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[Introduced][Status][Bill Documents][Fiscal Note][Bills Directory]

S.B. 48





Sponsor: L. Alma Mansell

             17      This act affects sections of Utah Code Annotated 1953 as follows:
             18      AMENDS:
             19          31A-22-613, as last amended by Chapter 38, Laws of Utah 1996
             20          58-13-2, as last amended by Chapter 288, Laws of Utah 1998
             21          58-13-3, as last amended by Chapter 288, Laws of Utah 1998
             22          58-16a-102, as last amended by Chapter 13, Laws of Utah 1997
             23          58-16a-305, as renumbered and amended by Chapter 13, Laws of Utah 1997
             24          58-16a-306, as enacted by Chapter 13, Laws of Utah 1997
             25          58-16a-501, as enacted by Chapter 13, Laws of Utah 1997
             26          58-16a-502, as enacted by Chapter 13, Laws of Utah 1997
             27          58-16a-503, as renumbered and amended by Chapter 13, Laws of Utah 1997

             28          58-16a-601, as renumbered and amended by Chapter 13, Laws of Utah 1997
             29          58-17a-305, as enacted by Chapter 247, Laws of Utah 1996
             30      ENACTS:
             31          58-16a-801, Utah Code Annotated 1953
             32      Be it enacted by the Legislature of the state of Utah:
             33          Section 1. Section 31A-22-613 is amended to read:
             34           31A-22-613. Permitted provisions for disability insurance policies.
             35          The following provisions may be contained in a disability insurance policy, but if they are
             36      in that policy, they shall conform to at least the following minimum requirements for the
             37      policyholder:
             38          (1) Any provision respecting change of occupation may provide only for a lower maximum
             39      benefit payment and for reduction of loss payments proportionate to the change in appropriate
             40      premium rates, if the change is to a higher rated occupation, and this provision shall provide for
             41      retroactive reduction of premium rates from the date of change of occupation or the last policy
             42      anniversary date, whichever is the more recent, if the change is to a lower rated occupation.
             43          (2) Section 31A-22-405 applies to misstatement of age in disability policies, with the
             44      appropriate modifications of terminology.
             45          (3) Any policy which contains a provision establishing, as an age limit or otherwise, a date
             46      after which the coverage provided by the policy is not effective, and if that date falls within a
             47      period for which a premium is accepted by the insurer or if the insurer accepts a premium after that
             48      date, the coverage provided by the policy continues in force, subject to any right of cancellation,
             49      until the end of the period for which the premium was accepted. This Subsection (3) does not
             50      apply if the acceptance of premium would not have occurred but for a misstatement of age by the
             51      insured.
             52          (4) Any provision dealing with preexisting conditions shall be consistent with Subsections
             53      31A-22-605 (9)(a) and 31A-22-609 (2), and any applicable rule adopted by the commissioner.
             54          (5) (a) If an insured is otherwise eligible for maternity benefits, a policy may not contain
             55      language which requires an insured to obtain any additional preauthorization or preapproval for
             56      customary and reasonable maternity care expenses or for the delivery of the child after an initial
             57      preauthorization or preapproval has been obtained from the insurer for prenatal care. A
             58      requirement for notice of admission for delivery is not a requirement for preauthorization or

             59      preapproval, however, the maternity benefit may not be denied or diminished for failure to provide
             60      admission notice. The policy may not require the provision of admission notice by only the
             61      insured patient.
             62          (b) This Subsection (5) does not prohibit an insurer from:
             63          (i) requiring a referral before maternity care can be obtained;
             64          (ii) specifying a group of providers or a particular location from which an insured is
             65      required to obtain maternity care; or
             66          (iii) limiting reimbursement for maternity expenses and benefits in accordance with the
             67      terms and conditions of the insurance contract so long as such terms do not conflict with
             68      Subsection (5)(a).
             69          (6) An insurer may only represent that a policy:
             70          (a) offers a vision benefit if the policy:
             71          (i) charges a premium for the benefit; and
             72          (ii) provides reimbursement for materials or services provided under the policy; and
             73          (b) covers laser vision correction, whether photorefractive keratectomy, laser assisted
             74      in-situ keratomelusis, or related procedure, if the policy:
             75          (i) charges a premium for the benefit; and
             76          (ii) the procedure is at least a partially covered benefit.
             77          Section 2. Section 58-13-2 is amended to read:
             78           58-13-2. Emergency care rendered by licensee.
             79          A person licensed under Title 58, Occupations and Professions, to practice as any of the
             80      following health care professionals, who is under no legal duty to respond, and who in good faith
             81      renders emergency care at the scene of an emergency gratuitously and in good faith, is not liable
             82      for any civil damages as a result of any acts or omissions by the person in rendering the emergency
             83      care:
             84          (1) osteopathic physician;
             85          (2) physician and surgeon;
             86          (3) naturopath;
             87          (4) dentist or dental hygienist;
             88          (5) chiropractic physician;
             89          (6) physician assistant; [or]

             90          (7) optometrist; or
             91          [(7)] (8) nurse licensed under Section 58-31b-301 .
             92          Section 3. Section 58-13-3 is amended to read:
             93           58-13-3. Qualified immunity -- Health professionals -- Charity care.
             94          (1) (a) The Legislature finds many residents of this state do not receive medical care and
             95      preventive health care because they lack health insurance or because of financial difficulties or
             96      cost. The Legislature also finds that many physicians, charity health care facilities, and other
             97      health care professionals in this state would be willing to volunteer medical and allied services
             98      without compensation if they were not subject to the high exposure of liability connected with
             99      providing these services.
             100          (b) The Legislature therefore declares that its intention in enacting this section is to
             101      encourage the provision of uncompensated volunteer health care in charity care settings in
             102      exchange for a limitation on liability for the health care facilities and health care professionals who
             103      provide those volunteer services.
             104          (2) As used in this section:
             105          (a) "Health care facility" means any clinic or hospital, church, or organization whose
             106      primary purpose is to sponsor, promote, or organize uncompensated health care services for people
             107      unable to pay for health care services.
             108          (b) "Health care professional" means individuals licensed under Title 58, Occupations and
             109      Professions, as physicians and surgeons, osteopaths, podiatrists, optometrists, chiropractors,
             110      dentists, dental hygienists, registered nurses, certified nurse midwives, and other nurses licensed
             111      under Section 58-31b-301 .
             112          (c) "Remuneration or compensation":
             113          (i) (A) means direct or indirect receipt of any payment by the physician and surgeon, health
             114      care facility, other health care professional, or organization, on behalf of the patient, including
             115      payment or reimbursement under medicare or medicaid, or under the state program for the
             116      medically indigent on behalf of the patient; and
             117          (B) compensation, salary, or reimbursement to the health care professional from any source
             118      for the health care professional's services or time in volunteering to provide uncompensated health
             119      care; and
             120          (ii) does not mean any grant or donation to the health care facility used to offset direct

             121      costs associated with providing the uncompensated health care such as medical supplies or drugs.
             122          (3) A health care professional who provides health care treatment at a health care facility
             123      is not liable in a medical malpractice action if:
             124          (a) the treatment was within the scope of the health care professional's license under this
             125      title;
             126          (b) neither the health care professional nor the health care facility received compensation
             127      or remuneration for the treatment;
             128          (c) the acts or omissions of the health care professional were not grossly negligent or
             129      willful and wanton; and
             130          (d) prior to rendering services, the health care professional disclosed in writing to the
             131      patient, or if a minor, to the patient's parent or legal guardian, that the health care professional is
             132      providing the services without receiving remuneration or compensation and that in exchange for
             133      receiving uncompensated health care, the patient consents to waive any right to sue for
             134      professional negligence except for acts or omissions which are grossly negligent or are willful and
             135      wanton.
             136          (4) A health care facility which sponsors, promotes, or organizes the uncompensated care
             137      is not liable in a medical malpractice action for acts and omissions if:
             138          (a) the health care facility meets the requirements in Subsection (3)(b);
             139          (b) the acts and omissions of the health care facility were not grossly negligent or willful
             140      and wanton; and
             141          (c) the health care facility has posted, in a conspicuous place, a notice that in accordance
             142      with this section the health care facility is not liable for any civil damages for acts or omissions
             143      except for those acts or omissions that are grossly negligent or are willful and wanton.
             144          (5) Immunity from liability under this section does not extend to the use of general
             145      anesthesia or care that requires an overnight stay in a general acute or specialty hospital licensed
             146      under Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act.
             147          Section 4. Section 58-16a-102 is amended to read:
             148           58-16a-102. Definitions.
             149          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             150          (1) "Board" means the Optometrist Licensing Board created in Section 58-16a-201 .
             151          (2) "Contact lens" means any lens that:

             152          (a) has a spherical, cylindrical, or prismatic power or curvature;
             153          (b) is made pursuant to a current prescription; and
             154          (c) is intended to be worn on the surface of the eye.
             155          (3) (a) "Contact lens prescription" means a written or verbal order for contact lenses that
             156      includes:
             157          [(a)] (i) the commencement date [written] of the prescription;
             158          [(b)] (ii) the base curve, power, diameter, material or brand name, and expiration date;
             159          [(c) the quantity of lenses if other than one per eye; and]
             160          [(d) the signature of the licensed optometrist or physician prescribing the contact lenses.]
             161          (iii) for a written order, the signature of the prescribing optometrist or physician; and
             162          (iv) for a verbal order, a record maintained by the recipient of:
             163          (A) the name of the prescribing optometrist or physician; and
             164          (B) the date when the prescription was issued or ordered.
             165          (b) A prescription may include:
             166          (i) a limit on the quantity of lenses that may be ordered under the prescription if:
             167          (A) the prescription is for more than one contact per eye; or
             168          (B) required for medical reasons documented in the patient's files; and
             169          (ii) the expiration date of the prescription, which may not be less than one year from the
             170      commencement date, unless documented medical reasons require continuous monitoring, nor more
             171      than two years.
             172          (c) A prescription shall be valid for two years if the prescription does not include an
             173      expiration date.
             174          (4) "Contact lens prescription verification" means a written request from a person who
             175      sells contact lenses that:
             176          (a) is sent to the prescribing optometrist or physician; and
             177          (b) seeks the confirmation of the accuracy of a patient's prescription.
             178          [(4)] (5) "Eye and its adnexa" means the human eye and all structures situated within the
             179      orbit, including the conjunctiva, lids, lashes, and lacrimal system.
             180          [(5)] (6) "Fitting of a contact lens" means:
             181          (a) the using of a keratometer to measure the human eye;
             182          (b) utilizing refractive data provided by a licensed optometrist or ophthalmologist; and

             183          (c) trial fitting of contact lenses, which includes a period of time for evaluation for fit and
             184      performance, to determine a tentative contact lens prescription for a patient if the patient:
             185          (i) has not worn contact lenses before; or
             186          (ii) has changed to a different type or base curve.
             187          [(6)] (7) "Laser surgery" means surgery in which human tissue is cut, burned, or vaporized
             188      by means of laser or ionizing radiation.
             189          [(7)] (8) "Ophthalmic lens" means any lens used to treat the eye and that:
             190          (a) has a spherical, cylindrical, or prismatic power;
             191          (b) is made pursuant to an unexpired prescription; and
             192          (c) is intended to be used in eyeglasses or spectacles.
             193          [(8)] (9) "Optometric assistant" means an unlicensed individual:
             194          (a) working under the direct and immediate supervision of a licensed optometrist; and
             195          (b) engaged in specific tasks assigned by the licensed optometrist in accordance with the
             196      standards and ethics of the profession.
             197          [(9)] (10) "Optometrist" or "optometric physician" means an individual licensed under this
             198      chapter.
             199          [(10)] (11) "Optometry" and "practice of optometry" mean any one or any combination of
             200      the following practices:
             201          (a) examination of the human eye and its adnexa to detect and diagnose defects or
             202      abnormal conditions;
             203          (b) determination or modification of the accommodative or refractive state of the human
             204      eye or its range or power of vision by administration and prescription of pharmaceutical agents or
             205      the use of diagnostic instruments;
             206          (c) prescription, ordering, administration, or adaptation of ophthalmic lenses, contact
             207      lenses, ophthalmic devices, pharmaceutical agents, laboratory tests, or ocular exercises to diagnose
             208      and treat diseases, defects, or other abnormal conditions of the human eye and its adnexa; [or]
             209          (d) display of any advertisement, circular, sign, or device offering to:
             210          (i) examine the eyes;
             211          (ii) fit glasses or contact lenses; or
             212          (iii) adjust frames; [or]
             213          [(iv) duplicate, replace, or accept for duplication or replacement any ophthalmic lens or

             214      contact lens;]
             215          (e) removal of a foreign body from the eye or its adnexa, that is not deeper than the
             216      anterior [one-half] 1/2 of the cornea;
             217          (f) consultation regarding the eye and its adnexa with other appropriate health care
             218      providers, including referral to other appropriate health care providers; and
             219          (g) a person, not licensed as an optometrist, directing a licensee under this chapter to
             220      withhold or alter the eye care services the licensee has ordered.
             221          [(11)] (12) "Pharmaceutical agent" means any diagnostic or therapeutic drug or
             222      combination of drugs that has the property of assisting in the diagnosis, prevention, treatment, or
             223      mitigation of abnormal conditions or symptoms of the eye and its adnexa.
             224          [(12)] (13) "Prescription drug" has the same definition as in Section 58-17a-102 .
             225          [(13)] (14) "Unexpired" means a prescription that was issued:
             226          (a) not more than two years prior to presentation of the prescription for an ophthalmic lens
             227      [or lenses]; or
             228          (b) in accordance with Subsection (3)(a)(iii) for a contact lens.
             229          Section 5. Section 58-16a-305 is amended to read:
             230           58-16a-305. License -- Exemptions.
             231          In addition to the exemptions from licensure in Section 58-1-307 , the following persons
             232      may engage in acts included in the definition of the practice of optometry subject to the stated
             233      circumstances and limitations without being licensed under this chapter:
             234          (1) a person who sells [eyeglasses] contact lenses on prescription provided by a person
             235      authorized under state law to practice either optometry or medicine and surgery if the person
             236      complies with Section 58-16a-801 ;
             237          (2) a person who sells eyeglasses or spectacles as articles of merchandise or who fabricates
             238      them from a prescription if the person:
             239          (a) [he] does so in the ordinary course of trade from a permanently located and established
             240      place of business;
             241          (b) [he] does not traffic or attempt to traffic upon assumed skill in testing the eye and
             242      adapting lenses according to the test;
             243          (c) [he] does not duplicate, replace, or accept for replacement any ophthalmic lens [or
             244      lenses], except in the case of an emergency[, unless he is an exclusive wholesale optical

             245      establishment];
             246          (d) [he] does not use in the testing of the eyes any lenses or instruments other than the
             247      lenses actually sold; and
             248          (e) [he] does not give or offer eyeglasses or spectacles as premiums as defined in Section
             249      13-26-2 ; and
             250          (3) a person who [sells] fits contact lenses under the following conditions:
             251          (a) he has a current certification from both the American Board of Opticianry and the
             252      National Contact Lens Examiners;
             253          (b) he does not give or offer contact lenses as premiums;
             254          (c) he does not perform a refraction, over-refraction, or attempt to traffic upon assumed
             255      skill in testing the eye;
             256          (d) he operates in the ordinary course of trade from a permanently located and established
             257      place of business;
             258          (e) he performs the work involved in fitting contact lenses himself and does not delegate
             259      the contact lens fitting to any other individual who is not qualified under this Subsection (3);
             260          (f) he does not use in the testing of the eye any lenses or instruments other than the lenses
             261      he actually will sell;
             262          [(f)] (g) he provides services only to a patient who:
             263          (i) presents an unexpired contact lens prescription; or
             264          (ii) has had an eye examination within the prior six months by an optometrist or
             265      ophthalmologist meeting the requirements under Section 58-16a-306 ; [and]
             266          [(g)] (h) he maintains a copy of the patient's contact lens prescription for not less than
             267      seven years[.];
             268          (i) he enters into a written agreement with an optometrist or an ophthalmologist before
             269      July 1, 2000, to fit contact lenses prescribed by that optometrist or ophthalmologist;
             270          (j) he fits contact lenses for at least two years under the direct supervision of the
             271      optometrist or ophthalmologist identified in Subsection (3)(i) before July 1, 2000, as documented
             272      in the written agreement; and
             273          (k) the optometrist or ophthalmologist described in Subsection (3)(i):
             274          (i) ensures that the final contact lens is accurate;
             275          (ii) presents a written copy of the prescription to the person fitting the contact lens; and

             276          (iii) ensures that a copy of the prescription is provided to the patient, except as provided
             277      in Section 58-16a-306 .
             278          Section 6. Section 58-16a-306 is amended to read:
             279           58-16a-306. Contact lens prescription -- Qualifications.
             280          (1) An optometrist or ophthalmologist issuing a contact lens prescription [that may be
             281      filled by a person fitting contact lenses under Subsection 58-16a-305 (3)] shall:
             282          [(1)] (a) be licensed under this title to practice in Utah;
             283          [(2) have a current written agreement with the person fitting the contact lenses to fit the
             284      contact lenses to be prescribed by that particular optometrist or ophthalmologist;]
             285          [(3) be an optometrist or ophthalmologist for whom the person fitting the contact lenses
             286      has performed not less than two years of contact lens apprenticeship which apprenticeship shall
             287      be noted in the written agreement; and]
             288          [(4)] (b) ensure the final contact lens prescription is accurate [and shall];
             289          (c) present a written copy of the prescription to the [person fitting the contact lens under
             290      Subsection 58-16a-305 (3).] patient after fitting unless:
             291          (i) there are unpaid fees associated with the examination or treatment; or
             292          (ii) providing a copy is not in the best medical interests of the patient in the professional
             293      judgement of the prescribing optometrist or physician; and
             294          (d) provide a copy of the patient's contact lens prescription to a person who sells contact
             295      lenses upon the request of the patient or the person selling the contact lenses.
             296          (2) An optometrist or physician may not be held liable as a result of providing a
             297      prescription to a patient as required by Subsection (1).
             298          Section 7. Section 58-16a-501 is amended to read:
             299           58-16a-501. Unlawful conduct.
             300          "Unlawful conduct" includes, in addition to the definition in Section 58-1-501 :
             301          (1) buying, selling, or fraudulently obtaining, any optometry diploma, license, certificate,
             302      or registration;
             303          (2) aiding or abetting the buying, selling, or fraudulently obtaining, of any optometry
             304      diploma, license, certificate, or registration;
             305          (3) selling contact lenses [without having received a written unexpired prescription] in a
             306      manner inconsistent with Section 58-16a-801 or intentionally altering a prescription unless the

             307      person selling the lenses is a licensed optometrist or ophthalmologist[, or an individual exempt
             308      from licensure under Subsection 58-16a-305 (3)]; or
             309          (4) representing oneself as or using the title of "optometrist," "optometric physician,"
             310      "doctor of optometry," or "O.D.," unless currently licensed [or exempted from licensure] under this
             311      chapter.
             312          Section 8. Section 58-16a-502 is amended to read:
             313           58-16a-502. Unprofessional conduct.
             314          "Unprofessional conduct" includes, in addition to the definition in Section 58-1-501 :
             315          (1) using or employing the services of an optometric assistant to assist a licensee in any
             316      manner not in accordance with:
             317          (a) the generally recognized practices and standards of ethics of the profession; or
             318          (b) applicable state law or division rule;
             319          (2) failure to refer a patient to an appropriate licensed practitioner when:
             320          (a) the patient's condition does not respond to treatment; or
             321          (b) the treatment is not within the scope of competence or licensure of the licensee;
             322          (3) providing confidential information regarding a patient to any third party who does not
             323      have a legal and professional ground for obtaining the information;
             324          (4) knowingly prescribing, selling, giving away, or administering any prescription drug
             325      except for a legitimate medical purpose and upon a proper diagnosis indicating the use of the drug
             326      in the amount prescribed or provided;
             327          (5) giving or receiving directly or indirectly any fee, commission, rebate, or other
             328      compensation for professional services not actually and personally rendered, except as part of a
             329      legal relationship within a lawful professional partnership, corporation, or association; [or]
             330          (6) failure to transfer pertinent and necessary information from a patient's medical records
             331      to another optometrist or physician when so requested by the patient or his representative, as
             332      designated in writing[.]; or
             333          (7) failure to provide a contact lens prescription to a person who sells contact lenses in
             334      accordance with Section 58-16a-306 .
             335          Section 9. Section 58-16a-503 is amended to read:
             336           58-16a-503. Penalty for unlawful conduct.
             337          [Any] (1) Except as provided in Subsection (2), any person who violates the unlawful

             338      conduct provision defined in Section 58-16a-501 or Subsection 58-1-501 (1)(a) or (1)(c) is guilty
             339      of a third degree felony.
             340          (2) A person who violates Subsection 58-16a-501 (3) is guilty of a class C misdemeanor.
             341          Section 10. Section 58-16a-601 is amended to read:
             342           58-16a-601. Scope of practice.
             343          (1) An optometrist may:
             344          (a) provide any optometric services not specifically prohibited under this chapter or
             345      division rules and that are within the optometrist's training, skills, and scope of competence; and
             346          (b) prescribe or administer any pharmaceutical agent for the eye and its adnexa, including
             347      all oral pharmaceutical agents S [ [ , ] except that :(i) the oral antibiotics may only be prescribed
             347a      for: [ ] . ]
             348           (A) [ [ ] (i) eyelid-related ocular conditions or diseases; and [ ] ]
             349           (B) [ [ ] (ii) any other ocular disease or condition as specified by division rule. [ ] ] ; AND

             349a1      TAKEN
             349b      ORALLY
             349b2      OR ADNEXA IN A QUANTITY NOT TO
             349b1      EXCEED 72 HOURS IN
             349c      DURATION AND WHICH MAY NOT BE REFILLED. s
             350          (2) An optometrist may not:
             351          (a) perform surgery, including laser surgery; or
             352          (b) prescribe or administer any Schedule II [or Schedule III] controlled substance as
             353      defined in Title 58, Chapter 37, Controlled Substances.
             354          (3) An optometrist is a health care provider for purposes of Sections 31A-22-617 and
             355      31A-22-618 .
             356          Section 11. Section 58-16a-801 is enacted to read:
Part 8. Contact Lens Seller

             358          58-16a-801. Contact lens seller.
             359          (1) A person may sell contact lenses if the person:
             360          (a) does so in the ordinary course of trade from a permanently located and established
             361      place of business;
             362          (b) does not perform refractions, over-refractions, or attempts to traffic upon assumed skill
             363      in testing the eye;
             364          (c) does not offer or give contact lenses as premiums, as defined in Section 13-26-2 ;
             365          (d) does not fit contact lenses;
             366          (e) provides a contact lens to a patient after:
             367          (i) receiving an unexpired verbal or written prescription; or
             368          (ii) sending a contact lens prescription verification to the prescribing optometrist or

             369      physician, regardless of whether the prescribing optometrist or physician responds to or confirms
             370      the verification, provided that:
             371          (A) the person has all of the information necessary to fill the prescription;
             372          (B) the prescribing optometrist or physician has not informed the person that the
             373      prescription has expired or is otherwise inaccurate prior to the person shipping or hand-delivering
             374      the contact lens to the patient;
             375          (C) the person confirms a valid, unexpired contact lens prescription for the patient if the
             376      person is aware that the patient provided inaccurate prescription information in his last order; and
             377          (D) the person informs the patient that the prescription has expired or that there is a
             378      medical problem associated with the prescription if the information is communicated by the
             379      prescribing optometrist or physician to the person within 72 hours of the contact lens
             379a      S PRESCRIPTION s verification
             380      being sent; and
             381          (f) maintains patient information, including the method and date of any prescription
             382      verification, for no less than seven years.
             383          (2) Nothing in this section may be construed as requiring a person to be licensed or
             384      certified in any way under this or any another chapter of this title to sell contact lenses in
             385      accordance with Subsection (1).
             386          Section 12. Section 58-17a-305 is amended to read:
             387           58-17a-305. Exemptions from licensure.
             388          In addition to the exemptions from licensure in Section 58-1-307 [,]:
             389          (1) an individual who has completed all qualifications for licensure as a pharmacy
             390      technician, except an experience requirement which may be established by rule under Subsection
             391      58-17a-302 (4), may practice under the direct personal supervision of a pharmacist while
             392      completing that requirement for a period not to exceed six consecutive months without being
             393      licensed under this chapter[.]; and
             394          (2) a person may sell contact lenses in accordance with Section 58-16a-801 without being
             395      licensed under this chapter.

Legislative Review Note
    as of 1-24-00 3:33 PM

A limited legal review of this legislation raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel

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