text:
 Avis juridique important
 |
 21993A1231(16)
 Acordo europeu entre as Comunidades Europeias e os seus Estados-membros, por um lado, e a República da Hungria, por outro - Troca de cartas entre a Comunidade Económica Europeia («a Comunidade») e a Hungria respeitante ao trânsito
 Jornal Oficial no L 347 de 31/12/1993 p. 0269 - 0270 Edição especial finlandesa: Capítulo 11 Fascículo 25 p. 0276 Edição especial sueca: Capítulo 11 Fascículo 25 p. 0276
 Troca de cartas entre a Comunidade Económica Europeia («a Comunidade») e a Hungria respeitante ao trânsitoA. Carta da HungriaExcelentíssimo Senhor,No decurso das negociações do acordo europeu entre a Comunidade e os seus Estados-membros e a Hungria, chegou-se ao seguinte acordo:1. As partes do acordo europeu não tomarão quaisquer medidas susceptíveis de afectar a situação resultante da aplicação dos acordos bilaterais existentes entre os Estados-membros da Comunidade e a Hungria.2. a) Em especial, no contexto de uma solução global para os problemas de trânsito através da Hungria para os Estados-membros da Comunidade mais directamente em questão, a Hungria concederá em 1992, para além do actual contingente concedido no âmbito dos acordos bilaterais para 1991, licenças do seguinte modo:>POSIÇÃO NUMA TABELA>Todas as licenças isentas e tributáveis respeitam a viagens de ida e volta. Para 1993 e 1994, o número total de licenças isentas e tributáveis será aumentado, anualmente, em 5 %, de modo que o número de licenças adicionais ascenda, em 1993, a 300 licenças isentas e a 6 160 tributáveis e, em 1994, a 615 licenças isentas e a 7 168 licenças tributáveis. O número de licenças adicionais de país terceiro mantém-se em 100 tanto para 1993 como para 1994.b) A taxa, acima referida, de aumento de 5 %, aplicada em 1993 e 1994 no que respeita às licenças isentas e tributáveis, será objecto de reexame mantendo contudo o princípio de «stand-still», no caso de um acordo bilateral sobre transportes entre a Comunidade e a Hungria entrar em vigor até ao final de 1994. Caso tal acordo entre em vigor numa data posterior, as licenças acima mencionadas serão objecto de negociações embora se mantenha o princípio de «stand-still».Muito agradeceria a Vossa Excelência se dignasse confirmar-me o acordo da Comunidade quanto ao conteúdo da presente carta.Queira aceitar, Excelentíssimo Senhor, os protestos da minha mais elevada consideração.Pelo Governo da HungriaB. Carta da ComunidadeExcelentíssimo Senhor,Tenho a honra de acusar recepção da carta de hoje de Vossa Excelência do seguinte teor:«Excelentíssimo Senhor,No decurso das negociações do acordo europeu entre a Comunidade e os seus Estados-membros e a Hungria, chegou-se ao seguinte acordo:1. As partes do acordo europeu não tomarão quaisquer medidas susceptíveis de afectar a situação resultante da aplicação dos acordos bilaterais existentes entre os Estados-membros da Comunidade e a Hungria.2. a) Em especial, no contexto de uma solução global para os problemas de trânsito através da Hungria para os Estados-membros da Comunidade mais directamente em questão, a Hungria concederá em 1992, para além do actual contingente concedido no âmbito dos acordos bilaterais para 1991, licenças do seguinte modo:>POSIÇÃO NUMA TABELA>Todas as licenças isentas e tributáveis respeitam a viagens de ida e volta. Para 1993 e 1994, o número total de licenças isentas e tributáveis será aumentado, anualmente, em 5 %, de modo que o número de licenças isentas e tributáveis será aumentado, anualmente, em 5 %, de modo que o número de licenças adicionais ascenda, em 1993, a 300 licenças isentas e a 6 160 tributáveis e, em 1994, a 615 licenças isentas e a 7 168 licenças tributáveis. O Número de licenças adicionais de país terceiro mantém-se em 100 tanto para 1993 como para 1994.b) A taxa, acima referida, de aumento de 5 %, aplicada em 1993 e 1994 no que respeita às licenças isentas e tributáveis, será objecto de reexame mantendo contudo o princípio de "stand-still", no caso de um acordo bilateral sobre transportes entre a Comunidade e a Hungria entrar em vigor até ao final de 1994. Caso tal acordo entre em vigor numa data posterior, as licenças acima mencionadas serão objecto de negociações embora se mantenha o princípio de "stand-still".Muito agradeceria a Vossa Excelência se dignasse confirmar-me o acordo da Comunidade quanto ao conteúdo da presente carta.».Tenho a honra de confirmar o acordo da Comunidade quanto ao conteúdo desta carta.Queira aceitar, Excelentíssimo Senhor, os protestos da minha mais elevada consideração.Em nome da Comunidade


type: wikipedia

text:
Argos (Grieks: Ἄργος) is de naam van een Griekse stad en gemeente in de nomos Argolis (waaraan ze overigens haar naam gaf), met ongeveer 21.000 inwoners. Het is een van de oudste steden van Griekenland en wordt gedomineerd door de 290 m hoge Lárisa-heuvel. Er zijn laat-klassieke resten van een agora, tempels, een stadsmuur en een theater (uit de 4e tot de 2e eeuw v.Chr.) en van Romeinse bouwwerken, onder meer een aquaduct en thermen (uit de 1e tot de 3e eeuw na Chr.). De moderne, enigszins rommelige stad is het handelscentrum van Argolis, met agrarische verwerkingsindustrie, en is een belangrijk verkeersknooppunt. Om het halfuur is er een busverbinding met Nafplio.
 Geschiedenis
 Het belang van Argos in de oudste geschiedenis van Griekenland kan moeilijk overschat worden, als men nagaat welke plaats het inneemt in talloze Griekse mythen en sagen: het was onder meer de stad van koning Danaüs en zijn vijftig dochters, de Danaïden, en een andere koning, Diomedes, erkende volgens Homerus in de Trojaanse oorlog het leiderschap van Agamemnon. Hoewel het volgens Homerus "paardenfokkende" Argos, in de Myceense periode in feite heerste over de naburige burchten van Mycene en Tiryns, werd het in de praktijk geheel overvleugeld door Mycene (waarmee het in de tragedies zelfs ronduit vereenzelvigd wordt).Reeds in de Neolithische periode, omstreeks 3000 v.Chr., moet er een vestigingsplaats zijn geweest, en er stond ook een Achaeïsche akropolis (een van de vele heuvelburchten waaraan de gehele omgeving zo rijk is), totdat de invallende Doriërs er ca. 1100 v.Chr. de Achaeërs verdreven.
 In de 8e-7e eeuw v.Chr. werd Argos geregeerd door de tiran Pheidon, die naar de hegemonie onder de Dorische staten streefde en zijn stad uitbouwde tot de machtigste van de Peloponnesos. Waarschijnlijk was het tijdens zijn bewind dat Argos Sparta versloeg in de Slag bij Hyssae (668 v.Chr.) De traditionele rivaliteit tussen Sparta en Argos, die al uit de 8e eeuw v.Chr. dateerde werd hiermee nog eens bevestigd. Pheidon was waarschijnlijk ook degene die een militaire innovatie, de falanx van zwaar bewapende hoplieten op zijn naam heeft staan.
 Hij liet ook de eerste Griekse munten slaan (op het eiland Aegina), en het Argeïsche stelsel van maten en gewichten werd in heel de Peloponnesos aanvaard. Na zijn dood begon Korinthe zich als machtscentrum te manifesteren, en de invloed van Argos zonk in de mate waarin die van Sparta steeg.
 In 494 v.Chr., dus tijdens de Eerste Perzische Oorlog, versloeg Sparta Argos bij Tiryns, wat tot blijvende onderlinge vijandschap leidde. De stad werd in dat jaar door de dichteres Telesilla gered van verovering door de Spartanen. Argos vocht verder niet mee met de andere Grieken tegen de Perzen.
 Rond 460 v.Chr. werd er een democratische regering ingevoerd en in 451 v.Chr. werd een 30-jarige vrede met Sparta gesloten. Tijdens de Peloponnesische Oorlog koos het niettemin in de regel partij voor Athene, zij het als een weinig betrouwbare partner, bv. in de gevechten bij Mantinea in 418 v.Chr. Argos deelde in de nederlaag van Athene; dit was aanleiding tot een scherp conflict tussen de aristocraten (die bij Sparta zwoeren) en de democraten (die het met Athene hielden). Deze innerlijke verdeeldheid leidde uiteindelijk tot de politieke ondergang van Argos: in 404 v.Chr. leed het een zware nederlaag tegen koning Cleomenes I van Sparta. Met Korinte werd een politieke eenheid bereikt, die bijdroeg aan het einde van Sparta als grote mogendheid in de Slag bij Leuctra (371 v.Chr.) Nog tot in de tijd van Epaminondas bleef de rivaliteit met Sparta bestaan, onder meer (opnieuw) bij Mantinea in 362 v.Chr.
 In de Hellenistische tijd sloot het zich – overigens als laatste - aan bij de Achaeïsche Bond, nadat een reeks tirannen de macht naar zich toegetrokken hadden. Na de ontbinding van de Bond in 146 v.Chr. behield Argos zijn beperkte autonomie.Onder de Romeinen beleefde het zelfs een nieuwe periode van bloei: thermen en andere openbare gebouwen verrezen. In 267 na Chr. werd het eerst door de Goten, in 395 door Alarik I veroverd en geplunderd.
 Argos won eerst weer in betekenis in de middeleeuwen, toen westerse ridders tijdens de Vierde Kruistocht (1204) hun versterkte kastelen in de buurt lieten bouwen. Tijdens de Griekse Onafhankelijkheidsoorlog vonden in Argos twee Nationale vergaderingen plaats (in de ruïne van het theater, cf. infra), en werd de Lárisa-vesting met succes verdedigd door de vrijheidsstrijders Kolokotronis en Ypsilantis. Daarna werd Argos in 1828 door de Turken verwoest en geheel herbouwd: hierdoor heeft het stadsbeeld van het nieuwe Argos weinig interessants te bieden.
 Bezienswaardig
 De voornaamste cultus van de stad was die van de godin Hera, die er haar vermaarde heiligdom had, het Heraion, gelegen op ca. 8 km buiten het centrum, langs de weg naar Mycene. Het nu verdwenen cultusbeeld voor de tempel werd gemaakt door Polycletus de Oudere (480-420 v.Chr.), de voornaamste vertegenwoordiger van de School van Argos, die enkele toonaangevende beeldhouwers heeft geleverd. Ook Polycletus de Jongere (435-360 v.Chr.), die onder meer het theater van Epidaurus bouwde, werd in Argos geboren.
 Het meest suggestieve monument van Argos is echter het theater, een imposant gebouw met 81 rijen zitplaatsen, dat plaats bood aan 20.000 toeschouwers. Het werd in de 4e eeuw v.Chr. tegen de flank van de Lárisa-heuvel aan gebouwd, maar de Romeinen brachten later ingrijpende wijzigingen aan: zo verbouwden zij onder andere de orchestra tot een bassin waarin - voor het vermaak van het niet zo literair ingestelde Romeinse publiek - zeeslagje (naumachia) kon worden gespeeld.
 Literatuur
 Marcel Piérart en Gilles Touchais, Argos. Une ville grecque de 6000 ans, 1996.
 Stad in Griekenland
 Voormalige gemeente in Griekenland
 Oud-Griekse stad


text:
Augustinas Janulaitis (1878 m. kovo 19 d. Malavėnuose, Šiaulių valsčius, Rusijos imperija – 1950 m. gegužės 22 d. Kaune. Palaidotas Petrašiūnų kapinėse.) – teisėtyrininkas, teisėjas, publicistas, teisės ir literatūros istorikas, politinis veikėjas.
 Biografija
 Kilęs iš 13 vaikų šeimos. Seserys Julija Biliūnienė ir Veronika Alseikienė, brolis Pranciškus Janulaitis. 1886 m. Augustinas įstojo į Šiaulių gimnaziją, bet 1893 m. už lietuviškos spaudos laikymą ir pogrindinę veiklą pašalintas. 1896 m. baigė Rygos gimnaziją. 1896–1900 m. studijavo teisę Maskvos universitete, iš jo du kartus buvo pašalintas.
 1899 m. rugpjūčio 8 d. dalyvavo pirmojo lietuviško spektaklio „Amerika pirtyje“ pastatyme Palangoje, pats 1900 m. sausio 16 d. vaidino jo pastatyme Liepojoje. 1896–1901 m. bendradarbiavo varpininkų leidiniuose „Ūkininkas“ ir „Varpas“ (Žmogaus ir A. Juodvalkio slapyvardžiais), nuo 1898 m. – „Vienybėje lietuvninkų“ ir kt.
 1900–1901 m. kalintas Liepojoje. Sužinojęs, kad nuspręsta jį ištremti į Sibirą, pabėgo į Tilžę, kur 1902–1905 m. redagavo „Darbininkų balsą“. Nuo 1901 iki 1923 m. LSDP narys, buvo renkamas CK nariu (slapyvardis J. Lizdeika).
 1903–1905 m. studijavo Berno universitete. 1906 m. su padirbtu pasu pagautas prie sienos ir Vilniaus apygardos teismo nuteistas 10 mėn. kalėjimo už lietuviškos literatūros gabenimą. Atlikęs bausmę, jau tikrąja pavarde grįžo į Maskvą tęsti studijų universitete ir 1907 m. jį baigė. 1908 m. su M. Biržiška redagavo „Žariją“, bendradarbiavo leidiniuose „Vilniaus žinios“, „Lietuvos žinios“, „Visuomenė“. Dirbo advokatu, 1912 m. tapo prisiekusiuoju advokatu tame pačiame Vilniaus apygardos teisme.
 1916–1917 m. vokiečių internuotas Čersko karo belaisvių stovykloje. 1918 m. dirbo „Darbo balso“ redakcijoje. 1918 m., Augustinui Voldemarui išvykus į Paryžių vadovauti Lietuvos delegacijai Taikos konferencijoje, ėjo užsienio reikalų ministro pareigas. Likęs Vilniuje, Vinco Kapsuko suimtas.
 1919–1925 m. Lietuvos Vyriausiojo tribunolo teisėjas, 1924 m. – pirmininkas. Nuo 1922 m. Lietuvos universiteto Teisės fakulteto Istorijos katedros vedėjas, 1924 m. – ordinarinis profesorius, 1932 m. – Garbės daktaras, 1935 m. – dekanas Kaune, nuo 1939 m. – Vilniaus universitete. Be to, dėstė Aukštuosiuose karininkų kursuose, nuo 1936 m. – Dotnuvos žemės ūkio akademijoje.
 1922–1925 m. Valstybinės archeologijos komisijos pirmininkas. Redagavo Istorijos draugijos organą „Praeitis“ (1 t. išėjo 1930 m., 2 t. – 1933 m.). 1924–1939 m. redagavo VDU „Teisės fakulteto darbus“ (10 tomų).
 1945 m. – Vilniaus universiteto Istorijos filologijos fakulteto dekanas, vėliau – LTSR Mokslų akademijos tikrasis narys.
 Iki 1908 m. parašė daug straipsnių politinėmis temomis. Išvertė Karlo Markso „Manifestą“ (išleido Martynas Jankus). Po 1908 m. parašė daug istorinių tyrinėjimų darbų, parengė spaudai Jono Biliūno raštus, vertė Ibseno, Dostojevskio knygas. Spaudoje pasirašinėjo Žmogaus ir kitais slapyvardžiais.
 Bibliografija
 Simanas Daukantas, 1913 m.
 Žydai Lietuvoje, 1923 m.
 1863–1864 m. sukilimas Lietuvoje, 1921 m.,
 Lietuvos bajorai ir jų seimeliai XIX a., 1936 m.,
 Šaltiniai
 Nuorodos
 Biografija.
 Vyriausiojo Tribunolo teisėjai
 Lietuvos teismų pirmininkai
 Lietuvos teisės istorikai
 Lietuvos redaktoriai
 Knygnešiai
 Lietuvos masonai
 Varpininkai
 Lietuvos literatūros istorikai


type: other

text:
[ARHIIV] m�ngumeistrid » Muud m�ngud » GTA IV
 postitati 16.5.2008 17:30
 Nagu nii m�nigi juba teab, on selline meistriteos nagu GTA IV juba aprilli l�pust saadik v�ljas. Kahjuks see (esialgu) arvutile ei ole ( ) . Kuid andke teada, kes on saanud seda Xbox 360 v�i PS3 peal m�ngida..
 M�ngu tegevus toimub nagu GTA III Liberty Citys, kuid seekord oled ida-eurooplasest Niko rollis, kes linna saabudes avastab, et ameerika pole p�ris see, mida ta ootas. Niipalju, kui mina n�inud olen ja tean, on asi suht huvitavam ja on ka realistlikum kui enne- saab peaaegu iga asja taha varjuda, autode purunemine on reaalsem jne. Kui oleks v�imalust, hangiksin selle suht kindlalt...
 postitati 16.5.2008 18:40
 Igatahes suur edasiminek Rockstarilt. Kuid tundub, et auto f��sikat v�ga palju edendatud pole. GTA-lik autof��sika on mulle natukene.... veider, selline liiga p�rklik. Olen ka suuremat sorti Driver seeria f�nn ja sealne auto f��sika on minu arvates v�ga kindel ja pakub rohkem m�nu. Oleks ka GTA-l see omadus olemas oleks k�ik 11/10.
 postitati 28.5.2008 16:31
 Tegin l�bi, vahetevahel oli raske kui p�rgu, eriti kohtades kus actionit on palju. Niko vahel ei tahtnud mul lihtsalt coverisse minna, kas l�ks ta coverisse vaenlase tule alla v�i teisele poole, kuigi see ei riku m�ngu. L�pp on dramaatiline though.
 Xbox 360 versioon.
 [Muudetud: 28.5.2008 Arvuti12]
 postitati 12.6.2008 23:14
 oleks see vaid arvutile tulnud siis oleksin uhkem selle m�ngu �le.
 postitati 12.6.2008 23:47
 tuleb arvutile oktoobris...
 postitati 24.8.2008 22:26
 November 18 tuleb...
 postitati 25.8.2008 10:09
 mai saa aru milleks nad kohe seda pc-le teha ei v�inud...
 postitati 25.8.2008 12:58
 Neil on raha nagu vaja.
 �eldakse alguses et PC-le ei tule siis k�ik ostavad X360 v�i PS3-le ja hiljem kui enam nii palju ei osteta siis PC-le tehakse
 postitati 25.8.2008 13:19
 kust otsast nemad rohkem raha nii saavad? ega rockstar games ju xboxi v�i ps3-e ei tooda...
 ja vaevalt et gta iv p�rast tohutult rohkem xboxe v�i ps3-sid ostetakse
 et neil tootjatel rockstar gamesiga mingi leping v�iks olla,et esialgu gta iv pc-le ei tule vms...
 ja kui pc-le oleks ka tulnud siis oleks ikkagi k�ik xboxi / pc3-e omanikud selle vastavale konsoolile ostnud
 [Muudetud: 25.8.2008 smiley]
 postitati 30.8.2008 20:07
 PC=rohkem piraatlust kui konsoolil.
 PCle portimine=M�ngu tegijad peavad veel rohkem raha kulutama.
 [Muudetud: 30.8.2008 Arvuti12]
 postitati 30.8.2008 20:27
 sa vist oled vahepeal unustanud �ra millest �ldse jutt k�ib arvuti12
 1.et kui nad hiljem m�ngu pc-le v�lja lasevad siis on v�hem piraatlust?
 2.kui hiljem pc-le m�ngu teevad siis kulub sellele v�hem raha kui varem?
 jutt oli siiski sellest miks nad selle pc versiooniga nii kaua viivitavad,aga t�esti kui midagi tarka �elda pole siis pole vaja �ldse midagi �elda
 postitati 30.8.2008 20:53
 Kas see ei tulnud juba v�lja PC-le?
 postitati 30.8.2008 21:05
 Nad tegelt poleks pidanud PC oma tegema, paras , siis PC omadele. tahate head m�ngu, ostke konsool
 postitati 30.8.2008 21:22
 suudan ilma gta IV-ta ka elada ning nagunii tuleb asi pc-le ka
 postitati 30.8.2008 21:38
 Tsitaat: Arvuti12
 Kui mina ostan, siis ostan ise, mitte emme ja issi ei anna raha. Showoff.
 Ja et miks konsoolid saavad varem osasid m�nge nautida? Asi kasumis. Rockstar saab raha PS3e ja Xboxi firmadelt selle eest, et ta viivitab PC-le v�ljalasuga, sest selline taktika ajab PC omanikele konsoolide isu peale.
 postitati 30.8.2008 22:31
 nagu ma varem �tlesin
 "ega rockstar games ju xboxi v�i ps3-e ei tooda...
 et neil tootjatel rockstar gamesiga mingi leping v�iks olla,et esialgu gta iv pc-le ei tule vms..."
 aga vb t�esti on neil leping
 postitati 30.8.2008 22:38
 Mina ostan ise kah m�nge, FURYl on �igus, sony ja microsoft maksavad, et nende konsoolil tuleks ennem, selle p�rast inimesed ostavad "ps3 v�i 360" kuna nad ei suuda oodata �ra GTA IV'd.
 postitati 31.8.2008 00:57
 SA'ga oli t�pselt sama lugu. Rockstarsil oli Sonyga leping, et nad viivitaksid. Minu nad ostsid k�ll nii �ra PS2-le.
 postitati 1.9.2008 20:49
 Nad l�psavad enne XBOXide ja PSide pealt ja siis kui nendelt eriti ei osteta enam.
 Siis lasevad PC-le et natukene boonust veel saada.
 Kui kohe PC-le siis enamus tiriks kohe PC-le kuskilt.
 Ja Smiley sa eksid. PS3 ja XBOX360 hakkati ikka k�vasti kohe rohkem ostma kui GTA IV v�lja tuli eriti veel neid IV-ga Bundleid.
 [Muudetud: 1-9-2008 Ziim]
 postitati 22.1.2009 22:16
 Kas keegi on mingil ajaloolisel arvutil ka GTAIV proovinud?
 Endal 256MB ati 9600 pro, 2.4Ghz celeron, 1GB RAM 166MHz
 Klokkida saab ka, 2,88GHz ja ramm k�ib t�isv�imsusel 200MHz.
 Arvata v�ib et ei t��ta?
 postitati 22.1.2009 23:03
 ei tohiks t��data kuna mu klassivennal on k�vasti k�vem arvuti kui sul ja tal ei l�inud ka t��le kuna videokaart on tal 256mb... kui on videokaart mis on alates 512mb siis t��tab muidu mitte...
 postitati 23.1.2009 06:22
 rallitaja, kas t�esti m�ng lihtsalt karjub, et 256mb videom�lu ja keeldub k�ivitumast? Kahtleksin selles s�gavalt. Su klassivend tegi �kki lihtsalt midagi valesti.
 -DMI-, Ma usun, et t��le l�heb ta sul ikka, kuid celeron prose ja vaid 1gb m�lu pole just parim kooslus. Videokaardiga on nii, kuidas on, k�ik maha keerata ja v�ikese resoga v�ib pea �ks-k�ik mis videoga �ks-k�ik mis m�ngu m�ngida.
 postitati 23.1.2009 10:40
 Ma vaatasin, mul on miinimum n�uded olemas, kui prtsessorit klokkida. Graafikakaart peaks jooksutama k�ll.
 postitati 23.1.2009 10:50
 GTA IV on m�ttetu.
 Saint's Row 2 teeb K�IKE �ieti, mida GTA ei tee. Ja lisaks on palju l�busam. See on nagu unistuste GTA.
 Alguses ehmatasin �ra seda proovides, eriti autode f��sika osas, aga 2 tundi hiljem oli selge, et GTA IV on sellega v�rreldes t�ielik, totaalne saast. Et GTA f�nnid - ja ma ise ka - ootasid tegelikult GTA IV-lt seda, mida pakkus hoopis SR2. Viimne kui �ks kuulsamat sorti m�ngusait kinnitab seda ka.
 F��sika, muide, on imelik ja esimesed tund-paar V�GA harjumatu, aga v�ga h�sti l�bi m�eldud, et saaks teha just seda, mida vaja: kimada ja paugutada. Mitte selline n*ss nagu GTA IV's. Kopterif��sika on PARIM �ldse, mida ma arvutim�ngus n�inud olen. Uskumatu, et NII lihtsaks saab teha kopteriga lendamise.
 Isiklikult f�nnan k�ige rohkem cutscene'sid. Need on paremad kui enamustes Hollywoodi actionfilmis, eriti kui surroundheliga kuulata, bass p�hjas.
 Et l�bu tunda m�ngust cheatimata, k�ige lihtsamal tasemel on m�ng nagu god-modega, surma saamiseks pead olema T�ESTI saamatu. Samas, raskem tase pakub t�sist v�itlust.
 Esimest korda �ldse vist arvutim�ngus n�en, et raskusastmetest on t�epoolest kasu ja kipub erinevatega proovima...
 Ainus probleem on, et kuna ta on samamoodi (lohakas) konsooliport nagu GTA IV, ja tahab hirrmus head masinat. Ja isegi sellel on uimane. Aga PC patch on kas v�ljas v�i kohe tuleb, loodetavasti parandab kiiruseprobleemid.
 Unustage GTA IV, hankige Saint's Row II. See m�ng teeb teoks iga �geda m�tte, mis sul tekkis GTA San Andreast m�ngides!
 [Muudetud: 23-1-2009 InCreator]
 postitati 23.1.2009 16:10
 Vaatan l�hemalt, aga kuna pole gta-d proovinud, tuleb seda ka kunagi teha.


type: caselaw

jurisdiction: EU

text:
 30.4.2011
 EL
 Επίσημη Εφημερίδα της Ευρωπαϊκής Ένωσης
 C 130/15
 Προσφυγή της 16ης Φεβρουαρίου 2011 — Apollo Tyres κατά ΓΕΕΑ — Endurance Technologies (ENDURACE)
 (Υπόθεση T-109/11)
 2011/C 130/28
 Γλώσσα του δικογράφου της προσφυγής: η αγγλική
 Διάδικοι
 Προσφεύγουσα: Apollo Tyres AG (Baden, Ελβετία) (εκπρόσωπος: S. Szilvasi, δικηγόρος)
 Καθού: Γραφείο Εναρμονίσεως στο πλαίσιο της Εσωτερικής Αγοράς (εμπορικά σήματα, σχέδια και υποδείγματα)
 Αντίδικος ενώπιον του τμήματος προσφυγών: Endurance Technologies Pvt Ltd (Aurangabad, Ινδία)
 Αιτήματα της προσφεύγουσας
 Η προσφεύγουσα ζητεί από το Γενικό Δικαστήριο:
 —
 να ακυρώσει την απόφαση που εξέδωσε στις 25 Νοεμβρίου 2010 το πρώτο τμήμα προσφυγών του Γραφείου Εναρμονίσεως στο πλαίσιο της Εσωτερικής Αγοράς (εμπορικά σήματα, σχέδια και υποδείγματα), επί της υποθέσεως R 625/2010-1·
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 να καταδικάσει την αντίδικο ενώπιον του τμήματος προσφυγών στα δικαστικά έξοδα.
 Ισχυρισμοί και κύρια επιχειρήματα
 Αιτούσα την καταχώριση του κοινοτικού σήματος: Η προσφεύγουσα
 Σήμα προς καταχώριση: Το λεκτικό σήμα «ENDURACE», για προϊόντα της κλάσεως 12 και υπηρεσίες των κλάσεων 35 και 37 — Αίτηση καταχωρίσεως κοινοτικού σήματος αριθ. 6419824
 Δικαιούχος του κατά τη διαδικασία ανακοπής αντιταχθέντος σήματος ή σημείου: Η αντίδικος ενώπιον του τμήματος προσφυγών
 Αντιταχθέν σήμα ή σημείο: Το καταχωρισθέν με αριθ. 5819149 κοινοτικό εικονιστικό σήμα «ENDURANCE», καθώς και έγχρωμο σχέδιο, για προϊόντα της κλάσεως 12
 Απόφαση του τμήματος ανακοπών: Μερική απόρριψη της αιτήσεως για την καταχώριση κοινοτικού σήματος
 Απόφαση του τμήματος προσφυγών: Απόρριψη της προσφυγής. Το αίτημα που υπέβαλε η ανακόπτουσα κατ’ εφαρμογή του άρθρου 8, παράγραφος 3, του κανονισμού (ΕΚ) 216/96 (1) έγινε εν μέρει δεκτό και, ως εκ τούτου, η αίτηση καταχωρίσεως κοινοτικού σήματος απορρίφθηκε εν μέρει
 Λόγοι ακυρώσεως: Παράβαση του άρθρου 8, παράγραφος 1, στοιχείο β', του κανονισμού 207/2009 του Συμβουλίου, καθόσον το τμήμα προσφυγών έκρινε πεπλανημένα ότι υφίσταται κίνδυνος συγχύσεως.
 (1) Κανονισμός (ΕΚ) 216/96 της Επιτροπής, της 5ης Φεβρουαρίου 1996, σχετικά με τον κανονισμό διαδικασίας των τμημάτων προσφυγών του Γραφείου Εναρμόνισης στο πλαίσιο της εσωτερικής αγοράς (σήματα, σχέδια και υποδείγματα), όπως τροποποιήθηκε με τον κανονισμό (ΕΚ) 2082/2004 της Επιτροπής, της 6ης Δεκεμβρίου 2004.


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V SA/Wa 57/16 - Postanowienie Wojewódzkiego Sądu Administracyjnego w Warszawie
 V SA/Wa 57/16 - Postanowienie Wojewódzkiego...
 Opublikowano: LEX nr 2138997
 V SA/Wa 57/16
 Wojewódzki Sąd Administracyjny w Warszawie po rozpoznaniu w dniu 14 lipca 2016 r. na posiedzeniu niejawnym sprawy ze skargi A. P. na postanowienie Dyrektora Izby Skarbowej w W. z dnia (...) grudnia 2015 r. nr (...) w przedmiocie odmowy umorzenia postępowania egzekucyjnego postanawia: - odrzucić skargę.
 Zarządzeniem z dnia 26 stycznia 2016 r. wezwano M. P., który podpisał skargę jako pełnomocnik skarżącej, do wykazania, iż spełnia wymogi dla pełnomocnika określone w art. 35 § 1 ustawy - Prawo o postępowaniu przed sądami administracyjnymi (Dz. U. z 2012 r. poz. 270 z późn. zm.) - dalej "p.p.s.a." oraz złożenie pełnomocnictwa do reprezentowania skarżącej (podpisanego przez skarżącą) przed wojewódzkim sądem administracyjnym lub przed sądami administracyjnymi - w terminie 7 dni pod rygorem pominięcia w postępowaniu sądowym.
 W odpowiedzi M. P. nadesłał kserokopię pełnomocnictwa udzielonego mu przez żonę - A. P. W związku z tym, zarządzeniem z dnia 25 marca 2016 r. ponownie wezwano pełnomocnika skarżącej do usunięcia braku formalnego skargi przez wykazanie, iż spełnia wymogi dla pełnomocnika procesowego określone w art. 35 § 1 p.p.s.a. oraz złożenie oryginału lub uwierzytelnionej kopii pełnomocnictwa do reprezentowania skarżącej przed wojewódzkim sądzie administracyjnym lub przed sądami administracyjnymi - w terminie 7 dni pod rygorem pominięcia w postępowaniu sądowym. Pełnomocnika pouczono o treści art. 35 § 1 i art. 48 § 3 i § 4 p.p.s.a. Jednocześnie poinformowano pełnomocnika, że w wykonaniu wcześniejszego wezwania do nadesłania pełnomocnictwa nadesłano kserokopię tego dokumentu niepotwierdzoną za zgodność z oryginałem stosownie do treści art. 48 § 3 p.p.s.a.
 W zakreślonym terminie M. P. nadesłał ponownie kserokopię pełnomocnictwa. Wobec tego zarządzeniem z dnia 18 maja 2016 r. pominięto M. P. w postępowaniu sądowym, a skarżącą wezwano do usunięcia braku formalnego skargi poprzez jej podpisanie i odesłanie po podpisaniu do sądu - w terminie 7 dni pod rygorem odrzucenia skargi.
 W odpowiedzi nadesłano kserokopię skargi wraz z kserokopią podpisu skarżącej. W zakreślonym terminie brak formalny skargi nie został zatem usunięty.
 W tej sytuacji Sąd zobligowany był do odrzucenia skargi w oparciu o z art. 58 § 1 pkt 3 p.p.s.a. Zgodnie z powołanym przepisem sąd odrzuca skargę w razie nieuzupełnienia w wyznaczonym terminie braków formalnych skargi.
 Mając na względzie powyższe Wojewódzki Sąd Administracyjny w Warszawie orzekł jak w sentencji postanowienia.


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Hverken unge eller ældre må forskelsbehandles pga. alder - Nyhed - Horten Advokatpartnerselskab
 Hverken unge eller ældre må forskelsbehandles pga. alder
 Højesteret har torsdag fastsat et godtgørelsesbeløb til piloter, der ved deres afskedigelse var blevet direkte forskelsbehandlet på grund af alder – denne gang de yngste – til seks måneders løn.
 Udvalgt til afskedigelse efter liste
 SAS skulle i 2009 afskedige en række piloter på grund af arbejdsmangel. Året før var en række ældre piloter blevet afskediget efter forhandling. En række af disse piloter fik af Højesteret tilkendt 4 måneders løn i godtgørelse ved dom den 1. oktober 2014 (UfR 2015.1). Se tidligere artikel om denne dom her.
 I afskedigelsesrunden i 2009 blev der afskediget i henhold til en senioritetsliste. Piloterne var indplaceret på denne liste i første omgang efter rekrutteringsomgang (dvs. ansættelsesår) og dernæst efter piloternes alder, således at de yngste blev afskediget først.
 Ligebehandlingsnævnet, Københavns Byret og Østre Landsret fandt alle, at der var tale om forskelsbehandling på grund af alder. Byretten fandt, at godtgørelsen skulle fastsættes til 9 måneders løn henset til de særdeles vidtgående økonomiske, familiemæssige og øvrige personlige konsekvenser, som afskedigelserne havde haft for piloterne. Landsretten stadfæstede dette godtgørelsesniveau.
 Højesterets lagde - igen - vægt på overtrædelsens grovhed
 Højesteret henviste til egen afgørelse af 1. oktober 2014 og gentog, at der ved fastsættelse af godtgørelsesniveauet skal tages hensyn til overtrædelsens grovhed, baggrunden for overtrædelsen og den krænkelse, der er blevet påført de forurettede.
 ... men vigtigst var dog "baggrunden for overtrædelsen"
 Derudover udtalte Højesteret, at der "i den forbindelse først og fremmest [skal] tages hensyn til baggrunden for overtrædelsen..." Herefter fortsatte Højesteret med henvisning til, at afskedigelsen af de 4 piloter var gennemført som følge af arbejdsmangel, var et led i en større nedskæringsrunde og fandt sted efter den mellem SAS og Dansk Pilotforening aftalte senioritetsliste.
 Tidligere har Højesteret fastslået, at man ved udmåling af godtgørelsen efter forskelsbehandlingsloven kunne tage udgangspunkt i den praksis, der havde udviklet sig for fastsættelse af godtgørelsesniveau efter ligebehandlingsloven. Dette fastslog Højesteret i dommen, U.2013.2575.H, der omhandlede godtgørelse for afskedigelse af en advokatsekretær på grund af hendes ADHD.
 I oktober-dommen kom Højesteret frem til en godtgørelse svarende til 4 måneders løn, da der var formildende omstændigheder, da SAS (dengang) havde ønsket at tage hensyn til yngre piloter, der havde stiftet familie og derfor var afhængige af deres indtægt på bekostning af de ældre piloter, der måtte antages at være forsørgelsesmæssigt sikret, eftersom de i størstedelen af deres arbejdsliv måtte planlægge deres pension efter en pligtig afgangsalder på 60 år.
 Ved den nye dom fastsatte Højesteret derfor godtgørelsen til 6 måneders løn.
 Dommen gentager, at selvom der tages udgangspunkt i den praksis, som er udviklet for udmålingen af godtgørelse efter ligebehandlingsloven, kan man ikke stille direkte lighedstegn mellem godtgørelsesniveauerne for overtrædelse af ligebehandlingsloven og forskelsbehandlingsloven. Udgangspunktet kan fraviges, hvis der er vægtige hensyn, der taler for en højere eller lavere godtgørelse.


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Lag om avbytarservice för pälsdjursuppfödare 1264/2009 - Uppdaterad lagstiftning - FINLEX ®
 Du är här: Finlex › Lagstiftning › Uppdaterad lagstiftning › Vuosi 2009 › 22.12.2009/1264
 5 punkten har upphävts genom L 30.12.2015/1664. (30.12.2015/1664)
 Om det timpris som pälsdjursuppfödaren och avbytarserviceproducenten kommit överens om är lägre än den ersättning som nämns i 2 mom., ska det pris som pälsdjursuppfödaren och serviceproducenten kommit överens om betalas i ersättning. Priset kan endast utgöras av sådan ersättning för arbete som avses i 25 § i lagen om förskottsuppbörd (1118/1996).
 Avbytarservice söks hos den lokala enhet inom vars verksamhetsområde pälsdjursuppfödaren i huvudsak bedriver pälsdjursuppfödning. Ansökan ska göras skriftligt pälsfarmsvis före utgången av oktober det kalenderår som föregår det år under vilket avbytarservicen tas emot. Den lokala enheten ska också pröva ansökningar som inlämnats sedan fristen gått ut om dröjsmålet berott på vägande skäl och de arbeten som hör till den sökta avbytarservicen ännu inte har påbörjats.
 15 § har upphävts genom L 30.12.2015/1664.
 Pälsdjursuppfödaren ska ansöka skriftligt om ersättning för själv ordnad avbytartjänst hos den lokala enheten före utgången av den kalendermånad som följer efter tidpunkten för avbytartjänsten. Ersättning kan beviljas även om ansökan inte lämnats in inom föreskriven tid om det vore oskäligt att vägra ersättning på grund av att ansökan lämnats in för sent.
 Till ansökan ska fogas serviceproducentens bekräftelse på att de uppgifter som avses i 2 mom. 1–6 punkten är riktiga.
 32 § har upphävts genom L 7.8.2015/1035.
 Omprövning av ett beslut av en lokal enhet får begäras hos LPA på det sätt som anges i förvaltningslagen.
 Det beslut som meddelas med anledning av begäran om omprövning får överklagas genom besvär hos Vasa förvaltningsdomstol på det sätt som anges i förvaltningsprocesslagen (586/1996).
 Trots vad som föreskrivs i 14 § i lagen om offentlighet i myndigheternas verksamhet (621/1999) beslutar den lokala enheten om utlämnande av uppgifter ur en handling som den förfogar över och som hänför sig till avbytarservice enligt denna lag.
 3) som på grund av brist på medel inte har kunnat ersättas till fullt belopp av anslaget för det år då avbrottet skedde.
 Trots bestämmelserna i 24 § 2 mom. bestäms storleken på den ersättning per lokal enhet som betalas för 2010 på grundval av antalet pälsdjursuppfödare som är verksamma inom den lokala enhetens område och som beviljats avbytarservice genom beslut som fattats före den 1 april 2010. Under perioden januari–juni betalas ersättningen i form av månatliga förskott, men så att förskottet för januari betalas samtidigt med förskottet för februari. Förskottets belopp är 17 euro per månad per sådan pälsfarm inom den lokala enhetens verksamhetsområde där det enligt LPA:s bedömning finns minst en pälsdjursuppfödare som uppfyller villkoren för avbytarservice.
 Trots bestämmelserna i 24 § 2 mom. bestäms storleken på den ersättning per lokal enhet som betalas för 2011 på grundval av antalet sådana pälsdjursuppfödare som är verksamma inom den lokala enhetens område och som beviljats avbytarservice för 2011 genom beslut som fattats före den 1 april 2011. Under perioden januari–juni betalas ersättningen i form av månatliga förskott. Förskottets belopp bestäms enligt antalet pälsdjursuppfödare som är verksamma inom den lokala enhetens område och som beviljats avbytarservice genom beslut som fattats före den 1 april 2010.
 Trots bestämmelserna i 27 § 1 mom. är förskottets storlek 2010 under perioden januari–juni 250 euro per månad per sådan pälsfarm inom den lokala enhetens verksamhetsområde där det enligt LPA:s bedömning finns minst en pälsdjursuppfödare som uppfyller villkoren för avbytarservice, och förskottet för januari betalas samtidigt med förskottet för februari. Från och med juli bestäms förskottets belopp enligt antalet pälsdjursuppfödare som är verksamma inom den lokala enhetens område och som beviljats avbytarservice genom beslut som fattats före den 1 april 2010 samt på grundval av LPA:s uppskattning av hur stor den genomsnittliga kostnaden för en semesterdag blir i den lokala enheten under 2010.
 Trots bestämmelserna i 27 § 1 mom. bestäms förskottets storlek under perioden januari–juni 2011 på grundval av antalet pälsdjursuppfödare som är verksamma inom den lokala enhetens område och som beviljats avbytarservice genom beslut som fattats före den 1 april 2010 samt på grundval av LPA:s uppskattning av hur stor den genomsnittliga kostnaden för en semesterdag blir i den lokala enheten under 2011. Från och med juli bestäms förskottets belopp enligt antalet pälsdjursuppfödare som är verksamma inom den lokala enhetens område och som beviljats avbytarservice för 2011 genom beslut som fattats före den 1 april 2011 samt på grundval av LPA:s uppskattning av hur stor den genomsnittliga kostnaden för en semesterdag blir i den lokala enheten under 2011.
 RP 112/2015, ShUB 15/2015, RSv 108/2015
 RP 150/2016, ShUB 19/2016, RSv 126/2016
 1 kap - Allmänna bestämmelser1 § - Lagens tillämpningsområde och beaktande av Europeiska unionens lagstiftning2 § - Definitioner3 § - Villkor för avbytarservice4 § - Avbytarservicens kvantitet5 § - Uppgifter som ingår i avbytarservicen6 § - Avgift för extraledighet7 § - Ersättning för själv ordnad avbytartjänst7 a § - Avbytare som pälsdjursuppfödaren själv skaffat8 § - Ersättande av service som lämnats utan grund och återbetalning av ersättning som betalats utan grund9 § - Dröjsmålsränta och verkställighet av betalningsskyldighet2 kap - Närmare bestämmelser om avbytartjänster som en lokal enhet ordnar10 § - Samtidig semester11 § - Antalet helgdagar som ingår i semester12 § - Pälsdjursuppfödarens åtgärder före en avbytartjänst12 a § - Avbytarens säkerhet i arbetet och arbetsledning 3 kap - Sökande och genomförande av avbytarservice samt beslutsfattande13 § - Ansökan om avbytarservice14 § - Bestämmande av uppgiftsandel15 § 16 § - Tidpunkten för avbytarservice som ordnas av den lokala enheten17 § - Ansökan om och utbetalning av ersättning för själv ordnad avbytartjänst18 § - Beslutsfattande4 kap - Bestämmelser om förvaltning19 § - Allmän ledning, styrning och övervakning20 § - Verkställighet21 § - Uppdragsavtal22 § - Den lokala enhetens skyldighet att ordna avbytarservice23 § - LPA:s uppgifter5 kap - Ersättande av kostnader24 § - Statens ersättning för förvaltningskostnader25 § - Kostnader för avbytarservice som berättigar till ersättning av staten 26 § - Grunderna för ersättning som betalas till kommuner som ingått uppdragsavtal27 § - Betalning av förskott till kommuner som ingått uppdragsavtal28 § - Det slutliga beloppet av den ersättning som staten betalar till kommuner som ingått uppdragsavtal29 § - Avbrytande av betalning30 § - Betalning av ersättning till LPA för kostnaderna för avbytarservice31 § - LPA:s redogörelser för kostnaderna för avbytarservice6 kap - Sökande av ändring32 § 33 § - Ändringssökande34 § - Avgörande av meningsskiljaktigheter som beror på uppdragsavtalet7 kap - Särskilda bestämmelser35 § - Pälsdjursuppfödares anmälningsskyldighet35 a § - Avbytarserviceproducentens anmälningsskyldighet36 § - Sekretess och utlämnande av uppgifter37 § - Rätt att få uppgifter38 § - LPA:s rätt att använda uppgifter som lämnats i andra ärenden39 § - Justering av belopp med lönekoefficient39 a § - Bevarande av handlingar39 b § - Avbrytande av ordnandet av avbytarservice8 kap - Ikraftträdande- och övergångsbestämmelser40 § - Ikraftträdande41 § - Övergångsbestämmelser som gäller avbytarservicens kvantitet samt ordnande av och ansökan om avbytarservice42 § - Övergångsbestämmelse som gäller kostnaderna för den lokala förvaltningen43 § - Övergångsbestämmelse som gäller förskotten för kostnaderna för avbytarserviceIkraftträdelsestadganden:17.12.2010/1162:7.8.2015/1035:30.12.2015/1664:18.11.2016/975:


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 25.9.2017
 HR
 Službeni list Europske unije
 C 318/2
 Zahtjev za prethodnu odluku koji je 3. travnja 2017. uputio Verwaltungsgerichtshof Baden-Württemberg (Njemačka) – Abubacarr Jawo protiv Savezne Republike Njemačke
 (Predmet C-163/17)
 (2017/C 318/03)
 Jezik postupka: njemački
 Sud koji je uputio zahtjev
 Verwaltungsgerichtshof Baden-Württemberg
 Stranke glavnog postupka
 Tužitelj: Abubacarr Jawo
 Tuženik: Savezna Republika Njemačka
 Prethodna pitanja
 1.
 Je li u smislu članka 29. stavka 2. druge rečenice Uredbe (EU) br. 604/2013 (1) podnositelj zahtjeva za azil pobjegao samo u slučaju ako ciljano i svjesno izbjegava nacionalna tijela nadležna za provedbu transfera kako bi omeo odnosno otežao transfer, ili je dovoljno da tijekom duljeg vremena više ne boravi u dodijeljenom stanu i tijelo nije obaviješteno o tome gdje se nalazi te se zbog toga ne može provesti planirani transfer?
 Može li se predmetna osoba pozvati na pravilnu primjenu propisa i u postupku protiv odluke o transferu prigovoriti da je istekao rok od šest mjeseci za transfer jer nije pobjegla?
 2.
 Dolazi li do produljenja roka iz članka 29. stavka 1. podstavka 1. Uredbe (EU) br. 604/2013 samo zbog toga što je država članica koja provodi transfer još prije isteka roka odgovornu državu članicu obavijestila o tome da je predmetna osoba pobjegla, te je istodobno navela konkretan rok, koji ne smije prelaziti 18 mjeseci, do kojega će se provesti transfer, ili je produljenje moguće samo na taj način da predmetne države članice sporazumno utvrde produljeni rok?
 3.
 Je li transfer podnositelja zahtjeva za azil u odgovornu državu članicu nedopušten, ako bi u slučaju priznanja međunarodne zaštite on u toj državi, s obzirom na očekivane životne uvjete, bio izložen ozbiljnom riziku od postupanja u smislu članka 4. Povelje o temeljnim pravima?
 Je li ovo pitanje i dalje obuhvaćeno područjem primjene prava Unije?
 Prema kojim mjerilima prava Unije se ocjenjuju životni uvjeti osoba kojima je priznata međunarodna zaštita?
 (1) Uredba (EU) br. 604/2013 Europskog parlamenta i Vijeća od 26. lipnja 2013. o utvrđivanju kriterija i mehanizama za određivanje države članice odgovorne za razmatranje zahtjeva za međunarodnu zaštitu koji je u jednoj od država članica podnio državljanin treće zemlje ili osoba bez državljanstva, (SL L 180, str. 31.) (SL, posebno izdanje na hrvatskom jeziku, poglavlje 19., svezak 15., str. 108., ispravak SL 2017., L 49, str. 50.)


type: contracts

text:
 Avis juridique important
 |
 21999D0156
 Απόφαση της Μεικτής Επιτροπής του ΕΟΧ αριθ. 156/1999, της 26ης Νοεμβρίου 1999, για την τροποποίηση του παραρτήματος II (Τεχνικοί κανόνες, πρότυπα, δοκιμές και πιστοποίηση) της συμφωνίας για τον ΕΟΧ
 Επίσημη Εφημερίδα αριθ. L 061 της 01/03/2001 σ. 0004 - 0004
 Απόφαση της Μεικτής Επιτροπής του ΕΟΧαριθ. 156/1999της 26ης Νοεμβρίου 1999για την τροποποίηση του παραρτήματος II (Τεχνικοί κανόνες, πρότυπα, δοκιμές και πιστοποίηση) της συμφωνίας για τον ΕΟΧΗ ΜΕΙΚΤΗ ΕΠΙΤΡΟΠΗ ΤΟΥ ΕΟΧ,Έχοντας υπόψη τη συμφωνία για τον Ευρωπαϊκό Οικονομικό Χώρο, όπως τροποποιήθηκε από το πρωτόκολλο προσαρμογής της συμφωνίας για τον Ευρωπαϊκό Οικονομικό Χώρο, εφεξής "η συμφωνία", και ιδίως το άρθρο 98,Εκτιμώντας τα ακόλουθα:(1) Το παράρτημα II της συμφωνίας τροποποιήθηκε με την απόφαση αριθ. 143/1999 της Μεικτής Επιτροπής του ΕΟΧ, της 5ης Νοεμβρίου 1999(1).(2) Πρέπει να ενσωματωθεί στη συμφωνία η οδηγία 1999/7/ΕΚ της Επιτροπής, της 26ης Ιανουαρίου 1999, για την προσαρμογή στην τεχνική πρόοδο της οδηγίας 70/311/ΕΟΚ του Συμβουλίου για το σύστημα διευθύνσεως των οχημάτων με κινητήρα και των ρυμουλκουμένων τους(2),ΑΠΟΦΑΣΙΖΕΙ:Άρθρο 1Στο σημείο 6 (οδηγία 70/311/ΕΟΚ του Συμβουλίου) του κεφαλαίου I του παραρτήματος II της συμφωνίας προστίθεται η ακόλουθη περίπτωση:"- 399 L 0007: Οδηγία 1999/7/ΕΚ της Επιτροπής, της 26ης Ιανουαρίου 1999 (ΕΕ L 40 της 13.2.1999, σ. 36)."Άρθρο 2Τα κείμενα της οδηγίας 1999/7/ΕΚ στην ισλανδική και νορβηγική γλώσσα, τα οποία περιλαμβάνονται στο παράρτημα των αντίστοιχων γλωσσικών εκδόσεων της παρούσας απόφασης, είναι αυθεντικά.Άρθρο 3Η παρούσα απόφαση αρχίζει να ισχύει στις 28 Νοεμβρίου 1999, υπό την προϋπόθεση ότι έχουν πραγματοποιηθεί προς τη Μεικτή Επιτροπή του ΕΟΧ, όλες οι κοινοποιήσεις που προβλέπονται στο άρθρο 103 παράγραφος 1 της συμφωνίας.Άρθρο 4Η παρούσα απόφαση δημοσιεύεται στο τμήμα ΕΟΧ και στο συμπλήρωμα ΕΟΧ της Επίσημης Εφημερίδας των Ευρωπαϊκών Κοινοτήτων.Βρυξέλλες, 26 Νοεμβρίου 1999.Για τη Μεικτή Επιτροπή του ΕΟΧΟ ΠρόεδροςN. v. Liechtenstein(1) ΕΕ L 15 της 18.1.2001, σ. 36.(2) ΕΕ L 40 της 13.2.1999, σ. 36.


text:
Η τρέχουσα σελίδα αφορά το έτος 1085 κατά το Γρηγοριανό ημερολόγιο
 Γεγονότα
 25 Μαΐου - Ο Αλφόνσο ΣΤ' της Καστίλλης παίρνει πίσω το Τολέδο από τους Μαυριτανούς.
 Ανατίθεται από τον Γουλιέλμο Α' της Αγγλίας η καταγραφή Domesday, προφανώς προκληθείσα από την αποτυχημένη εισβολή του Κνούτου Δ' της Δανίας, για να διασφαλιστεί η σωστή φορολογία και οι στρατολογήσεις.
 Γεννήσεις
 Γουλιέλμος, κόμης του Σαλλί
 Ιμαντεντίν Ζενγκί, Τούρκος ατάμπεης
 Ούγος Β', δούκας της Βουργουνδίας
 Θάνατοι
 25 Μαΐου - Πάπας Γρηγόριος Ζ ́
 17 Ιουλίου - Ροβέρτος Γυισκάρδος, Νορμανδός τυχοδιώκτης
 Εξωτερικοί σύνδεσμοι
 Έτη


text:
 16.5.2019
 RO
 Jurnalul Oficial al Uniunii Europene
 L 128/17
 DECIZIA NR. 126/2017 A COMITETULUI MIXT AL SEE
 din 7 iulie 2017
 de modificare a anexei II (Reglementări tehnice, standarde, încercări și certificare) la Acordul privind SEE [2019/733]
 COMITETUL MIXT AL SEE,
 având în vedere Acordul privind Spațiul Economic European („Acordul privind SEE”), în special articolul 98,
 întrucât:
 (1)
 Regulamentul (UE) 2015/2283 al Parlamentului European și al Consiliului 25 noiembrie 2015 privind alimentele noi, de modificare a Regulamentului (UE) nr. 1169/2011 al Parlamentului European și al Consiliului și de abrogare a Regulamentului (CE) nr. 258/97 al Parlamentului European și al Consiliului și a Regulamentului (CE) nr. 1852/2001 al Comisiei (1) trebuie încorporat în Acordul privind SEE.
 (2)
 Prezenta decizie se referă la legislația privind produsele alimentare. Această legislație nu se aplică Principatului Liechtenstein atât timp cât aplicarea Acordului dintre Comunitatea Europeană și Confederația Elvețiană privind schimburile comerciale cu produse agricole se extinde la Liechtenstein, astfel cum se prevede în partea introductivă a capitolului XII din anexa II la Acordul privind SEE. Prezenta decizie nu se aplică, așadar, Principatului Liechtenstein.
 (3)
 Regulamentul (UE) 2015/2283 abrogă, cu efect de la 1 ianuarie 2018, Regulamentul (CE) nr. 258/97 al Parlamentului European și al Consiliului (2) și Regulamentul (CE) nr. 1852/2001 al Comisiei (3), care sunt încorporate în Acordul privind SEE și care, prin urmare, trebuie abrogate în conformitate cu Acordul privind SEE, cu efect de la 1 ianuarie 2018.
 (4)
 Prin urmare, anexa II la Acordul privind SEE ar trebui modificată în consecință,
 ADOPTĂ PREZENTA DECIZIE:
 Articolul 1
 În anexa II la Acordul privind SEE, capitolul XII se modifică după cum urmează:
 1.
 După punctul 123 [Regulamentul (UE) 2017/236 al Comisiei] se inserează următorul punct:
 „124.
 32015 R 2283: Regulamentul (UE) 2015/2283 al Parlamentului European și al Consiliului din 25 noiembrie 2015 privind alimentele noi, de modificare a Regulamentului (UE) nr. 1169/2011 al Parlamentului European și al Consiliului și de abrogare a Regulamentului (CE) nr. 258/97 al Parlamentului European și al Consiliului și a Regulamentului (CE) nr. 1852/2001 al Comisiei (JO L 137, 11.12.2015, p. 1).”
 2.
 La punctul 86 [Regulamentul (UE) nr. 1169/2011 al Parlamentului European și al Consiliului] se adaugă următoarea liniuță:
 —
 „—
 32015 R 2283: Regulamentul (UE) 2015/2283 al Parlamentului European și al Consiliului din 25 noiembrie 2015 (JO L 137, 11.12.2015, p. 1).”
 3.
 Textele de la punctele 96 [Regulamentul (CE) nr. 258/97 al Parlamentului European și al Consiliului] și 97 [Regulamentul (CE) nr. 1852/2001 al Comisiei] se elimină cu efect de la 1 ianuarie 2018.
 Articolul 2
 Textele Regulamentului (UE) 2015/2283 în limbile islandeză și norvegiană, care urmează să fie publicate în suplimentul SEE la Jurnalul Oficial al Uniunii Europene, sunt autentice.
 Articolul 3
 Prezenta decizie intră în vigoare la 8 iulie 2017, cu condiția să se fi efectuat toate notificările prevăzute la articolul 103 alineatul (1) din Acordul privind SEE (*1).
 Articolul 4
 Prezenta decizie se publică în secțiunea SEE și în suplimentul SEE ale Jurnalului Oficial al Uniunii Europene.
 Adoptată la Bruxelles, 7 iulie 2017.
 Pentru Comitetul mixt al SEE
 Președintele
 Sabine MONAUNI
 (1) JO L 137, 11.12.2015, p. 1.
 (2) JO L 43, 14.2.1997, p. 1.
 (3) JO L 253, 21.9.2001, p. 17.
 (*1) Nu au fost semnalate obligații constituționale.


jurisdiction: US

text: b'Department of Health and Human Services\n OFFICE OF\n INSPECTOR GENERAL\n\n\n\n\n MEDICARE COMPLIANCE\n REVIEW OF\n MERCY MEDICAL CENTER IN\n DES MOINES\n FOR CALENDAR YEARS\n 2009 AND 2010\n\n Inquiries about this report may be addressed to the Office of Public Affairs at\n Public.Affairs@oig.hhs.gov.\n\n\n\n\n Patrick J. Cogley\n Regional Inspector General\n\n November 2013\n A-07-12-05028\n\x0c Office of Inspector General\n https://oig.hhs.gov/\n\n\n\nThe mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, as amended, is\nto protect the integrity of the Department of Health and Human Services (HHS) programs, as well as the\nhealth and welfare of beneficiaries served by those programs. This statutory mission is carried out\nthrough a nationwide network of audits, investigations, and inspections conducted by the following\noperating components:\n\nOffice of Audit Services\n\nThe Office of Audit Services (OAS) provides auditing services for HHS, either by conducting audits with\nits own audit resources or by overseeing audit work done by others. Audits examine the performance of\nHHS programs and/or its grantees and contractors in carrying out their respective responsibilities and are\nintended to provide independent assessments of HHS programs and operations. These assessments help\nreduce waste, abuse, and mismanagement and promote economy and efficiency throughout HHS.\n\nOffice of Evaluation and Inspections\nThe Office of Evaluation and Inspections (OEI) conducts national evaluations to provide HHS, Congress,\nand the public with timely, useful, and reliable information on significant issues. These evaluations focus\non preventing fraud, waste, or abuse and promoting economy, efficiency, and effectiveness of\ndepartmental programs. To promote impact, OEI reports also present practical recommendations for\nimproving program operations.\n\nOffice of Investigations\nThe Office of Investigations (OI) conducts criminal, civil, and administrative investigations of fraud and\nmisconduct related to HHS programs, operations, and beneficiaries. With investigators working in all 50\nStates and the District of Columbia, OI utilizes its resources by actively coordinating with the Department\nof Justice and other Federal, State, and local law enforcement authorities. The investigative efforts of OI\noften lead to criminal convictions, administrative sanctions, and/or civil monetary penalties.\n\nOffice of Counsel to the Inspector General\nThe Office of Counsel to the Inspector General (OCIG) provides general legal services to OIG, rendering\nadvice and opinions on HHS programs and operations and providing all legal support for OIG\xe2\x80\x99s internal\noperations. OCIG represents OIG in all civil and administrative fraud and abuse cases involving HHS\nprograms, including False Claims Act, program exclusion, and civil monetary penalty cases. In\nconnection with these cases, OCIG also negotiates and monitors corporate integrity agreements. OCIG\nrenders advisory opinions, issues compliance program guidance, publishes fraud alerts, and provides\nother guidance to the health care industry concerning the anti-kickback statute and other OIG enforcement\nauthorities.\n\x0c Notices\n\n\n THIS REPORT IS AVAILABLE TO THE PUBLIC\n at https://oig.hhs.gov/\n\n Section 8L of the Inspector General Act, 5 U.S.C. App., requires\n that OIG post its publicly available reports on the OIG Web site.\n\nOFFICE OF AUDIT SERVICES FINDINGS AND OPINIONS\n\n The designation of financial or management practices as\n questionable, a recommendation for the disallowance of costs\n incurred or claimed, and any other conclusions and\n recommendations in this report represent the findings and\n opinions of OAS. Authorized officials of the HHS operating\n divisions will make final determination on these matters.\n\x0c EXECUTIVE SUMMARY\n\nMercy Medical Center in Des Moines did not fully comply with Medicare requirements for\nbilling outpatient and inpatient services, resulting in overpayments of approximately $573,000\nover more than 2 years.\n\nWHY WE DID THIS REVIEW\n\nThis review is part of a series of hospital compliance reviews. Using computer matching, data\nmining, and data analysis techniques, we identified hospital claims that were at risk for\nnoncompliance with Medicare billing requirements. For calendar year (CY) 2011, Medicare\npaid hospitals $151 billion, which represents 45 percent of all fee-for-service payments;\ntherefore, the Office of Inspector General must provide continual and adequate oversight of\nMedicare payments to hospitals.\n\nThe objective of this review was to determine whether Mercy Medical Center in Des Moines (the\nHospital) complied with Medicare requirements for billing outpatient and inpatient services on\nselected claims.\n\nBACKGROUND\n\nThe Centers for Medicare & Medicaid Services (CMS) pays for hospital outpatient services on a\nrate-per-service basis that varies according to the assigned ambulatory payment classification.\nCMS pays inpatient hospital costs at predetermined rates for patient discharges. The rates vary\naccording to the diagnosis-related group (DRG) to which a beneficiary\xe2\x80\x99s stay is assigned and the\nseverity level of the patient\xe2\x80\x99s diagnosis. The DRG payment is, with certain exceptions, intended\nto be payment in full to the hospital for all inpatient costs associated with the beneficiary\xe2\x80\x99s stay.\n\nThe Hospital is an 802-bed acute care hospital located in Des Moines, Iowa. Medicare paid the\nHospital approximately $292 million for 277,157 outpatient and 27,073 inpatient claims for\nservices provided to beneficiaries during CYs 2009 and 2010 based on CMS\xe2\x80\x99s National Claims\nHistory data.\n\nOur audit covered $8,202,585 in Medicare payments to the Hospital for 557 claims that we\njudgmentally selected as potentially at risk for billing errors. These claims consisted of 155\noutpatient and 402 inpatient claims. Of the 557 claims, 523 claims had dates of service in CYs\n2009 or 2010, and 34 claims (involving outpatient and inpatient manufacturer credits for\nreplaced medical devices) had dates of service in CYs 2008 or 2011.\n\nWHAT WE FOUND\n\nThe Hospital complied with Medicare billing requirements for 466 of the 557 outpatient and\ninpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing\nrequirements for the remaining 91 claims, resulting in overpayments of $573,331 for CYs 2009\nand 2010 (77 claims) and CYs 2008 and 2011 (14 claims). Specifically, 35 outpatient claims had\nbilling errors, resulting in overpayments of $391,126, and 56 inpatient claims had billing errors,\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) i\n\x0cresulting in overpayments of $182,205. These errors occurred primarily because the Hospital did\nnot have adequate controls to prevent the incorrect billing of Medicare claims within the selected\nrisk areas that contained errors.\n\nWHAT WE RECOMMEND\n\nWe recommend that the Hospital:\n\n \xe2\x80\xa2 refund to the Medicare contractor $573,331, consisting of $391,126 in overpayments for\n 35 incorrectly billed outpatient claims and $182,205 in overpayments for 56 incorrectly\n billed inpatient claims, and\n\n \xe2\x80\xa2 strengthen controls to ensure full compliance with Medicare requirements.\n\nAUDITEE COMMENTS AND OUR RESPONSE\n\nIn written comments on our draft report, the Hospital partially agreed with our first\nrecommendation. The Hospital disagreed with our finding regarding 18 outpatient claims that\ninvolved the replacement of medical devices. Specifically, the Hospital said that it would have\nbeen inaccurate to report the \xe2\x80\x9cFB\xe2\x80\x9d modifier on these 18 claims and that our finding regarding\nthese claims was an incorrect application of Medicare payment policy. The Hospital agreed with\nour findings and recommendations for the remaining claims and, with respect to both of our\nrecommendations, described corrective actions that it had taken.\n\nAfter reviewing the Hospital\xe2\x80\x99s comments, we maintain that all of our findings and\nrecommendations are valid. Medicare payment policy regarding the reporting of manufacturer\ncredits for replaced medical devices is clear and specific as to the devices in question.\n\n\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) ii\n\x0c TABLE OF CONTENTS\n\n\nINTRODUCTION .........................................................................................................................1\n\n Why We Did This Review .....................................................................................................1\n\n Objective ................................................................................................................................1\n\n Background ............................................................................................................................1\n The Medicare Program ..................................................................................................1\n Hospital Outpatient Prospective Payment System ........................................................1\n Hospital Inpatient Prospective Payment System ...........................................................1\n Hospital Claims at Risk for Incorrect Billing ................................................................2\n Medicare Requirements for Hospital Claims and Payments .........................................2\n Mercy Medical Center in Des Moines ..........................................................................3\n\n How We Conducted This Review ..........................................................................................3\n\nFINDINGS .....................................................................................................................................3\n\n Billing Errors Associated With Outpatient Claims ................................................................4\n Manufacturer Credits for Replaced Medical Devices Not Reported ............................4\n Incorrectly Billed Healthcare Common Procedure Coding System Codes ...................4\n Incorrectly Billed Observation Services........................................................................4\n\n Billing Errors Associated With Inpatient Claims ..................................................................5\n Incorrectly Billed as Inpatient .......................................................................................5\n Manufacturer Credits for Replaced Medical Devices Not Reported ............................6\n Incorrectly Billed as Separate Inpatient Stays ...............................................................6\n Incorrectly Billed Diagnosis-Related Group Codes ......................................................6\n Unsupported Charges ....................................................................................................7\n Incorrect Source-of-Admission Code............................................................................7\n\nRECOMMENDATIONS ...............................................................................................................7\n\nAUDITEE COMMENTS...............................................................................................................8\n\nOFFICE OF INSPECTOR GENERAL RESPONSE ....................................................................8\n\nAPPENDIXES\n\n A: Audit Scope and Methodology .......................................................................................9\n\n B: Results of Review by Risk Area ...................................................................................11\n\n C: Auditee Comments ........................................................................................................12\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) iii\n\x0c INTRODUCTION\n\nWHY WE DID THIS REVIEW\n\nThis review is part of a series of hospital compliance reviews. Using computer matching, data\nmining, and data analysis techniques, we identified hospital claims that were at risk for\nnoncompliance with Medicare billing requirements. For calendar year (CY) 2011, Medicare\npaid hospitals $151 billion, which represents 45 percent of all fee-for-service payments;\ntherefore, the Office of Inspector General (OIG) must provide continual and adequate oversight\nof Medicare payments to hospitals.\n\nOBJECTIVE\n\nOur objective was to determine whether Mercy Medical Center in Des Moines (the Hospital)\ncomplied with Medicare requirements for billing outpatient and inpatient services on selected\nclaims.\n\nBACKGROUND\n\nThe Medicare Program\n\nMedicare Part A provides inpatient hospital insurance benefits and coverage of extended care\nservices for patients after hospital discharge, and Medicare Part B provides supplementary\nmedical insurance for medical and other health services, including coverage of hospital\noutpatient services. The Centers for Medicare & Medicaid Services (CMS) administers the\nMedicare program.\n\nCMS contracts with Medicare contractors to, among other things, process and pay claims\nsubmitted by hospitals.\n\nHospital Outpatient Prospective Payment System\n\nCMS implemented an outpatient prospective payment system (OPPS), which is effective for\nservices furnished on or after August 1, 2000, for hospital outpatient services. Under the OPPS,\nMedicare pays for hospital outpatient services on a rate-per-service basis that varies according to\nthe assigned ambulatory payment classification (APC). CMS uses Healthcare Common\nProcedure Coding System (HCPCS) codes and descriptors to identify and group the services\nwithin each APC group. 1 All services and items within an APC group are comparable clinically\nand require comparable resources.\n\nHospital Inpatient Prospective Payment System\n\nCMS pays hospital costs at predetermined rates for patient discharges under the inpatient\nprospective payment system (IPPS). The rates vary according to the diagnosis-related group\n\n1\n HCPCS codes are used throughout the health care industry to standardize coding for medical procedures, services,\nproducts, and supplies.\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 1\n\x0c(DRG) to which a beneficiary\xe2\x80\x99s stay is assigned and the severity level of the patient\xe2\x80\x99s diagnosis.\nThe DRG payment is, with certain exceptions, intended to be payment in full to the hospital for\nall inpatient costs associated with the beneficiary\xe2\x80\x99s stay. In addition to the basic prospective\npayment, hospitals may be eligible for an additional payment, called an outlier payment, when\nthe hospital\xe2\x80\x99s costs exceed certain thresholds.\n\nHospital Claims at Risk for Incorrect Billing\n\nOur previous work at other hospitals identified these types of claims at risk for noncompliance:\n\n \xe2\x80\xa2 outpatient and inpatient manufacturer credits for replaced medical devices,\n\n \xe2\x80\xa2 outpatient and inpatient claims paid in excess of charges,\n\n \xe2\x80\xa2 outpatient claims billed with observation services that resulted in outlier payments,\n\n \xe2\x80\xa2 outpatient claims billed with Doxorubicin Hydrochloride,\n\n \xe2\x80\xa2 outpatient claims billed with modifiers,\n\n \xe2\x80\xa2 inpatient short stays,\n\n \xe2\x80\xa2 inpatient same-day discharges and readmissions,\n\n \xe2\x80\xa2 inpatient claims billed with high severity level DRG codes,\n\n \xe2\x80\xa2 inpatient claims with payments greater than $150,000,\n\n \xe2\x80\xa2 inpatient psychiatric facility (IPF) emergency department adjustments, and\n\n \xe2\x80\xa2 inpatient transfers.\n\nFor the purposes of this report, we refer to these areas at risk for incorrect billing as \xe2\x80\x9crisk areas.\xe2\x80\x9d\nWe reviewed these risk areas as part of this review.\n\nMedicare Requirements for Hospital Claims and Payments\n\nMedicare payments may not be made for items or services that \xe2\x80\x9c\xe2\x80\xa6 are not reasonable and\nnecessary for the diagnosis or treatment of illness or injury or to improve the functioning of a\nmalformed body member\xe2\x80\x9d (the Social Security Act (the Act), \xc2\xa7 1862(a)(1)(A)). In addition, the\nAct precludes payment to any provider of services or other person without information necessary\nto determine the amount due the provider (the Act, \xc2\xa7 1833(e)).\n\nFederal regulations state that the provider must furnish to the Medicare contractor sufficient\ninformation to determine whether payment is due and the amount of the payment (42 CFR\n\xc2\xa7 424.5(a)(6)).\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 2\n\x0cThe Medicare Claims Processing Manual (the Manual) requires providers to complete claims\naccurately so that Medicare contractors may process them correctly and promptly (Pub. No.\n100-04, chapter 1, \xc2\xa7 80.3.2.2). The Manual states that providers must use HCPCS codes for\nmost outpatient services (chapter 23, \xc2\xa7 20.3).\n\nMercy Medical Center in Des Moines\n\nThe Hospital is an 802-bed acute care hospital located in Des Moines, Iowa. Medicare paid the\nHospital approximately $292 million for 277,157 outpatient and 27,073 inpatient claims for\nservices provided to beneficiaries during CYs 2009 and 2010 based on CMS\xe2\x80\x99s National Claims\nHistory data.\n\nHOW WE CONDUCTED THIS REVIEW\n\nOur audit covered $8,202,585 in Medicare payments to the Hospital for 557 claims that we\njudgmentally selected as potentially at risk for billing errors. These claims consisted of 155\noutpatient and 402 inpatient claims. Of the 557 claims, 523 claims had dates of service in CYs\n2009 or 2010, and 34 claims (involving outpatient and inpatient manufacturer credits for\nreplaced medical devices) had dates of service in CYs 2008 or 2011. 2 We focused our review on\nthe risk areas that we had identified as a result of previous OIG reviews at other hospitals. We\nevaluated compliance with selected billing requirements but did not use medical review to\ndetermine whether the services were medically necessary. This report focuses on selected risk\nareas and does not represent an overall assessment of all claims submitted by the Hospital for\nMedicare reimbursement.\n\nWe conducted this performance audit in accordance with generally accepted government\nauditing standards. Those standards require that we plan and perform the audit to obtain\nsufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions\nbased on our audit objectives. We believe that the evidence obtained provides a reasonable basis\nfor our findings and conclusions based on our audit objectives.\n\nSee Appendix A for the details of our scope and methodology.\n\n FINDINGS\n\nThe Hospital complied with Medicare billing requirements for 466 of the 557 outpatient and\ninpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing\nrequirements for the remaining 91 claims, resulting in overpayments of $573,331 for CYs 2009\nand 2010 (77 claims) and CYs 2008 and 2011 (14 claims). Specifically, 35 outpatient claims had\nbilling errors, resulting in overpayments of $391,126, and 56 inpatient claims had billing errors,\nresulting in overpayments of $182,205. These errors occurred primarily because the Hospital did\nnot have adequate controls to prevent the incorrect billing of Medicare claims within the selected\nrisk areas that contained errors. For the results of our review by risk area, see Appendix B.\n\n\n2\n We selected these 34 claims for review because the risk area that involves manufacturer credits for replaced\nmedical devices has a high risk of billing errors.\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 3\n\x0cBILLING ERRORS ASSOCIATED WITH OUTPATIENT CLAIMS\n\nThe Hospital incorrectly billed Medicare for 35 of 155 selected outpatient claims, which resulted\nin overpayments of $391,126.\n\nManufacturer Credits for Replaced Medical Devices Not Reported\n\nFederal regulations require a reduction in the OPPS payment for the replacement of an implanted\ndevice if (1) the device is replaced without cost to the provider or the beneficiary, (2) the\nprovider receives full credit for the cost of the replaced device, or (3) the provider receives\npartial credit equal to or greater than 50 percent of the cost of the replacement device (42 CFR\n\xc2\xa7 419.45). For services furnished on or after January 1, 2007, CMS requires the provider to\nreport the modifier \xe2\x80\x9cFB\xe2\x80\x9d and reduced charges on a claim that includes a procedure code for the\ninsertion of a replacement device if the provider incurs no cost or receives full credit for the\nreplaced device. If the provider receives a replacement device without cost from the\nmanufacturer, the provider must report a charge of no more than $1 for the device. 3\n\nFor 30 out of 155 selected claims, the Hospital received full credit for replaced medical devices\nbut did not report the \xe2\x80\x9cFB\xe2\x80\x9d modifier and reduced charges on its claims. (Of the 30 claims, 20\nhad dates of service in CYs 2009 or 2010, and 10 had dates of service in CYs 2008 or 2011.)\nThese overpayments occurred because the Hospital did not have adequate controls to report the\nappropriate modifier and charges to reflect credits received from manufacturers. As a result of\nthese errors, the Hospital received overpayments of $382,842.\n\nIncorrectly Billed Healthcare Common Procedure Coding System Codes\n\nThe Act precludes payment to any provider of services or other person without information\nnecessary to determine the amount due the provider (the Act, \xc2\xa7 1833(e)). The Manual states:\n\xe2\x80\x9cIn order to be processed correctly and promptly, a bill must be completed accurately\xe2\x80\x9d\n(chapter 1, \xc2\xa7 80.3.2.2).\n\nFor 3 out of 155 selected claims, the Hospital submitted the claims to Medicare with incorrect\nHCPCS codes. The Hospital stated that staff members erroneously transposed numbers in the\nHCPCS codes. As a result of these errors, the Hospital received overpayments of $4,773.\n\nIncorrectly Billed Observation Services\n\nMedicare payments may not be made for items or services that \xe2\x80\x9c\xe2\x80\xa6 are not reasonable and\nnecessary for the diagnosis or treatment of illness or injury or to improve the functioning of a\nmalformed body member\xe2\x80\x9d (the Act, \xc2\xa7 1862(a)(1)(A)). The Manual states: \xe2\x80\x9cObservation time\nbegins at the clock time documented in the patient\xe2\x80\x99s medical record, which coincides with the\ntime that observation care is initiated in accordance with a physician\xe2\x80\x99s order \xe2\x80\xa6 observation time\nends when all medically necessary services related to observation care are completed\xe2\x80\x9d (chapter 4,\n\xc2\xa7 290.2.2). The Manual also states: \xe2\x80\x9cObservation services must also be reasonable and necessary\n\n3\n CMS provides guidance on how a provider should report no-cost and reduced-cost devices under the OPPS (CMS\nTransmittal 1103, dated November 3, 2006, and the Manual, chapter 4, \xc2\xa7 61.3).\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 4\n\x0cto be covered by Medicare\xe2\x80\x9d (chapter 4, \xc2\xa7 290.1). In addition, the Manual states: \xe2\x80\x9cIn order to be\nprocessed correctly and promptly, a bill must be completed accurately\xe2\x80\x9d (chapter 1, \xc2\xa7 80.3.2.2).\n\nFor 2 out of 155 selected claims, the Hospital billed Medicare for incorrect units of service for\nHCPCS code G0378 (hospital observation services). Specifically, the Hospital billed 255 and\n229 units of service when the correct amounts were 80 and 108, respectively. The Hospital\nstated that when calculating the observation hours, no consideration was given to the medical\nnecessity of the excessive observation hours. As a result of these errors, the Hospital received\noverpayments of $3,511.\n\nBILLING ERRORS ASSOCIATED WITH INPATIENT CLAIMS\n\nThe Hospital incorrectly billed Medicare for 56 of 402 selected inpatient claims, which resulted\nin overpayments of $182,205.\n\nIncorrectly Billed as Inpatient\n\nMedicare payments may not be made for items or services that \xe2\x80\x9c\xe2\x80\xa6 are not reasonable and\nnecessary for the diagnosis or treatment of illness or injury or to improve the functioning of a\nmalformed body member\xe2\x80\x9d (the Act, \xc2\xa71862(a)(1)(A)). Payment for services furnished to an\nindividual may be made only to providers of services that are eligible and only if, \xe2\x80\x9cwith respect\nto inpatient hospital services ... which are furnished over a period of time, a physician certifies\nthat such services are required to be given on an inpatient basis for such individual\xe2\x80\x99s medical\ntreatment \xe2\x80\xa6.\xe2\x80\x9d (the Act, \xc2\xa7 1814(a)(3)). Additionally, Medicare Part A will pay for inpatient\nhospital services \xe2\x80\x9c\xe2\x80\xa6 only if a physician certifies and recertifies,\xe2\x80\x9d among other things, the\nreasons for continued hospitalization\xe2\x80\x9d (42 CFR \xc2\xa7 424.13(a)).\n\nFor 15 out of 402 selected claims, the Hospital incorrectly billed Medicare Part A for beneficiary\nstays that should have been billed as outpatient or outpatient with observation services. 4\n\nThe Hospital explained that the errors were a result of several causes:\n\n \xe2\x80\xa2 Patient Care Managers were not available to review cases on weekends or after hours.\n\n \xe2\x80\xa2 Inconsistency in physician documentation for the level of care led to misinterpretation of\n the order.\n\n \xe2\x80\xa2 Physicians did not always complete the level of care in the standard order sets.\n\n \xe2\x80\xa2 A knowledge deficit due to the ambiguity of the criteria.\n\n\n4\n The Hospital may be able to bill Medicare Part B for all services (except for services that specifically require an\noutpatient status) that would have been reasonable and necessary had the beneficiary been treated as a hospital\noutpatient rather than admitted as an inpatient. We were unable to determine the effect that billing Medicare Part B\nwould have on the overpayment amount because these services had not been billed and adjudicated by the Medicare\nadministrative contractor prior to the issuance of our report.\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 5\n\x0cAs a result of these errors, the Hospital received overpayments of $79,008.\n\nManufacturer Credits for Replaced Medical Devices Not Reported\n\nFederal regulations require reductions in the IPPS payments for the replacement of an implanted\ndevice if (1) the device is replaced without cost to the provider, (2) the provider receives full\ncredit for the device cost, or (3) the provider receives a credit equal to 50 percent or more of the\ndevice cost (42 CFR \xc2\xa7 412.89). The Manual states that to bill correctly for a replacement device\nthat was provided with a credit, hospitals must code Medicare claims with a combination of\ncondition code 49 or 50, along with value code \xe2\x80\x9cFD\xe2\x80\x9d (chapter 3, \xc2\xa7 100.8).\n\nFor 21 out of 402 selected claims, the Hospital received reportable medical device credits from\nmanufacturers but did not adjust its inpatient claims with the appropriate condition and value\ncodes to reduce payment as required. (Of the 21 claims, 17 had dates of service in CYs 2009 or\n2010, and 4 had dates of service in CYs 2008 or 2011.) These overpayments occurred because\nthe Hospital did not have adequate controls to report the appropriate condition and value codes in\norder to accurately reflect credits it had received from manufacturers. As a result of these errors,\nthe Hospital received overpayments of $73,459.\n\nIncorrectly Billed as Separate Inpatient Stays\n\nThe Manual (chapter 3, \xc2\xa7 40.2.5) states:\n\n When a patient is discharged/transferred from an acute care Prospective Payment\n System (PPS) hospital, and is readmitted to the same acute care PPS hospital on\n the same day for symptoms related to, or for evaluation and management of, the\n prior stay\xe2\x80\x99s medical condition, hospitals shall adjust the original claim generated\n by the original stay by combining the original and subsequent stay on a single\n claim.\n\nFor 2 out of 402 selected claims, the Hospital billed Medicare separately for related discharges\nand readmissions that occurred within the same day. The Hospital stated that coding rules are\nopen to interpretation and, in the cases cited, the coder believed that the claims were not related\nand determined that the claims should have been billed separately. As a result of these errors,\nthe Hospital received overpayments of $14,009.\n\nIncorrectly Billed Diagnosis-Related Group Codes\n\nMedicare payments may not be made for items or services that \xe2\x80\x9c\xe2\x80\xa6 are not reasonable and\nnecessary for the diagnosis or treatment of illness or injury or to improve the functioning of a\nmalformed body member\xe2\x80\x9d (the Act, \xc2\xa71862(a)(1)(A)). In addition, the Manual states: \xe2\x80\x9cIn order\nto be processed correctly and promptly, a bill must be completed accurately\xe2\x80\x9d (chapter 1,\n\xc2\xa7 80.3.2.2).\n\nFor 2 out of 402 selected claims, the Hospital billed Medicare for incorrect DRG codes. For\neach of these two claims, either the principal diagnosis or the procedure code was incorrect. The\n\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 6\n\x0cHospital attributed these errors to coding mistakes. As a result of these errors, the Hospital\nreceived overpayments of $10,748.\n\nUnsupported Charges\n\nThe Act states: \xe2\x80\x9c[N]o such payments shall be made to any provider unless it has furnished such\ninformation \xe2\x80\xa6 in order to determine the amounts due such provider \xe2\x80\xa6 for the period with\nrespect to which the amounts are being paid \xe2\x80\xa6.\xe2\x80\x9d (the Act, \xc2\xa7 1815(a)).\n\nFor 4 out of 402 selected claims, the Hospital submitted claims to Medicare with unsupported\ncharges, resulting in a higher outlier payment than was warranted. For three claims, the Hospital\nbilled for medications that were not supported by the medical records. For the other claim, the\nHospital billed for a procedure that was not supported by the medical records. The Hospital\nattributed these incorrect claims to human error. As a result of these errors, the Hospital received\noverpayments of $4,048.\n\nIncorrect Source-of-Admission Code\n\nCMS increases the Federal per diem rate for the first day of a Medicare beneficiary\xe2\x80\x99s IPF stay to\naccount for the costs associated with maintaining a qualifying emergency department (42 CFR\n\xc2\xa7 412.424). The Manual states that CMS makes this additional payment regardless of whether\nthe beneficiary used emergency department services; however, the IPF should not receive the\nadditional payment if the beneficiary was discharged from the acute-care section of the same\nhospital (chapter 3, \xc2\xa7 190.6.4). The Manual also states that IPFs report source-of-admission code\n\xe2\x80\x9cD\xe2\x80\x9d to identify patients who have been transferred to the IPF from the same hospital (chapter 3,\n\xc2\xa7 190.6.4.1). An IPF\xe2\x80\x99s proper use of this code is intended to alert the Medicare contractor not to\napply the emergency department adjustment.\n\nFor 12 out of 402 selected claims, the Hospital incorrectly coded the source-of-admission for\nbeneficiaries who were admitted to the IPF upon discharge from the Hospital\xe2\x80\x99s acute-care\nsection. The Hospital attributed these incorrect claims to human error. As a result of these\nerrors, the Hospital received overpayments of $933.\n\n RECOMMENDATIONS\n\nWe recommend that the Hospital:\n\n \xe2\x80\xa2 refund to the Medicare contractor $573,331, consisting of $391,126 in overpayments for\n 35 incorrectly billed outpatient claims and $182,205 in overpayments for 56 incorrectly\n billed inpatient claims, and\n\n \xe2\x80\xa2 strengthen controls to ensure full compliance with Medicare requirements.\n\n\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 7\n\x0c AUDITEE COMMENTS\n\nIn written comments on our draft report, the Hospital partially agreed with our first\nrecommendation. The Hospital disagreed with our finding regarding 18 outpatient claims that\ninvolved the replacement of medical devices. For each of these claims, the replaced medical\ndevice in question was an implantable cardioverter-defibrillator (ICD), a device that includes\nboth an impulse generator and a lead wire. Thus, the lead wire is just one component of the\nreplaced device. The Hospital stated that because it did not receive a credit in the amount of the\nfull cost of the ICD, it would have been inaccurate to report the \xe2\x80\x9cFB\xe2\x80\x9d modifier on these 18\nclaims and, therefore, no payment reduction was necessary. According to the Hospital, our\nfinding regarding these claims was an incorrect application of Medicare payment policy. 5\n\nThe Hospital agreed with our findings and recommendations for the other overpayments that we\nhad identified and described corrective actions that it had taken in response to both of our\nrecommendations. With respect to our second recommendation, the Hospital stated that it had\nreviewed its billing process in each area to determine how the process could be further improved,\nand that it had implemented improvements to ensure future compliance in each area.\n\nThe Hospital\xe2\x80\x99s comments appear in their entirety as Appendix C.\n\n OFFICE OF INSPECTOR GENERAL RESPONSE\n\nAfter reviewing the Hospital\xe2\x80\x99s comments, we maintain that all of our findings and\nrecommendations are valid. Medicare payment policy regarding the reporting of manufacturer\ncredits for replaced medical devices is clear and specific as to the devices in question. CMS\nlists, in the Federal Register, the devices to which the payment policy on replaced medical\ndevices applies. 6 This list includes the ICDs that were involved in all 18 of the claims associated\nwith the finding with which the Hospital disagreed.\n\nFurthermore, CMS has responded to comments on its payment policy that deal with instances\nwhen a hospital receives a full credit for only one component of a pacemaker or ICD\nreplacement procedure that involves both a lead and a generator. 7 CMS responded by\nconfirming that the modifier should be assigned to the procedure code and that a payment offset\namount should be applied.\n\n\n\n\n5\n The payment policy in question is called the No Cost/Full Credit and Partial Credit Device Adjustment Policy.\n6\n 74 Fed. Reg. 60316, 60464 (Nov. 20, 2009) and 77 Fed. Reg. 68210, 68357 (Nov. 15, 2012).\n7\n 77 Fed. Reg. 68210, 68357 (Nov. 15, 2012). Although this volume of the Federal Register was issued after our\naudit period, the language to which we refer here does not establish new policy, but rather, reiterates existing policy.\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 8\n\x0c APPENDIX A: AUDIT SCOPE AND METHODOLOGY\n\nSCOPE\n\nOur audit covered $8,202,585 in Medicare payments to the Hospital for 557 claims that we\njudgmentally selected as potentially at risk for billing errors. These claims consisted of 155\noutpatient and 402 inpatient claims. Of the 557 claims, 523 claims had dates of service in CYs\n2009 or 2010, and 34 claims (involving outpatient and inpatient manufacturer credits for\nreplaced medical devices) had dates of service in CYs 2008 or 2011 (see footnote 2).\n\nWe focused our review on the risk areas that we had identified as a result of previous OIG\nreviews at other hospitals. We evaluated compliance with selected billing requirements, but did\nnot use medical review to determine whether the services were medically necessary.\n\nWe limited our review of the Hospital\xe2\x80\x99s internal controls to those applicable to the outpatient and\ninpatient areas of review because our objective did not require an understanding of all internal\ncontrols over the submission and processing of claims. We established reasonable assurance of\nthe authenticity and accuracy of the data obtained from the National Claims History file, but we\ndid not assess the completeness of the file.\n\nThis report focuses on selected risk areas and does not represent an overall assessment of all\nclaims submitted by the Hospital for Medicare reimbursement.\n\nWe conducted our fieldwork at the Hospital from March 2012 to March 2013.\n\nMETHODOLOGY\n\nTo accomplish our objective, we:\n\n \xe2\x80\xa2 reviewed applicable Federal laws, regulations, and guidance;\n\n \xe2\x80\xa2 extracted the Hospital\xe2\x80\x99s outpatient and inpatient paid claim data from CMS\xe2\x80\x99s National\n Claims History file for CYs 2009 and 2010;\n\n \xe2\x80\xa2 obtained information on known credits for replacement medical devices from the device\n manufacturers for CYs 2008 through 2011;\n\n \xe2\x80\xa2 used computer matching, data mining, and other data analysis techniques to identify\n claims potentially at risk for noncompliance with selected Medicare billing requirements;\n\n \xe2\x80\xa2 judgmentally selected 557 claims (155 outpatient and 402 inpatient) for detailed review;\n\n \xe2\x80\xa2 reviewed available data from CMS\xe2\x80\x99s Common Working File for the selected claims to\n determine whether the claims had been cancelled or adjusted;\n\n\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 9\n\x0c \xe2\x80\xa2 reviewed the itemized bills and medical record documentation provided by the Hospital\n to support the selected claims;\n\n \xe2\x80\xa2 requested that the Hospital conduct its own review of the selected claims to determine\n whether the services were billed correctly;\n\n \xe2\x80\xa2 discussed the incorrectly billed claims with Hospital personnel to determine the\n underlying causes of noncompliance with Medicare requirements;\n\n \xe2\x80\xa2 calculated the correct payments for those claims requiring adjustments; and\n\n \xe2\x80\xa2 discussed the results of our review with Hospital officials on March 28, 2013.\n\nWe conducted this performance audit in accordance with generally accepted government\nauditing standards. Those standards require that we plan and perform the audit to obtain\nsufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions\nbased on our audit objectives. We believe that the evidence obtained provides a reasonable basis\nfor our findings and conclusions based on our audit objectives.\n\n\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 10\n\x0c APPENDIX B: RESULTS OF REVIEW BY RISK AREA\n\n\n Claims\n Value of With Value of\n Selected Selected Over- Over-\n Risk Area Claims Claims payments payments\nOutpatient\nManufacturer Credits for Replaced Medical\n 44 $989,126 30 $382,842\nDevices\nClaims Paid in Excess of Charges 3 10,038 3 4,773\nClaims Billed With Observation Services That\n 10 59,133 2 3,511\nResulted in Outlier Payments\nClaims Billed With Doxorubicin Hydrochloride 73 242,657 0 0\n\nClaims Billed With Modifiers 25 109,531 0 0\n\n Outpatient Totals 155 $1,410,485 35 $391,126\n\n\nInpatient\n\nShort Stays 248 $1,320,917 15 $79,008\nManufacturer Credits for Replaced Medical\n 43 1,056,547 21 73,459\nDevices\nSame-Day Discharges and Readmissions 12 244,962 2 14,009\nClaims Billed With High Severity Level\n 41 1,013,401 2 10,748\nDiagnosis-Related Group Codes\nClaims With Payments Greater Than $150,000 10 2,142,484 4 4,048\nPsychiatric Facility Emergency Department\n 27 226,406 12 933\nAdjustments\nTransfers 15 478,217 0 0\n\nClaims Paid in Excess of Charges 6 309,166 0 0\n\n Inpatient Totals 402 $6,792,100 56 $182,205\n\n\n Outpatient and Inpatient Totals 557 $8,202,585 91 $573,331\n\n Notice: The table above illustrates the results of our review by risk area. In it, we have organized outpatient and\n inpatient claims by the risk areas we reviewed. However, we have organized this report\xe2\x80\x99s findings by the types of\n billing errors we found at the Hospital. Because we have organized the information differently, the information in\n the individual risk areas in this table does not match precisely with this report\xe2\x80\x99s findings.\n\n\n\n Medicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 11\n\x0c APPENDIX C: AUDITEE COMMENTS\n\n\n\n\n\n tl\\j~[f);;ENTER\n DES MOINES\n I ll 1 6th Ave.\n Des Moines, lA 50314-26 11\n 515-247-3 12 1\n\n\n\n A member ofMercy Health Network\n\n\n\n October 4, 2013\n\n Patrick J. Cogley\n Office of the Inspector General\n Office of Audit Services, Region VII\n 601 East 12th Street, Room 0429\n Kansas City, MO 66106\n\n Re: Draft of I-IHS-OIG Audit Services Report Number A-07-12-05028\n\n Dear Mr. Cogley:\n\n Mercy Medical Center - Des Moines appreciates the opportunity to respond to the draft\n report identified above. For over 120 years, Mercy has maintained its commitment to providing\n quality medical care to our patients and to our community. Our values guide us to do what is best\n for our patients while maintaining compliance with the highest standards of care. This commitment\n includes our obligation to process claims for services provided while ensuring compliance with all\n appropriate standards. The OIG review largely validates we have been successful in our efforts to\n ensure fair and accurate billing to the Medicare program. We disagree with one of the audit\n standards, which we discuss below.\n\n OIG Audit ofReplacement Medical Devices Applied Incorrect Standard\n\n The draft report asserts that modifier FB should have been applied to 30 claims for\n outpatient surgery that involved the replacement of a medical device. We disagree with the audit\'s\n findings with respect to 18 of those 30 claims. 1\n\n Medicare has special payment rules for situations where a medical device manufacturer\n provides a replacement device to a hospital for no-charge or at a significant discount (typically\n because the device failed while under warranty). If the hospital received a replacement device for\n no-charge the hospital must attach modifier FB to its outpatient claim, and Medicare will reduce the\n APC payment by the offset amount related device. If the hospital received a credit for more than\n 50% of the cost of the replacement device, the hospital must attach modifier FC to its outpatient\n claim, and Medicare will reduce the APC payment by the partial offset an amount, which is an\n amount based upon a percentage of the device cost. 42 C.F.R. \xc2\xa7 419.45; CMS Pub. 100-04, Ch. 4\n \xc2\xa7 61.3.\n\n For 18 of the claims that the draft report asserts should have been billed with modifier FB,\n the procedure involved the replacement of both the impulse generator of the implantable\n cardioverter-defibrillator (ICD) and a lead wire. The hospital received a credit from the\n\n 1\n For the remaining 12 claims, we agree that each claim should have included modifier FB. We have\n submitted revised bills and refunded the related overpayments for the 12 claims.\n\n\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 12\n\x0c manufacturer for the cost of the lead wire, but not for the cost of the impulse generator. The draft\n report asserts that modifier FB should have been attached to these claims because a credit was\n given for the full cost of the lead wire. That position incorrectly applies Medicare payment policy.\n In these 18 cases, the replaced device is the ICD, which includes both impulse generator and its\n lead wires. As such, the lead wire is just one component of the "replaced device." Since the\n hospital did not receive a credit in the amount of the full cost of the ICD, it would be inaccurate to\n include modifier FB on the claim. Further, since the value of the credit for the lead wire was less\n than 50% of the cost of the replacement ICD, it would have been inaccurate to include modifier FC\n on the claim. As such, we are confident that these 18 claims were correctly paid and no payment\n reduction based upon the manufacturer\'s credit for the lead is appropriate.\n\n In sum, we respectfully disagree with the audit findings related to 18 claims involving\n outpatient replacement medical devices. We have not refunded those claims and fully intend to\n appeal.\n\n Other OIG Audit of High Risk Areas Found Few and Only Isolated Issues\n\n The other claims audited were in select high risk areas (outpatient HCPCS coding,\n observation versus inpatient admission status, readmissions, DRG coding, inpatient outliers that\n include expensive drugs, inpatient medical device credits, and source of admission for inpatient\n psychiatric facility adjustments). Despite that narrow focus, the audit found only a modest number\n of isolated errors and no indication of systl;!mic deficiencies. We acknowledge that the claims\n identified in the draft report were incorrectly paid, and we have submitted refunds for all claims\n identified by the audit (other than the 18 outpatient medical device claims discussed above).\n Further, we reviewed our billing process in each area to determine how our process could be further\n improved, and we implemented improvements to ensure future compliance in each area.\n\n Conclusion\n\n The OIG\'s audit was not a random audit of all inpatient and outpatient claims, rather the\n audit targeted several high risk areas. As such, the audit is not representative of Mercy\'s overall\n billing compliance. Indeed, the audit report does not purport to assess overall compliance, rather\n the report acknowledges that it is limited to "selected risk areas." Nonetheless, of the $8,202,585\n payments reviewed, we believe that only $244,688 of the payments were incorrect, which relates to\n a compliance rate that is better than 97%. We have taken steps to further increase that compliance\n rate, but we are pleased to have achieved such an positive outcome in the context of an audit\n targeting only high-risk areas.\n\n We appreciate your consideration of the points raised above. Please feel free to contact me\n if you have any questions.\n\n\n\n\n ~r -\n stre ds,\n\n\n obert P. Ritz\n President\n\n RPR:ds\n\n\n 46156768.1\n\n\n\n\nMedicare Compliance Review of Mercy Medical Center in Des Moines (A-07-12-05028) 13\n\x0c'