昨日、先々代１７回忌、先代の３回忌法要を勤めました。先々代は祖父、先代は父に当たります。
去年の先代一周忌までは檀家葬で勤めていただきましたが、今年からは金森家が施主になります。大したことは出来ませんが、祖父母や父が喜んでくれることは何だろう … と思いながら準備をしました。まずハードな面としては、この日に向けて本堂の畳替えをし、新畳で 最初に法事をすることができました。これは、来る４月２１日の回番御忌（かいばんぎょき）に向け、慶祝事業の一環として成就したのですが、畳替えが完了したのが２月２８日。この日は 奇しくも父の命日でした。回番御忌とは近江八幡市内１２ヶ寺が当番制で回している１０数年に一度の大法要ですが、これは先々代の発案だと聞いています。３巡目の西願寺の当番が今年の４月２１日。この日は奇しくも祖父の１７回忌の当日に当たります。檀信徒一同で成した、タイミングが合った畳替えでした。
またソフトな面として、自前で法要が出来たことが嬉しかったです。導師が祖母の実家・善教寺上人。役僧が母の実家・重願寺上人、そして先代の弟子だった水月尼。そして、中２の長男、小６二男が音頭をとって読経をしてくれました。私自身も、縁深き僧侶方に勤めて欲しいですし、まして、自分の孫やひ孫にお経を読んでもらったら これほど嬉しいことはないだろうなぁ … と思い、配役を決めました。
法事を勤めるのは大変です。時間もお金もかかりますし、気疲れもハンパじゃありません（笑）。しかし、施主として法事を行い学んだことは、一つ一つ意味を考えて勤めれば、必ず大きな縁や力に護られてることに気付くのです。あたかも亡き人と会話をして、幸せの確認作業をしている感覚です。この学びは 法事をせねば決してわかりません。法事というものは上手くできてるなぁ・・・また、次なる世代への無言の教えにもなるんだなぁ・・・過去・現在・未来と一本の線がつながり、自分の存在意義がわかり、有り難いなぁ・・・と思いました。また、その法事に携わる 住職の責任の重さも学びました。有縁の皆様、誠に有難うございました。心より感謝申し上げます。合掌
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Nowadays, well being care fraud is all above the information. There
undoubtedly is fraud in health care. The similar is accurate for each individual organization or
endeavor touched by human fingers, e.g. banking, credit rating, insurance policies, politics,
and so on. There is no problem that health and fitness
treatment suppliers who abuse their situation and our trust to steal are a difficulty.
So are people from other professions who do the exact.
Why does well being treatment fraud appear to get the ‘lions-share’ of
attention? Could it be that it is the best auto to travel agendas for divergent groups where
taxpayers, wellbeing care consumers and health treatment suppliers are dupes in a wellness
care fraud shell-recreation operated with ‘sleight-of-hand’ precision?
Get a closer glance and just one finds this is no video game-of-chance.
Taxpayers, buyers and suppliers normally get rid of mainly because the problem with overall health treatment fraud is
not just the fraud, but it is that our government and insurers
use the fraud issue to additional agendas though at the similar time are unsuccessful to be accountable and
get duty for a fraud issue they aid and let to flourish.
one.Astronomical Cost Estimates
What superior way to report on fraud then to tout fraud cost estimates, e.g.
– “Fraud perpetrated towards both general public and private wellbeing programs fees between $seventy two and $220 billion yearly, rising the charge of medical treatment and wellness insurance policy and undermining community have faith in in our overall health treatment procedure… It is no extended a secret that fraud represents one particular of the swiftest developing and most highly-priced forms of criminal offense in The us right now… We pay out these expenses as taxpayers and through higher wellness insurance policy premiums… We will have to be proactive in combating health treatment fraud and abuse… We must also assure that regulation enforcement has the equipment that it requirements to prevent, detect, and punish wellbeing care fraud.”
[Senator Ted Kaufman (D-DE), ten/28/09 push launch]
– The General Accounting Office environment (GAO) estimates that fraud in healthcare ranges from $sixty billion to
$600 billion for every year – or anyplace in between three% and ten% of the
$two trillion well being treatment spending budget. [Well being Treatment Finance News studies, 10/2/09] The GAO is the investigative arm of
Congress.
– The Countrywide Health Treatment Anti-Fraud Affiliation (NHCAA) reports in excess of $54 billion is stolen each individual calendar year in frauds built to adhere us and our insurance policies firms with
fraudulent and illegal healthcare costs. [NHCAA, world wide web-web page]
NHCAA was established and is funded by wellbeing insurance organizations.
Regretably, the reliability of the purported estimates is doubtful at finest.
Insurers, point out and federal companies, and other people may gather fraud
information linked to their individual missions, wherever
the form, high-quality and quantity of info compiled may differ extensively.
David Hyman, professor of Regulation, College of Maryland, tells us that the
broadly-disseminated estimates of the incidence
of health and fitness treatment fraud and abuse (assumed to be ten%
of total shelling out) lacks any empirical foundation at all, the
very little we do know about wellbeing treatment fraud and abuse is dwarfed by
what we do not know and what we know that is not so.
[The Cato Journal, three/22/02]
two.Health and fitness Treatment Standards
The regulations & procedures governing health care – differ from point out to state and
from payor to payor – are intensive and incredibly bewildering
for providers and other folks to understand as they are prepared in legalese and not basic talk.
Companies use certain codes to report situations taken care of
(ICD-9) and expert services rendered (CPT-4 and HCPCS).
These codes are applied when searching for payment from payors for companies
rendered to individuals. Whilst created to universally
use to aid accurate reporting to replicate providers’ providers,
quite a few insurers instruct vendors to report codes based on what the insurer’s computer enhancing systems identify – not on what the
company rendered. Further more, apply creating consultants instruct suppliers
on what codes to report to get paid – in some situations codes that
do not accurately mirror the provider’s service.
Individuals know what solutions they obtain from their
doctor or other company but may well not have a clue as to what those people billing codes or assistance
descriptors suggest on explanation of positive aspects received from insurers.
This absence of being familiar with could consequence in shoppers going on with out getting clarification of what the codes suggest, or may perhaps end result
in some believing they have been improperly billed. The multitude of insurance policy
programs accessible now, with different ranges of protection, ad a wild
card to the equation when services are denied for non-protection – especially
if it is Medicare that denotes non-protected services as not medically essential.
three.Proactively addressing the well being treatment fraud challenge
The authorities and insurers do incredibly minor to proactively handle the trouble with
tangible routines that will outcome in detecting inappropriate claims prior to they are paid out.
Without a doubt, payors of health and fitness treatment claims
proclaim to operate a payment technique dependent on believe in that providers
bill properly for services rendered, as they can not overview just
about every claim right before payment is designed since the reimbursement technique would shut down.
They assert to use innovative personal computer applications to appear for glitches and designs in statements,
have increased pre- and publish-payment audits of chosen companies to detect fraud, and have
developed consortiums and task forces consisting of regulation enforcers and insurance policy investigators to review
the difficulty and share fraud details. Nevertheless, this exercise, for the most component, is working with action right after the claim is paid out and has little bearing on the proactive detection of fraud.
4.Exorcise health care fraud with the generation of new regulations
The government’s reports on the fraud problem are posted in earnest in conjunction with initiatives to reform our wellness treatment procedure, and our working experience exhibits
us that it finally outcomes in the governing administration introducing and enacting new legislation – presuming new
legal guidelines will consequence in more fraud detected, investigated
and prosecuted – without the need of developing how
new legal guidelines will accomplish this far more correctly than existing legal guidelines that have
been not used to their entire probable.
With these kinds of endeavours in 1996, we received the Wellness Insurance policies
Portability and Accountability Act (HIPAA). It was enacted by
Congress to tackle insurance coverage portability and accountability for
patient privateness and wellness treatment fraud and abuse.
HIPAA purportedly was to equip federal law enforcers and prosecutors with the instruments to attack fraud, and resulted in the creation of a number of new
well being treatment fraud statutes, which include:
Overall health Care Fraud, Theft or Embezzlement in Wellness Care, Obstructing
Felony Investigation of Wellness Treatment, and Untrue Statements Relating to Wellbeing Treatment Fraud Issues.
In 2009, the Wellness Care Fraud Enforcement Act appeared on the scene.
This act has lately been introduced by Congress with promises that it will develop on fraud avoidance attempts and fortify
the governments’ capacity to examine and prosecute waste, fraud and abuse in each government and private overall health insurance policy by sentencing improves redefining wellness treatment fraud offense strengthening whistleblower statements
creating widespread-feeling mental condition prerequisite for health and
fitness treatment fraud offenses and raising funding in federal antifraud paying.
Certainly, law enforcers and prosecutors Should
have the applications to efficiently do their careers. On the other hand, these actions by itself, with no inclusion of some tangible and
sizeable right before-the-assert-is-compensated steps, will
have very little influence on lowering the event of the difficulty.
What is one particular person’s fraud (insurance provider alleging medically unneeded products and services) is yet another person’s savior (service provider administering tests to defend towards likely lawsuits from legal sharks).
Is tort reform a likelihood from individuals pushing for wellness care reform?
Regretably, it is not! Assistance for laws placing new and onerous needs on companies in the name
of fighting fraud, however, does not surface to be a challenge.
If Congress definitely would like to use its legislative powers to
make a difference on the fraud dilemma they must think outside the house-the-box of what has currently
been performed in some type or manner. Emphasis on some entrance-conclude
action that bargains with addressing the fraud in advance of it transpires.
The subsequent are illustrative of ways that could be taken in an hard work to stem-the-tide on fraud and abuse:
-Demand all payors and vendors, suppliers and some others only use accredited coding devices, exactly where the codes are plainly described for ALL to know and fully grasp what the
distinct code means. Prohibit everyone from deviating from the outlined which
means when reporting providers rendered (providers,
suppliers) and adjudicating statements for payment (payors and other individuals).
Make violations a strict liability problem.
-Demand that all submitted claims to general public and personal insurers be signed
or annotated in some style by the patient (or proper representative) affirming they
gained the claimed and billed products and services. If these types of affirmation is not existing claim
just isn’t paid. If the claim is later decided to be problematic
investigators have the capability to talk with equally the
company and the client…
-Involve that all promises-handlers (specifically if they have authority to pay out promises),
consultants retained by insurers to help on adjudicating claims, and
fraud investigators be qualified by a countrywide accrediting corporation less than the purview of the authorities to show
that they have the requisite knowing for recognizing
well being care fraud, and the expertise to detect and investigate the fraud in wellness care promises.
If these accreditation is not received, then neither the staff nor the
marketing consultant would be permitted to touch a health
and fitness treatment claim or examine suspected wellbeing treatment
fraud.
-PROHIBIT public and non-public payors from asserting
fraud on claims earlier paid exactly where it is
recognized that the payor realized or should really have acknowledged
the declare was poor and really should not have been paid out.
And, in those conditions in which fraud is founded in compensated statements
any monies collected from vendors and suppliers for overpayments
be deposited into a national account to fund several fraud
and abuse education and learning packages for shoppers, insurers, law enforcers, prosecutors, legislators and other individuals fund front-line investigators for state health treatment
regulatory boards to examine fraud in their respective jurisdictions as properly as funding other health care associated exercise.
-PROHIBIT insurers from raising rates of policyholders based mostly on estimates of the event of fraud.
Call for insurers to establish a factual foundation for purported losses attributed to fraud coupled with demonstrating tangible proof of their efforts to detect
and examine fraud, as well as not having to pay fraudulent claims.
five.Insurers are victims of overall health treatment fraud
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