Enquête sur les marchés de l’eau
Enqu ?te sur les march ?s de l’eau :
...Quand le priv ? gagne des millions sur le dos du service public
lundi 10 mai par Lucie Delaporte
Deux juristes remettent en question la l ?galit ? d’une partie des profits colossaux r ?alis ?s par les grands groupes… qui sp ?culent avec l’argent des taxes qu’ils touchent au nom des communes.
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Une r ?cente ?tude men ?e par deux juristes vient remettre en question le fondement l ?gal d’une partie non n ?gligeable des profits des distributeurs de flotte comme Veolia, Suez ou la Saur. Publi ? dans une revue sp ?cialis ?e, la Semaine juridique, l’article est pass ? jusqu’ici presque inaper ?u. Pourtant, la d ?monstration est d ?tonante.
En sept pages, les deux jeunes doctorants Yann Wels et Gersende Bousquet expliquent tranquillement que des millions d’euros per ?us par les grandes entreprises d’eau et d’assainissement le sont de fa ?on peu orthodoxe. Au cœur de la controverse, une pratique ?tablie de longue date, qui voit les entreprises d ?l ?gataires assumer pour le compte des collectivit ?s, en plus de leurs missions traditionnelles, une ? prestation compl ?mentaire de recouvrement de fonds ?.
Qui plus est, d’autres services d ?l ?gu ?s ? des entreprises priv ?es par les collectivit ?s sont potentiellement concern ?s. Et l ? encore, les enjeux financiers sont de taille. ? Ne nous y trompons pas, c’est toute l’architecture de la d ?l ?gation de service public qui est en cause et qui peut ?tre mise ? mal du seul fait du rappel de la r ?glementation en vigueur, ?crivent Yann Wels et Gersende Bousquet. Il est en effet tout aussi ?vident que les mondes des d ?chets, des concessions de parking, tombent sous le coup d’un contr ?le d ?sormais renforc ? du maniement de fonds par des personnes priv ?es. ? Pour beaucoup de ces d ?l ?gataires, la perception de ces taxes, et les b ?n ?fices r ?alis ?s en les pla ?ant, constitue un fonds de roulement des plus confortables.
Arrangements Dans un monde de l’eau ? couteaux tir ?s, deux jeunes juristes remettent en question la l ?galit ? d’une partie des profits colossaux r ?alis ?s par les grands groupes… qui sp ?culent avec l’argent des taxes qu’ils touchent au nom des communes.
Sale temps pour les grands marchands de flotte. En pleine bataille fratricide pour le colossal march ? de l’Ile-de- France, soup ?onn ? d’entente et d’abus de position dominante par la Commission europ ?enne, le monde de l’eau a connu p ?riodes plus sereines.
Comme si cela ne suffisait pas, une r ?cente ?tude men ?e par deux juristes, Yann Wels et Gersende Bousquet, vient remettre en question le fondement l ?gal d’une partie non n ?gligeable de leurs profits.
Publi ? dans une revue sp ?cialis ?e, la Semaine juridique, l’article* est pass ? jusqu’ici presque inaper ?u. Pourtant, la d ?monstration est d ?tonante. En sept pages, les deux jeunes doctorants expliquent tranquillement que des millions d’euros per ?us par les grandes entreprises d’eau et d’assainissement le sont de fa ?on peu orthodoxe.
Au coeur de la controverse, une pratique ?tablie de longue date, qui voit les entreprises d ?l ?gataires assumer pour le compte des collectivit ?s, en plus de leurs missions traditionnelles, une ? prestation
compl ?mentaire de recouvrement de fonds ?. En clair, elles per ?oivent, directement sur la facture de l’usager, des taxes destin ?es aux collectivit ?s, qu’elles leur reversent ensuite.
Or cette pratique repose sur des sables juridiques mouvants. Trois recettes sont concern ?es : la surtaxe pour le compte de la collectivit ? (ce qui rembourse celle-ci de ses investissements), la redevance assainissement (dans le cadre d’une convention de facturation) et la participation pour raccordement ? l’ ?gout. Veolia, Suez, et Saur qui per ?oivent donc ces sommes ont, selon les contrats, un certain laps de temps pour reverser l’argent, six ? douze mois bien souvent. Entretemps, car il serait dommage de g ?cher, tous ces sous sont plac ?s et fructifient, ce qui constitue pour ces grands groupes de tr ?s confortables profits. ? En pla ?ant ces sommes sur des comptes g ?n ?rant des int ?r ?ts et en ne reversant que les sommes encaiss ?es (int ?r ?ts produits exclus), elles se rendent potentiellement coupables d’un v ?ritable d ?tournement de deniers publics ? , analysent les juristes.
Les r ?centes ?volutions r ?glementaires, qui vont dans le sens d’un encadrement de plus en plus strict du maniement des fonds publics, devraient contraindre, a minima, les collectivit ?s ? soumettre ces prestations ? un appel d’offres. ce qui n’est jamais fait. Du coup, les grands marchands d’eau s’exposent, affirment les deux juristes, ? la ? constitution d’une gestion de fait ?, c’est- ?-dire qu’elles s’immiscent dans le maniement de fonds publics sans avoir qualit ? pour le faire. ? La gestion de fait est constitutive du d ?lit d’usurpation de fonctions publiques. ? Et est ? puni de trois ans d’emprisonnement et de 45 000 euros d’amende ?, pr ?cise l’article.
? Aujourd’hui, si un usager d ?cidait de saisir la justice, elle lui donnerait certainement raison ?, estime Marc Laim ?, sp ?cialiste de la gestion de l’eau et consultant. Pourquoi les collectivit ?s locales ne d ?noncent-elles pas ellesm ?mes ce qui ressemble fort ? une aberration ? Pour Patrick Du Fau de Lamothe, juriste sp ?cialis ? dans la gestion de l’eau, ? dans un domaine hypertechnique, les collectivit ?s sont parfois d ?munies. Elles n’ont pas toujours conscience de ces probl ?matiques. Par ailleurs, leurs relations avec les d ?l ?gataires sont parfois tr ?s ?troites et on ne peut pas n ?gliger les effets de la calinoth ?rapie sur certains ?lus ? , plaide-t-il. Les entreprises de l’eau ne devraient pas rester indiff ?rentes ? cette implacable d ?monstration technique.
? L’enjeu est ?norme pour ces soci ?t ?s puisque les b ?n ?fices en question participent tr ?s largement ? leurs marges actuelles, estime Marc Laim ?. Et ce d’autant plus que leur mod ?le ?conomique bas ? sur : “plus je vends d’eau, plus je fais de profits” est en train de s’effondrer sous la pression des nouvelles exigences ?cologiques. ?
Pour S ?verine Teissier, porteparole d’Anticor, association de lutte contre la corruption, le cas a ceci d’int ?ressant qu’ ? on focalise toujours sur le financement de la vie politique par les grandes entreprises de l’eau, or ici il appara ?t plus juste de dire que le public finance le priv ? ?. Et par ces temps de rigueur budg ?taire annonc ?e, est-ce bien raisonnable...
? Maniement de fonds publics, d ?l ?gataire de service d’eau et gestion de fait – Entre pratiques publiques et infractions p ?nales ?, la Semaine juridique, n ? 16, 19 avril 2010.
Les sommes contest ?es repr ?senteraient des dizaines de millions d’euros. Abus, lobbying… nos enqu ?tes sur les march ?s de l’eau coulent de source : http://minu.me/2bde
Si la gestion de l’eau, et les ?normes march ?s qu’elle repr ?sente, est particuli ?rement montr ?e du doigt par l’article de la Semaine juridique (lire ci-dessus), d’autres services d ?l ?gu ?s ? des entreprises priv ?es par
les collectivit ?s sont potentiellement concern ?s. Et l ? encore, les enjeux financiers sont de taille.
? Ne nous y trompons pas, c’est toute l’architecture de la d ?l ?gation de service public qui est en cause et qui peut ?tre mise ? mal du seul fait du rappel de la r ?glementation en vigueur ?crivent en conclusion Yann Wels et Gersende Bousquet. Il est en effet tout aussi ?vident que les mondes des d ?chets, des concessions de parking, tombent sous le coup d’un contr ?le d ?sormais renforc ? du maniement de fonds par des personnes priv ?es. ? Pour beaucoup de ces d ?l ?gataires, la perception de ces taxes, et les b ?n ?fices r ?alis ?s en les pla ?ant, constitue un fonds de roulement des plus confortables.
Du c ?t ? de l’association des maires de France, Philippe Laurent, maire de Sceaux, se dit lui aussi conscient du probl ?me et reconna ?t la pertinence de l’article. ? Dans ma ville, nous avons eu un cas semblable ? ce que les entreprises de l’eau pratiquent avec un concessionnaire de parcm ?tre, une filiale du groupe Vinci. La chambre r ?gionale des comptes nous avait alert ?s sur le fait que l’entreprise conservait beaucoup trop longtemps les recettes pr ?lev ?es. Nous avons d ? la rappeler ? l’ordre. ?
Depuis, la Ville a surtout d ?cid ? de reprendre en direct la gestion de ses parkings. Selon lui, si jusqu’ici les associations d’usagers ne se sont pas encore saisies du sujet, c’est qu’ ? il existe dans ces d ?l ?gations beaucoup d’aspects probl ?matiques… ? Pas tr ?s rassurant.
Pourtant, pour Patrick Du Fau de Lamothe, juriste et militant au sein de l’association d’usagersTranscub ? Bordeaux, il ne faut pas se tromper de combat. ? Il n’est pas aberrant que ces entreprises d ?l ?gataires per ?oivent ces taxes, mais ce qui nous semble vraiment important, c’est que tout cela se fasse dans la transparence en reversant au besoin les profits g ?n ?r ?s entre-temps, affirme-t-il. Or nous ne pouvons que constater que l’article du code g ?n ?ral des collectivit ?s territoriales imposant un contr ?le des comptes d ?taill ?s des op ?rations des d ?l ?gataires n’est pas r ?ellement appliqu ? puisque ces commissions de contr ?le n’existent toujours pas ! ?Du c ?t ? du cabinet d’Alain Marleix, le secr ?taire d’ ?tat aux collectivit ?s locales, on prend la probl ?matique
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There certainly is fraud in wellness treatment.
The exact same is genuine for every business enterprise or endeavor touched
by human palms, e.g. banking, credit history, insurance policies, politics, and so forth.
There is no query that wellness treatment vendors who abuse their situation and our
believe in to steal are a dilemma. So are people from other professions who do the very
Why does wellness treatment fraud appear to get the 'lions-share' of interest ?
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teams where taxpayers, well being treatment buyers and wellness care companies are dupes in a overall
health treatment fraud shell-video game operated with 'sleight-of-hand'
Consider a closer seem and one finds this is no video game-of-probability.
Taxpayers, people and providers constantly lose mainly because the difficulty with health and fitness care fraud is not just the fraud, but it is that our government and
insurers use the fraud challenge to further agendas while at the similar time are unsuccessful to be accountable and take accountability for a fraud dilemma they facilitate and allow
for to prosper.
1.Astronomical Expense Estimates
What improved way to report on fraud then to tout fraud price estimates, e.g.
"Fraud perpetrated versus the two general public and personal overall health ideas prices concerning $seventy two and $220 billion on a yearly basis, escalating the cost of health-related treatment and well being insurance policies and undermining public believe in in our wellness care process... It is no longer a secret that fraud represents a single of the speediest rising and most high-priced forms of crime in The us nowadays... We shell out these charges as taxpayers and by higher health and fitness insurance rates... We should be proactive in combating health care fraud and abuse... We should also ensure that legislation enforcement has the equipment that it demands to prevent, detect, and punish wellness treatment fraud." [Senator Ted Kaufman (D-DE), ten/28/09 press launch]
The General Accounting Office environment (GAO) estimates that
fraud in health care ranges from $sixty billion to $600 billion for each 12 months - or
any place involving 3% and ten% of the $two trillion health and fitness care budget.
[Well being Treatment Finance News reports, ten/two/09] The GAO is the investigative arm of Congress.
The Nationwide Well being Treatment Anti-Fraud Association (NHCAA)
stories over $fifty four billion is stolen each year in scams developed to stick us and our insurance companies with fraudulent and illegal clinical fees.
[NHCAA, internet-internet site] NHCAA was developed and is funded by health insurance plan companies.
Sad to say, the trustworthiness of the purported estimates
is dubious at most effective. Insurers, point out
and federal businesses, and others could acquire fraud
data linked to their possess missions, where by the kind, excellent and
volume of information compiled differs commonly.
David Hyman, professor of Legislation, University of
Maryland, tells us that the widely-disseminated estimates of the incidence of
wellness treatment fraud and abuse (assumed to be ten% of whole
shelling out) lacks any empirical foundation at all, the tiny
we do know about wellness care fraud and abuse is dwarfed by what we
really don't know and what we know that is not so. [The Cato Journal, 3/22/02]
two.Overall health Treatment Criteria
The rules & policies governing health treatment - fluctuate from state to
state and from payor to payor - are substantial
and pretty bewildering for providers and other folks
to recognize as they are penned in legalese and not basic talk.
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and HCPCS). These codes are employed when searching
for compensation from payors for providers rendered to clients.
While established to universally utilize to facilitate precise
reporting to reflect providers' products and services, lots
of insurers instruct vendors to report codes based mostly on what the insurer's computer
system enhancing programs recognize - not on what the supplier rendered.
Even more, exercise developing consultants instruct companies on what codes to report to
get paid - in some cases codes that do not properly replicate the provider's support.
Buyers know what companies they receive from their health care provider or other supplier but could not have
a clue as to what these billing codes or company descriptors
imply on explanation of benefits obtained from insurers.
This lack of being familiar with could outcome
in shoppers shifting on without getting clarification of what
the codes suggest, or may well end result in some believing they ended up improperly billed.
The multitude of insurance policy options offered currently, with
different levels of coverage, advert a wild card to the equation when expert services are denied for non-coverage - primarily if it
is Medicare that denotes non-protected providers as not
3.Proactively addressing the health and fitness treatment fraud challenge
The federal government and insurers do pretty minimal to proactively deal with the difficulty with tangible pursuits that will consequence in detecting
inappropriate claims in advance of they are paid out.
In truth, payors of well being care promises proclaim
to run a payment method based mostly on believe in that suppliers invoice properly for solutions rendered, as they can not review every single
assert just before payment is created mainly because
the reimbursement method would shut down.
They claim to use subtle computer system programs to seem for glitches and patterns in promises, have
improved pre- and submit-payment audits of picked companies
to detect fraud, and have made consortiums and undertaking forces
consisting of regulation enforcers and insurance
plan investigators to review the challenge
and share fraud information. On the other hand,
this action, for the most aspect, is dealing with action right
after the assert is paid and has little bearing on the proactive detection of
4.Exorcise health care fraud with the development of new guidelines
The government's reports on the fraud challenge are posted in earnest in conjunction with endeavours to reform our health and fitness care procedure,
and our encounter exhibits us that it eventually outcomes in the authorities introducing and enacting new guidelines -
presuming new regulations will result in far more fraud detected, investigated and prosecuted -
without the need of setting up how new legal guidelines will accomplish this
extra successfully than current legal guidelines that have been not
used to their comprehensive prospective.
With this sort of endeavours in 1996, we obtained the Health
and fitness Insurance Portability and Accountability Act (HIPAA).
It was enacted by Congress to tackle insurance policy portability and accountability for individual privacy and wellbeing care fraud
and abuse. HIPAA purportedly was to equip federal legislation enforcers and prosecutors with the
equipment to attack fraud, and resulted in the development of a quantity of new wellbeing care fraud statutes, including :
Overall health Care Fraud, Theft or Embezzlement in Health Care, Obstructing Felony
Investigation of Health and fitness Treatment, and Fake Statements
Relating to Health Treatment Fraud Issues.
In 2009, the Health and fitness Treatment Fraud Enforcement Act appeared on the
scene. This act has not long ago been introduced
by Congress with claims that it will build on fraud prevention efforts and improve the governments' ability to investigate and prosecute waste, fraud and abuse in equally federal government and personal wellbeing insurance coverage by sentencing raises redefining wellness care fraud offense increasing whistleblower
promises generating prevalent-feeling mental
point out requirement for well being care fraud offenses and increasing
funding in federal antifraud spending.
Certainly, regulation enforcers and prosecutors Ought to have
the equipment to successfully do their work. Nevertheless, these steps by itself, devoid of
inclusion of some tangible and major in advance
of-the-claim-is-compensated actions, will have minor affect on cutting
down the occurrence of the difficulty.
What is actually a person person's fraud (insurance company
alleging medically unneeded companies) is yet another person's savior (service provider
administering checks to protect from probable lawsuits from legal sharks).
Is tort reform a possibility from those people pushing for health and fitness care
reform ? Regretably, it is not ! Help for laws inserting new
and onerous requirements on providers in the identify of combating fraud, however, does not look
to be a dilemma.
If Congress genuinely would like to use its legislative
powers to make a variation on the fraud issue they will have to consider outside-the-box of what has
now been performed in some form or fashion. Concentration on some front-stop action that bargains with addressing
the fraud in advance of it transpires. The following are illustrative
of actions that could be taken in an energy to stem-the-tide on fraud
and abuse :
Demand all payors and vendors, suppliers and many others only use authorized coding devices,
the place the codes are evidently defined for ALL
to know and have an understanding of what the
specific code indicates. Prohibit everyone from deviating from
the described that means when reporting providers rendered (suppliers, suppliers) and adjudicating statements for
payment (payors and other people). Make violations a rigorous legal responsibility situation.
Demand that all submitted promises to general public and non-public insurers be signed or annotated in some trend by the patient (or proper
representative) affirming they received the noted and billed
products and services. If such affirmation is not
current declare isn't really paid. If the declare is later on determined to be problematic
investigators have the means to talk with equally the supplier and the affected person...
Demand that all statements-handlers (primarily if they have authority to spend
claims), consultants retained by insurers to guide on adjudicating promises, and fraud investigators
be licensed by a countrywide accrediting organization under the purview of the govt to show that they have the requisite knowing for recognizing health and fitness care fraud,
and the know-how to detect and look into the
fraud in health care claims. If these kinds of accreditation is not received, then neither the worker nor the marketing consultant
would be permitted to contact a health and fitness treatment declare or examine suspected
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expert services rendered to people. Whilst produced to universally
implement to facilitate precise reporting to reflect providers'
solutions, a lot of insurers instruct companies to report codes based mostly on what the insurer's pc editing plans understand - not on what the service provider rendered.
Additional, follow constructing consultants instruct providers on what codes to report to
get paid - in some instances codes that do not accurately reflect the
Consumers know what providers they get from their medical professional or other service provider but might not have
a clue as to what those people billing codes or services descriptors signify
on explanation of gains gained from insurers. This deficiency of being familiar with may well consequence in consumers transferring on without the need of
attaining clarification of what the codes suggest,
or may well result in some believing they were being improperly
billed. The multitude of insurance options readily available nowadays, with varying stages of coverage,
ad a wild card to the equation when companies are denied for
non-coverage - especially if it is Medicare that denotes non-covered providers as not medically needed.
three.Proactively addressing the overall health care fraud problem
The governing administration and insurers do quite small to proactively handle the difficulty with tangible actions that
will result in detecting inappropriate claims prior to they
are paid. In truth, payors of health treatment claims proclaim
to function a payment procedure dependent on have faith
in that vendors invoice correctly for providers rendered, as they can not review each declare before payment is built since the reimbursement method would
They declare to use sophisticated laptop or computer applications to look for mistakes and patterns in claims, have enhanced pre-
and post-payment audits of picked suppliers to detect fraud, and have made consortiums
and activity forces consisting of regulation enforcers and coverage investigators
to study the challenge and share fraud info. Nevertheless, this action,
for the most element, is working with activity after the declare is paid and has minor bearing on the proactive detection of
4.Exorcise wellness care fraud with the development of new legislation
The government's experiences on the fraud dilemma are printed in earnest in conjunction with attempts to reform our well being care procedure,
and our knowledge displays us that it in the long run results in the
authorities introducing and enacting new guidelines -
presuming new legislation will end result in a lot more fraud detected, investigated and prosecuted - devoid of establishing how new laws will carry out this more proficiently than existing guidelines that
had been not utilized to their complete prospective.
With these initiatives in 1996, we obtained the Wellbeing Insurance
coverage Portability and Accountability Act (HIPAA).
It was enacted by Congress to handle insurance policy portability and accountability for affected
person privateness and wellness treatment fraud and abuse.
HIPAA purportedly was to equip federal law enforcers and prosecutors with the instruments to assault
fraud, and resulted in the creation of a range of new overall health care fraud statutes,
together with : Health Treatment Fraud, Theft or Embezzlement in Well being Care, Obstructing Legal Investigation of Overall health
Care, and Bogus Statements Relating to Overall health Care Fraud Matters.
In 2009, the Wellness Treatment Fraud Enforcement Act appeared on the scene.
This act has recently been released by Congress with claims
that it will construct on fraud prevention initiatives and fortify the governments' potential to look into and
prosecute waste, fraud and abuse in both government and private wellness insurance plan by sentencing boosts redefining wellbeing treatment fraud offense strengthening whistleblower promises producing popular-sense psychological state prerequisite for
health and fitness treatment fraud offenses and raising
funding in federal antifraud paying out.
Without doubt, legislation enforcers and prosecutors Will have to have the resources to efficiently
do their work. Nevertheless, these steps alone, devoid of inclusion of some tangible and considerable
in advance of-the-claim-is-paid out steps, will have little influence
on lessening the incidence of the difficulty.
What's 1 person's fraud (insurer alleging medically unnecessary products and services)
is a different person's savior (service provider administering tests to defend in opposition to possible lawsuits from lawful sharks).
Is tort reform a chance from people pushing for wellness treatment reform ?
Sad to say, it is not ! Help for legislation inserting new and onerous prerequisites
on providers in the name of preventing fraud, having said that, does not look to be a
If Congress really desires to use its legislative
powers to make a big difference on the fraud trouble they should believe outside-the-box
of what has presently been accomplished in some variety or manner.
Concentrate on some entrance-close action that specials with addressing the fraud before
it takes place. The subsequent are illustrative of methods that could be taken in an work
to stem-the-tide on fraud and abuse :
Demand from customers all payors and vendors, suppliers
and some others only use approved coding units,
in which the codes are plainly defined for ALL to know and understand what
the particular code signifies. Prohibit everyone from deviating from the outlined that means when reporting services rendered (providers, suppliers) and adjudicating statements for payment
(payors and many others). Make violations a stringent liability situation.
Involve that all submitted statements to general public and private insurers be signed or annotated in some manner by the
client (or ideal agent) affirming they obtained the described
and billed solutions. If this sort of affirmation is not current claim is just not paid
out. If the declare is afterwards established to be problematic investigators have
the capability to communicate with both of those the
supplier and the patient...
Need that all claims-handlers (especially if they have authority to pay back promises), consultants retained by insurers to guide on adjudicating claims, and fraud investigators be qualified by a nationwide accrediting
corporation beneath the purview of the authorities
to exhibit that they have the requisite being familiar with for recognizing health and fitness treatment fraud, and
the awareness to detect and investigate the fraud in well being care statements.
If these accreditation is not obtained, then neither the employee nor
the specialist would be permitted to touch a well being treatment assert or look into suspected well being care fraud.
PROHIBIT public and personal payors from asserting fraud on statements beforehand
paid wherever it is established that the payor realized or need to
have recognized the declare was inappropriate and ought to not have been paid out.
And, in these instances in which fraud is set up in compensated statements any monies gathered from providers and suppliers for overpayments be deposited into a countrywide account to fund a variety of fraud and abuse training courses for individuals, insurers, legislation enforcers, prosecutors, legislators
and other individuals fund front-line investigators for condition health
and fitness care regulatory boards to investigate fraud in their
respective jurisdictions as nicely as funding other wellness
treatment connected action.
PROHIBIT insurers from increasing premiums of policyholders based mostly on estimates of the prevalence of fraud.
Demand insurers to build a factual foundation for
purported losses attributed to fraud coupled with displaying
tangible proof of their endeavours to detect and look into fraud, as well as not paying
5.Insurers are victims of wellness treatment fraud
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