stage-3 eligibility+extraction run (hours; queue-driven and idempotent —
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re-run `stack prisma eligible palliative-rfi --max-chars 60000` to sweep any
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stragglers, then `stack prisma extract palliative-rfi`).
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- OCR run over 2,738 comments (hours) → auto re-sweep updates `topic:palliative`.
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- Europe PMC tier armed but EBI unreachable two days running — when it
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recovers, `stack prisma fetch palliative-rfi -w 8` for ~400 author
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manuscripts, then re-run eligibility for newly-fetched texts.
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- #652 stays open by design: PCM-1/2/3 descriptors await human review; CBE
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3665 reporting-condition decision; time thresholds.
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- #615 (post-close re-farm of CMS-2026-2377) after 2026-09-14.
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- P44: #650 draft (target 2026-09-12), #651 submit + archive receipt.
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