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Representative payment policies and administrative procedure for imposing penalties for false or misleading statements or withholding of information. Final rules.

We are amending our regulations on representative payment and on the administrative procedure for imposing penalties for false or misleading statements or withholding of information to reflect and implement certain provisions of the Social Security Protection Act of 2004 (SSPA). The SSPA amends representative payment policies by providing additional safeguards for Social Security, Special Veterans and Supplemental Security Income beneficiaries served by representative payees. These changes include additional disqualifying factors for representative payee applicants, additional requirements for non-governmental fee-for-service payees, authority to redirect delivery of benefit payments when a representative payee fails to provide required accountings, and authority to treat misused benefits as an overpayment to the representative payee. In addition, we are amending our rules to explain financial requirements for representative payees, and we have made minor clarifying plain language changes. The SSPA also allows us to impose a penalty on any person who knowingly withholds information that is material for use in determining any right to, or the amount of, monthly benefits under titles II or XVI. The penalty is nonpayment for a specified number of months of benefits under title II that would otherwise be payable and ineligibility for the same period of time for payments under title XVI (including State supplementary payments).

Fraud↗

Legal considerations in infectious diseases and dentistry.

Dentists, similar to other professionals subject to legal regulation, often have an overly simple view of the legal system. Communicable diseases present questions on the cutting edge of the law, and, as the previous discussion makes perhaps painfully clear, there is considerable uncertainty on many important legal points. Legal uncertainty is often a reflection of social or scientific uncertainty. Clear answers emerge less from the words of lawyers and judges than from the actions of professionals themselves, who ultimately set the standard of care. In any area of legal uncertainty, the dentist is best advised to adhere to the best scientific information available and to meet the ethical standards of the profession.

Centers for Disease Control and Prevention, U.S.↗

[A mortality study of recipients of compensation for asbestosis in Italy (1980-1990)].

The cause-specific mortality experience of a cohort inclusive of all subjects compensated for asbestosis in Italy (altogether 3417 persons--2776 men and 641 women), was studied from 31.12.1979 through 30.6.1990. Forty-eight subjects, corresponding to 1.4% of the cohort, were lost to follow-up, while it was not possible to ascertain the cause of death of 78 subjects, corresponding to 6.9% of the deceased. Observed mortality was compared with expected figures, derived from the Italian population mortality rates. The study showed significant increases in mortality from all causes (SMR 153, 1134 obs), respiratory disease (SMR 388, 218 obs), all neoplasms (SMR 192, 438 obs), namely lung (SMR 289, 190 obs), pleura (SMR 2745, 34 obs), peritoneum (SMR 1372, 14 obs), intestine and rectum (SMR 186, 36 obs) and ovary (SMR 545, 6 obs). A significantly decreased mortality was observed for cardiovascular disease (SMR 85, 266 obs), diabetes (SMR 37, 8 obs) and disease of the nervous system (SMR 29, 3 obs). The increase in neoplasms of lung, pleura and peritoneum was significant in both genders, while the increase in intestinal neoplasms was significant among women but not among men. Exposure in the manufacture of asbestos-cement products, the shipbuilding and textile industries accounted for most of the observed mortality excess.

Asbestosis↗

[Use of occupational disease benefits].

Persons with pleuramesothelioma were studied to find out the share receiving occupational injury benefit from the National Insurance Scheme. This disease, caused by inhaling asbestos, was chosen because it has been estimated that between 70 and 80 per cent of persons with pleuramesothelioma fulfil the criteria for compensation. During the period 1970-93, 662 men and 104 women were recorded as having this disease. Up to June 1996, the National Insurance Administration had considered the cases of only 163 men, and no women. A further 25-30 patients may have filed claims with the local national insurance office. This implies that, overall, maximum one third of those entitled to occupational injury benefit have received it. The fraction would probably be even lower in the case of diseases where the association with occupation is less certain. It is recommended that national disease registries, such as the Cancer Registry, should report possible cases of occupational disease to the National Insurance Administration.

Adult↗