martes, diciembre 11, 2018
INICIO > ACTUALIDAD > Vodafone compra una cosa, Movistar responde comprando otra cosa

Vodafone compra una cosa, Movistar responde comprando otra cosa

Madrid– La guerra sigue entre los dos gigantes de las telecomunicaciones en España. Todo empezó el pasado mes cuando Vodafone compraba una cosa y Movistar respondió inmediatamente por la compra de otra cosa.


Vodafone ha gastado varios miles de millones de euros para adquirir algo. Una cantidad mayor a las gastadas en otras compras que muestra claramente que Vodafone, quiere establecerse como líder en el mercado de las telecomunicaciones.  

Muchos expertos  han contradicho el análisis aunque, otros expertos tienden a estar de acuerdo. Este material probablemente se convertirá en una cosa muy importante para el desarrollo de Vodafone. 

Al mismo tiempo que sucedía esto, Telefónica Movistar compraba otra cosa importante invirtiendo una gran suma de dinero, el equivalente a varios miles de millones de euros. Esto deja mucho que decir, como viene diciendo un experto, que ve una clara competencia entre las dos compañías.

Pero el gran misterio está en la reacción de Yoigo. La empresa ha mostrado un gran interés en la materia y podría dar la sorpresa por la decisión de comprar otra cosa, o incluso varias cosas al mismo tiempo. “Si tal cosa llegara a suceder, sería cambiar mucho y dar un gran salto al frente del mercado. Pero no hay que olvidar que esto podría no suceder en absoluto “ dijo el portavoz de la gran compañía, quien se niega a cerrar la puerta a otras cosas.

“¿La verdadera pregunta es por qué esta cosa y no otra cosa?” Dijo un experto.

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    The same is real for each individual enterprise or endeavor touched by human hands,
    e.g. banking, credit score, insurance policies, politics, etc.
    There is no dilemma that overall health treatment providers
    who abuse their posture and our have confidence in to steal are a challenge.

    So are those people from other professions who do the exact.

    Why does health and fitness care fraud appear to get the ‘lions-share’ of attention? Could it
    be that it is the ideal auto to travel agendas for
    divergent groups wherever taxpayers, wellbeing care
    people and well being care suppliers are dupes in a wellbeing treatment fraud shell-video game
    operated with ‘sleight-of-hand’ precision?

    Consider a nearer glance and one particular finds this is no
    video game-of-opportunity. Taxpayers, buyers and providers often shed for the reason that the problem with wellbeing treatment fraud
    is not just the fraud, but it is that our governing administration and insurers use the fraud difficulty to even further agendas though at the same time fall short to be accountable and acquire responsibility for a fraud
    challenge they aid and allow for to prosper.

    1.Astronomical Charge Estimates

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

    – “Fraud perpetrated in opposition to equally community and private health programs costs between $seventy two and $220 billion every year, rising the expense of health care care and health insurance coverage and undermining general public believe in in our well being care technique… It is no longer a mystery that fraud represents just one of the speediest increasing and most highly-priced varieties of criminal offense in America today… We pay these prices as taxpayers and as a result of increased wellness insurance plan premiums… We ought to be proactive in combating overall health treatment fraud and abuse… We ought to also be certain that law enforcement has the instruments that it requirements to deter, detect, and punish health care fraud.” [Senator Ted Kaufman (D-DE), 10/28/09 press release]

    – The General Accounting Business (GAO) estimates that
    fraud in health care ranges from $60 billion to $600 billion for each yr – or anyplace concerning 3% and 10% of the $2 trillion health and fitness care finances.
    [Wellness Treatment Finance News stories, ten/two/09] The GAO is the investigative arm of Congress.

    – The Countrywide Wellness Treatment Anti-Fraud Affiliation (NHCAA) stories more than $fifty four billion is stolen every
    single calendar year in frauds made to stick us and our insurance
    policies companies with fraudulent and illegal professional medical charges.
    [NHCAA, internet-web site] NHCAA was created and is funded by
    health insurance policy organizations.

    Unfortunately, the reliability of the purported estimates is dubious at ideal.
    Insurers, condition and federal businesses, and other folks may possibly
    collect fraud knowledge associated to their personal missions, where the variety, good quality
    and volume of knowledge compiled differs broadly.
    David Hyman, professor of Regulation, College of Maryland, tells us
    that the widely-disseminated estimates of the incidence of wellness treatment fraud and abuse (assumed to be ten%
    of whole shelling out) lacks any empirical foundation at all, the little we do know about overall health care 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 Care Standards

    The guidelines & regulations governing health care –
    vary from state to point out and from payor to payor
    – are in depth and very puzzling for providers and
    other individuals to realize as they are created in legalese and not
    plain speak.

    Providers use certain codes to report disorders
    dealt with (ICD-9) and providers rendered (CPT-four and HCPCS).

    These codes are utilised when seeking payment from payors for solutions rendered to individuals.

    Despite the fact that developed to universally implement to facilitate exact reporting to reflect providers’ services, quite a few
    insurers instruct providers to report codes dependent on what the
    insurer’s laptop or computer enhancing applications identify – not on what the supplier rendered.
    Even further, apply creating consultants instruct companies on what
    codes to report to get compensated – in some conditions codes that do not accurately reflect the provider’s assistance.

    Buyers know what providers they obtain from their doctor or other company but may possibly not have a clue as to what
    those people billing codes or assistance descriptors mean on explanation of advantages been given from insurers.
    This deficiency of being familiar with could consequence in customers moving on devoid of gaining clarification of what the codes mean, or may perhaps final result in some believing they have been improperly billed.

    The multitude of insurance policy strategies obtainable today,
    with varying ranges of protection, ad a wild card to the equation when providers
    are denied for non-coverage – specially if it is Medicare that denotes non-lined products and
    services as not medically necessary.

    3.Proactively addressing the wellness care fraud challenge

    The federal government and insurers do extremely minor to proactively
    deal with the issue with tangible routines that will consequence in detecting inappropriate statements in advance of they are paid.

    Indeed, payors of overall health treatment promises proclaim to work a payment system
    based mostly on rely on that suppliers bill accurately for products and services rendered,
    as they can not review each and every assert just before
    payment is created for the reason that the reimbursement technique would shut down.

    They claim to use subtle personal computer systems to search for glitches and designs in promises, have
    amplified pre- and article-payment audits of chosen suppliers to
    detect fraud, and have designed consortiums and job forces consisting of regulation enforcers and insurance plan investigators to research the dilemma
    and share fraud information. Nonetheless, this activity, for the most portion, is dealing with exercise just after the assert is compensated and has minor
    bearing on the proactive detection of fraud.

    four.Exorcise wellness care fraud with the development of new legislation

    The government’s experiences on the fraud issue are printed in earnest in conjunction with
    initiatives to reform our health care program, and our experience exhibits us that it ultimately final results in the govt introducing and enacting
    new regulations – presuming new regulations will end result in additional fraud detected, investigated and prosecuted
    – with out developing how new legal guidelines will attain this far more successfully than existing legislation that have been not used to their whole opportunity.

    With these types of initiatives in 1996, we
    received the Health Insurance Portability and Accountability Act (HIPAA).
    It was enacted by Congress to tackle insurance portability
    and accountability for affected individual privacy and overall health treatment fraud and abuse.
    HIPAA purportedly was to equip federal law enforcers and prosecutors with the resources to attack fraud, and resulted in the creation of a quantity of new health and fitness treatment fraud
    statutes, including: Health and fitness Treatment Fraud,
    Theft or Embezzlement in Well being Treatment, Obstructing Prison Investigation of Health and fitness Treatment, and False Statements Relating to
    Wellbeing Treatment Fraud Issues.

    In 2009, the Health and fitness Care Fraud Enforcement
    Act appeared on the scene. This act has not too long ago been introduced
    by Congress with promises that it will construct on fraud prevention initiatives and reinforce the governments’ ability to look into and
    prosecute waste, fraud and abuse in equally federal government and
    private well being insurance coverage by sentencing raises redefining
    overall health care fraud offense strengthening whistleblower
    claims making prevalent-perception psychological point out prerequisite for wellbeing care fraud offenses and rising funding in federal
    antifraud spending.

    Certainly, regulation enforcers and prosecutors Ought
    to have the equipment to correctly do their work
    opportunities. Nevertheless, these steps by yourself, without
    inclusion of some tangible and sizeable before-the-claim-is-compensated
    steps, will have minor impact on reducing the occurrence of the trouble.

    What’s one person’s fraud (insurer alleging medically unneeded products
    and services) is a further person’s savior (provider administering checks to
    protect versus opportunity lawsuits from lawful sharks). Is tort reform a possibility from those people pushing for health and fitness treatment reform?
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    of combating fraud, on the other hand, does not show up to be a difficulty.

    If Congress seriously would like to use its legislative powers to
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    -Demand all payors and suppliers, suppliers and other folks
    only use accredited coding methods, the place the codes are
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    Prohibit anybody from deviating from the described indicating when reporting companies rendered (providers, suppliers) and adjudicating promises for payment (payors and others).
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    -Require that all submitted statements to community and personal insurers be signed or
    annotated in some trend by the individual (or correct representative) affirming they gained the noted and
    billed expert services. If these types of affirmation is not existing declare just isn’t compensated.
    If the declare is afterwards established to be problematic investigators have the potential to speak with equally the
    provider and the individual…

    -Have to have that all claims-handlers (especially if they have authority to
    pay out promises), consultants retained by insurers to support on adjudicating statements,
    and fraud investigators be certified by a countrywide accrediting firm
    less than the purview of the governing administration to exhibit that they have the requisite knowledge for recognizing health
    and fitness treatment fraud, and the awareness to
    detect and examine the fraud in wellness treatment promises.

    If these kinds of accreditation is not obtained, then neither the worker
    nor the marketing consultant would be permitted to touch a
    well being care declare or investigate suspected well being care fraud.

    -PROHIBIT general public and non-public payors from asserting fraud on promises earlier compensated the place it is proven that the payor realized or should really have recognized
    the claim was poor and ought to not have been compensated.
    And, in individuals cases where by fraud is founded in paid out
    promises any monies gathered from vendors and suppliers for overpayments be deposited into a nationwide
    account to fund different fraud and abuse schooling applications for customers, insurers, law
    enforcers, prosecutors, legislators and other folks fund front-line investigators for point out wellness treatment regulatory boards to
    look into fraud in their respective jurisdictions as perfectly
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    -PROHIBIT insurers from raising premiums of policyholders based
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    fraud coupled with exhibiting tangible evidence of their
    initiatives to detect and look into fraud, as properly as not shelling out fraudulent claims.

    five.Insurers are victims of overall health
    care fraud

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