Idag för 250 år sedan: 5 juli 1766

05th juli 2016

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

Idag för 250 år sedan: 2 december 1766

02nd december 2016

Idag för 250 år sedan: 15 oktober 1766

15th oktober 2016

Idag för 250 år sedan: 7 augusti 1766

07th augusti 2016

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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

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politics, etcetera. There is no dilemma that wellness treatment
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or truck to travel agendas for divergent teams exactly
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Take a closer seem and one finds this is no recreation-of-possibility.
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because the dilemma with health and fitness care fraud is not just the fraud, but it is that our authorities and
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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

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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.

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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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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,
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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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