Idag för 250 år sedan: 5 juli 1766

Tryckfrihetsförordningen mot skyndsam fullbordan

Från riksdagens tredje utskott. Idag hade tredje utskottet sitt första sammanträde efter att ledamoten Anders Chydenius överraskande förlorat sin riksdagsplats. Med Chydenius’ uteslutning har tryckfrihetsfrågan förlorat en av sina starkast pådrivande krafter, men det tycks inte som att detta kommer att hejda den efterlängtade reformen. Tvärtom var det kanske Chydenius’ frånvaro som fick utskottet att uppvisa en ovanlig enighet eller åtminstone kompromissvilja kring dagens tvistefrågor.

Det talas om att riksdagen snart kommer att avslutas och utskottets ordförande Gustaf Reuterholm uppmanade till en konstruktiv ton i det fortsatta arbetet. Flera ledamöter sparade därför sina reservationer till de kommande förhandlingarna i Stora deputationen, där förordningstexten kommer att nagelfaras innan den läggs fram för godkännande av stånden.

Enigheten till trots kommer Chydenius’ frånvaro att bli kännbar eftersom det är han som mestadels hållit i pennan. Han har dock inte lämnat efter sig några utkast till de delar som ännu återstår att skriva, utan här får utskottet mer än tidigare göra en gemensam insats. Arbetet går nu in i en avgörande fas och utskottet kommer att fortsätta sitt arbete i övermorgon.

Jonas Nordin

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  • Currently, wellness treatment fraud is all more than the news.
    There definitely is fraud in wellbeing care. The
    similar is legitimate for each individual company or endeavor touched by human hands, e.g.
    banking, credit rating, insurance policies,
    politics, etcetera. There is no dilemma that wellness treatment
    vendors who abuse their placement and our trust to steal are a dilemma.
    So are these from other professions who do the very same.

    Why does overall health treatment fraud surface to get
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    What greater way to report on fraud then to tout fraud cost estimates, e.g.

    – ”Fraud perpetrated versus both general public and personal health and fitness options charges involving $72 and $220 billion per year, growing the price of professional medical care and wellbeing coverage and undermining public belief in our wellbeing care procedure… It is no longer a top secret that fraud represents a single of the quickest rising and most costly forms of criminal offense in The usa now… We fork out these fees as taxpayers and via larger health and fitness insurance policy rates… We will have to be proactive in combating health and fitness care fraud and abuse… We will have to also ensure that regulation enforcement has the tools that it wants to discourage, detect, and punish health and fitness care fraud.” [Senator Ted Kaufman (D-DE), ten/28/09 press launch]

    – The General Accounting Workplace (GAO) estimates that fraud in healthcare ranges from $sixty billion to $600 billion for every calendar year – or wherever concerning 3% and 10% of
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    – The National Overall health Treatment Anti-Fraud Association (NHCAA) reviews above
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    two.Wellness Treatment Criteria

    The rules & guidelines governing well being treatment –
    differ from point out to state and from payor to payor – are intensive and pretty
    complicated for suppliers and other folks to comprehend as they are written in legalese and not simple communicate.

    Companies use particular codes to report conditions dealt with (ICD-9) and expert services rendered (CPT-4 and HCPCS).

    These codes are applied when in search of compensation from payors for expert services rendered to individuals.
    Whilst created to universally utilize to facilitate precise reporting to mirror
    providers’ services, quite a few insurers instruct companies
    to report codes dependent on what the insurer’s
    personal computer editing programs recognize – not on what the supplier rendered.
    Further more, follow making consultants instruct suppliers on what codes to report to get compensated – in some scenarios codes that do not
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    Individuals know what providers they obtain from their medical professional or
    other service provider but may perhaps not have a clue as to what individuals billing
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    insurers. This lack of understanding might outcome in shoppers shifting on with no
    attaining clarification of what the codes mean, or may consequence in some believing they have been improperly billed.

    The multitude of coverage designs offered today,
    with varying ranges of coverage, ad a wild card to
    the equation when services are denied for non-coverage
    – specifically if it is Medicare that denotes non-included services as not medically
    required.

    3.Proactively addressing the well being treatment fraud
    difficulty

    The govt and insurers do very very little
    to proactively deal with the dilemma with tangible actions that will end result in detecting inappropriate claims
    ahead of they are paid out. In fact, payors of wellbeing treatment promises proclaim to work a payment method primarily based
    on believe in that suppliers bill properly for solutions rendered, as they can not review each and every claim ahead of payment is produced due to the fact the
    reimbursement technique would shut down.

    They declare to use subtle laptop or computer plans to glimpse for errors
    and patterns in promises, have improved pre- and publish-payment audits of picked companies to detect fraud,
    and have created consortiums and task forces consisting of regulation enforcers and insurance plan investigators to study the problem and share fraud data.

    Even so, this exercise, for the most part, is dealing with activity right after the declare is
    paid and has small bearing on the proactive detection of
    fraud.

    four.Exorcise health treatment fraud with the development of new laws

    The government’s experiences on the fraud difficulty are
    released in earnest in conjunction with endeavours to
    reform our well being treatment system, and our knowledge exhibits us that it finally outcomes in the govt introducing and enacting new guidelines – presuming new legislation will result
    in a lot more fraud detected, investigated and prosecuted –
    with out setting up how new regulations will attain this a lot more
    successfully than present laws that were not utilized to their whole opportunity.

    With these initiatives in 1996, we got the Overall health Insurance coverage Portability
    and Accountability Act (HIPAA). It was enacted by
    Congress to address coverage portability and accountability for client privateness and well being care fraud and abuse.
    HIPAA purportedly was to equip federal legislation enforcers and prosecutors with the applications to attack fraud,
    and resulted in the development of a selection of new overall health treatment fraud statutes,
    like: Health Treatment Fraud, Theft or Embezzlement in Health Treatment,
    Obstructing Criminal Investigation of Health and fitness Care, and Bogus Statements Relating
    to Overall health Treatment Fraud Matters.

    In 2009, the Health and fitness Care Fraud Enforcement Act appeared on the scene.
    This act has recently been introduced by Congress with promises that
    it will create on fraud prevention attempts and improve the governments’ capacity
    to investigate and prosecute squander, fraud and abuse in equally government and non-public wellness insurance plan by sentencing improves redefining wellness treatment fraud offense improving whistleblower statements generating prevalent-feeling mental
    state necessity for well being care fraud offenses and expanding funding in federal antifraud investing.

    Undoubtedly, law enforcers and prosecutors Should have the
    applications to proficiently do their jobs. Even so, these steps by yourself, with out inclusion of some tangible and major prior to-the-claim-is-compensated
    actions, will have minor affect on cutting down the occurrence of the difficulty.

    What is actually 1 person’s fraud (insurance provider alleging medically needless providers)
    is yet another person’s savior (service provider administering checks to protect against potential
    lawsuits from lawful sharks). Is tort reform a probability from all those pushing for health
    treatment reform? Sadly, it is not! Assistance for laws placing new and onerous prerequisites on vendors in the name
    of preventing fraud, however, does not look to be a dilemma.

    If Congress definitely needs to use its legislative powers to make a change on the fraud
    issue they should believe outside the house-the-box of what
    has presently been performed in some variety or fashion. Concentration on some entrance-conclude exercise
    that promotions with addressing the fraud just before
    it occurs. The adhering to are illustrative of techniques that could be taken in an work to
    stem-the-tide on fraud and abuse:

    -Need all payors and vendors, suppliers and some others only use accepted coding
    methods, where the codes are clearly described for
    ALL to know and comprehend what the distinct code means.
    Prohibit any one from deviating from the described meaning when reporting products and services rendered (suppliers, suppliers)
    and adjudicating statements for payment (payors
    and others). Make violations a stringent legal responsibility challenge.

    -Demand that all submitted claims to general public and non-public insurers be signed or annotated in some style by the affected person (or proper consultant) affirming they received
    the reported and billed products and services. If this sort of affirmation is
    not present claim just isn’t paid. If the assert is later
    on established to be problematic investigators have the means to
    converse with both equally the company and the affected person…

    -Involve that all claims-handlers (especially if they have authority to spend claims), consultants retained by insurers to assist on adjudicating statements, and fraud investigators be licensed by a countrywide accrediting firm under the purview of the government to exhibit that they have the requisite being familiar with
    for recognizing health and fitness care fraud, and the information to detect
    and examine the fraud in health care claims. If these types of accreditation is
    not attained, then neither the staff nor the advisor
    would be permitted to contact a well being care claim
    or examine suspected well being care fraud.

    -PROHIBIT community and personal payors from asserting fraud on statements beforehand paid out the place it is
    proven that the payor realized or really should have regarded
    the declare was poor and need to not have been paid.

    And, in these circumstances where by fraud is recognized
    in compensated statements any monies gathered from
    companies and suppliers for overpayments be deposited into a
    countrywide account to fund various fraud and
    abuse education systems for shoppers, insurers, regulation enforcers,
    prosecutors, legislators and many others fund front-line
    investigators for state overall health care regulatory boards to investigate fraud in their
    respective jurisdictions as very well as funding other health
    and fitness treatment relevant exercise.

    -PROHIBIT insurers from raising premiums of policyholders based
    mostly on estimates of the occurrence of fraud. Call
    for insurers to build a factual foundation for purported losses attributed
    to fraud coupled with exhibiting tangible proof of their initiatives to detect and look into fraud,
    as very well as not paying out fraudulent statements.

    5.Insurers are victims of wellbeing treatment fraud

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      Currently, wellness treatment fraud is all more than the news.
      There definitely is fraud in wellbeing care. The
      similar is legitimate for each individual company or endeavor touched by human hands, e.g.
      banking, credit rating, insurance policies,
      politics, etcetera. There is no dilemma that wellness treatment
      vendors who abuse their placement and our trust to steal are a dilemma.
      So are these from other professions who do the very same.

      Why does overall health treatment fraud surface to get
      the ‘lions-share’ of awareness? Could it be that it is the best car
      or truck to travel agendas for divergent teams exactly
      where taxpayers, health care shoppers and health and fitness care providers are dupes in a wellbeing treatment fraud
      shell-sport operated with ‘sleight-of-hand’ precision?

      Take a closer seem and one finds this is no recreation-of-possibility.
      Taxpayers, individuals and providers always eliminate mainly
      because the dilemma with health and fitness care fraud is not just the fraud, but it is that our authorities and
      insurers use the fraud trouble to more agendas although at the identical time fail to be accountable and acquire
      obligation for a fraud trouble they aid and let to flourish.

      one.Astronomical Value Estimates

      What greater way to report on fraud then to tout fraud cost estimates, e.g.

      – ”Fraud perpetrated versus both general public and personal health and fitness options charges involving $72 and $220 billion per year, growing the price of professional medical care and wellbeing coverage and undermining public belief in our wellbeing care procedure… It is no longer a top secret that fraud represents a single of the quickest rising and most costly forms of criminal offense in The usa now… We fork out these fees as taxpayers and via larger health and fitness insurance policy rates… We will have to be proactive in combating health and fitness care fraud and abuse… We will have to also ensure that regulation enforcement has the tools that it wants to discourage, detect, and punish health and fitness care fraud.” [Senator Ted Kaufman (D-DE), ten/28/09 press launch]

      – The General Accounting Workplace (GAO) estimates that fraud in healthcare ranges from $sixty billion to $600 billion for every calendar year – or wherever concerning 3% and 10% of
      the $2 trillion overall health care price range.
      [Health Care Finance Information stories, 10/two/09] The GAO is the investigative arm
      of Congress.

      – The National Overall health Treatment Anti-Fraud Association (NHCAA) reviews above
      $54 billion is stolen each individual yr in cons created to stick us and our
      insurance policy firms with fraudulent and unlawful healthcare
      prices. [NHCAA, world-wide-web-site] NHCAA was produced and
      is funded by health insurance corporations.

      Sadly, the reliability of the purported estimates is dubious at greatest.

      Insurers, state and federal agencies, and some others may perhaps assemble fraud details similar to their personal missions, exactly where the variety,
      good quality and volume of data compiled varies greatly.
      David Hyman, professor of Legislation, University of Maryland, tells us
      that the commonly-disseminated estimates of the incidence of
      health and fitness care fraud and abuse (assumed to be 10% of overall expending)
      lacks any empirical foundation at all, the very little we do know about well being care fraud and abuse is dwarfed by what
      we don’t know and what we know that is not so. [The Cato Journal, three/22/02]

      two.Wellness Treatment Criteria

      The rules & guidelines governing well being treatment –
      differ from point out to state and from payor to payor – are intensive and pretty
      complicated for suppliers and other folks to comprehend as they are written in legalese and not simple communicate.

      Companies use particular codes to report conditions dealt with (ICD-9) and expert services rendered (CPT-4 and HCPCS).

      These codes are applied when in search of compensation from payors for expert services rendered to individuals.
      Whilst created to universally utilize to facilitate precise reporting to mirror
      providers’ services, quite a few insurers instruct companies
      to report codes dependent on what the insurer’s
      personal computer editing programs recognize – not on what the supplier rendered.
      Further more, follow making consultants instruct suppliers on what codes to report to get compensated – in some scenarios codes that do not
      accurately mirror the provider’s service.

      Individuals know what providers they obtain from their medical professional or
      other service provider but may perhaps not have a clue as to what individuals billing
      codes or provider descriptors signify on rationalization of added benefits obtained from
      insurers. This lack of understanding might outcome in shoppers shifting on with no
      attaining clarification of what the codes mean, or may consequence in some believing they have been improperly billed.

      The multitude of coverage designs offered today,
      with varying ranges of coverage, ad a wild card to
      the equation when services are denied for non-coverage
      – specifically if it is Medicare that denotes non-included services as not medically
      required.

      3.Proactively addressing the well being treatment fraud
      difficulty

      The govt and insurers do very very little
      to proactively deal with the dilemma with tangible actions that will end result in detecting inappropriate claims
      ahead of they are paid out. In fact, payors of wellbeing treatment promises proclaim to work a payment method primarily based
      on believe in that suppliers bill properly for solutions rendered, as they can not review each and every claim ahead of payment is produced due to the fact the
      reimbursement technique would shut down.

      They declare to use subtle laptop or computer plans to glimpse for errors
      and patterns in promises, have improved pre- and publish-payment audits of picked companies to detect fraud,
      and have created consortiums and task forces consisting of regulation enforcers and insurance plan investigators to study the problem and share fraud data.

      Even so, this exercise, for the most part, is dealing with activity right after the declare is
      paid and has small bearing on the proactive detection of
      fraud.

      four.Exorcise health treatment fraud with the development of new laws

      The government’s experiences on the fraud difficulty are
      released in earnest in conjunction with endeavours to
      reform our well being treatment system, and our knowledge exhibits us that it finally outcomes in the govt introducing and enacting new guidelines – presuming new legislation will result
      in a lot more fraud detected, investigated and prosecuted –
      with out setting up how new regulations will attain this a lot more
      successfully than present laws that were not utilized to their whole opportunity.

      With these initiatives in 1996, we got the Overall health Insurance coverage Portability
      and Accountability Act (HIPAA). It was enacted by
      Congress to address coverage portability and accountability for client privateness and well being care fraud and abuse.
      HIPAA purportedly was to equip federal legislation enforcers and prosecutors with the applications to attack fraud,
      and resulted in the development of a selection of new overall health treatment fraud statutes,
      like: Health Treatment Fraud, Theft or Embezzlement in Health Treatment,
      Obstructing Criminal Investigation of Health and fitness Care, and Bogus Statements Relating
      to Overall health Treatment Fraud Matters.

      In 2009, the Health and fitness Care Fraud Enforcement Act appeared on the scene.
      This act has recently been introduced by Congress with promises that
      it will create on fraud prevention attempts and improve the governments’ capacity
      to investigate and prosecute squander, fraud and abuse in equally government and non-public wellness insurance plan by sentencing improves redefining wellness treatment fraud offense improving whistleblower statements generating prevalent-feeling mental
      state necessity for well being care fraud offenses and expanding funding in federal antifraud investing.

      Undoubtedly, law enforcers and prosecutors Should have the
      applications to proficiently do their jobs. Even so, these steps by yourself, with out inclusion of some tangible and major prior to-the-claim-is-compensated
      actions, will have minor affect on cutting down the occurrence of the difficulty.

      What is actually 1 person’s fraud (insurance provider alleging medically needless providers)
      is yet another person’s savior (service provider administering checks to protect against potential
      lawsuits from lawful sharks). Is tort reform a probability from all those pushing for health
      treatment reform? Sadly, it is not! Assistance for laws placing new and onerous prerequisites on vendors in the name
      of preventing fraud, however, does not look to be a dilemma.

      If Congress definitely needs to use its legislative powers to make a change on the fraud
      issue they should believe outside the house-the-box of what
      has presently been performed in some variety or fashion. Concentration on some entrance-conclude exercise
      that promotions with addressing the fraud just before
      it occurs. The adhering to are illustrative of techniques that could be taken in an work to
      stem-the-tide on fraud and abuse:

      -Need all payors and vendors, suppliers and some others only use accepted coding
      methods, where the codes are clearly described for
      ALL to know and comprehend what the distinct code means.
      Prohibit any one from deviating from the described meaning when reporting products and services rendered (suppliers, suppliers)
      and adjudicating statements for payment (payors
      and others). Make violations a stringent legal responsibility challenge.

      -Demand that all submitted claims to general public and non-public insurers be signed or annotated in some style by the affected person (or proper consultant) affirming they received
      the reported and billed products and services. If this sort of affirmation is
      not present claim just isn’t paid. If the assert is later
      on established to be problematic investigators have the means to
      converse with both equally the company and the affected person…

      -Involve that all claims-handlers (especially if they have authority to spend claims), consultants retained by insurers to assist on adjudicating statements, and fraud investigators be licensed by a countrywide accrediting firm under the purview of the government to exhibit that they have the requisite being familiar with
      for recognizing health and fitness care fraud, and the information to detect
      and examine the fraud in health care claims. If these types of accreditation is
      not attained, then neither the staff nor the advisor
      would be permitted to contact a well being care claim
      or examine suspected well being care fraud.

      -PROHIBIT community and personal payors from asserting fraud on statements beforehand paid out the place it is
      proven that the payor realized or really should have regarded
      the declare was poor and need to not have been paid.

      And, in these circumstances where by fraud is recognized
      in compensated statements any monies gathered from
      companies and suppliers for overpayments be deposited into a
      countrywide account to fund various fraud and
      abuse education systems for shoppers, insurers, regulation enforcers,
      prosecutors, legislators and many others fund front-line
      investigators for state overall health care regulatory boards to investigate fraud in their
      respective jurisdictions as very well as funding other health
      and fitness treatment relevant exercise.

      -PROHIBIT insurers from raising premiums of policyholders based
      mostly on estimates of the occurrence of fraud. Call
      for insurers to build a factual foundation for purported losses attributed
      to fraud coupled with exhibiting tangible proof of their initiatives to detect and look into fraud,
      as very well as not paying out fraudulent statements.

      5.Insurers are victims of wellbeing treatment fraud

      Reply
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