False Claims Act & the Healthcare Industry PDF Download
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Author: Robert S. Salcido
Publisher:
ISBN: 9781663386311
Category : Fraud
Languages : en
Pages : 0
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Book Description
Author: Robert S. Salcido
Publisher:
ISBN: 9781663386311
Category : Fraud
Languages : en
Pages : 0
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Book Description
Author: Aspen Health Law Center
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 156
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Book Description
Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.
Author: Terry L. Leap
Publisher: Ilr Press
ISBN: 9780801449796
Category : Health & Fitness
Languages : en
Pages : 237
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Book Description
Confronting medical fraud and its economic, psychological, and social costs.
Author: Joel M. Androphy
Publisher: Law Journal Seminars Press
ISBN: 9781588521330
Category : Law
Languages : en
Pages :
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Book Description
This book covers the merits of a potential action; determining whether the relator would be barred or restricted from any recovery for retaliation and more.
Author: Paul W. Shaw
Publisher:
ISBN: 9781663315007
Category : Fraud investigation
Languages : en
Pages : 775
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Book Description
The authors examine each stage of a fraud and abuse investigation, beginning with an overview of federal and state enforcement agencies, and concluding with a discussion of the potential collateral consequences of an investigation. They have supplemented their analysis extensively with sample documents, including indictments, requests for records, subpoenas, internal response memoranda, and responses to auditors, prosecutors, and more. Taken together, the materials in this book provide a true Handbook for anyone who needs to quickly and thoroughly understand the complex nature of a government fraud and abuse investigation.-Preface.
Author: Stephen M. Kohn
Publisher: Rowman & Littlefield
ISBN: 0762774797
Category : Law
Languages : en
Pages : 355
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Book Description
UPDATED IN MARCH 2013 to include the historic $104-million Bradley Birkenfeld whistleblower case and more! From the nation’s leading whistleblower attorney, comes the third edition of the first-ever consumer guide to whistleblowing. In The Whistleblower’s Handbook, Stephen Martin Kohn explains nearly all federal and state laws regarding whistleblowing. In the step-by-step bulk of the book, he also presents twenty-one rules for whistleblowers.
Author: David E. Matyas
Publisher:
ISBN: 9781422434369
Category : Health insurance
Languages : en
Pages : 495
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Book Description
Author: Malcolm K Sparrow
Publisher: Basic Books
ISBN: 0465010741
Category : Political Science
Languages : en
Pages : 306
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Book Description
Who steals? An extraordinary range of folk -- from low-life hoods who sign on as Medicare or Medicaid providers equipped with nothing more than beepers and mailboxes, to drug trafficking organizations, organized crime syndicates, and even major hospital chains. In License to Steal, Malcolm K. Sparrow shows how the industry's defenses, which focus mostly on finding and correcting billing errors, are no match for such well orchestrated attacks. The maxim for thieves simply becomes "bill your lies correctly." Provided they do that, fraud perpetrators with any degree of sophistication can steal millions of dollars with impunity, testing payment systems carefully, and then spreading fraudulent billings widely enough across patient and provider accounts to escape detection. The kinds of highly automated, quality controlled claims processing systems that pervade the industry present fraud perpetrators with their favorite kind of target: rich, fast paying, transparent, utterly predictable check printing systems, with little threat of human intervention, and with the U.S. Treasury on the end of the electronic line. Sparrow picks apart the industry's response to the government's efforts to control this problem. The provider associations (well heeled and politically influential) have vociferously opposed almost every recent enforcement initiative, creating the unfortunate public impression that the entire health care industry is against effective fraud control. A significant segment of the industry, it seems, regards fraud and abuse not as a problem, but as a lucrative enterprise worth defending. Meanwhile, it remains a perfectly commonplace experience for patients or their relatives to examine a medical bill and discover that half of it never happened, or that; likewise, if patients then complain, they discover that no one seems to care, or that no one has the resources to do anything about it. Sparrow's research suggests that the growth of capitated managed care systems does not solve the problem, as many in the industry had assumed, but merely changes its form. The managed care environment produces scams involving underutilization, and the withholding of medical care schemes that are harder to uncover and investigate, and much more dangerous to human health. Having worked extensively with federal and state officials since the appearance of his first book on this subject, Sparrow is in a unique position to evaluate recent law enforcement initiatives. He admits the "war on fraud" is at least now engaged, but it is far from won.
Author: United States
Publisher:
ISBN:
Category : Law
Languages : en
Pages : 1146
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Book Description
"The United States Code is the official codification of the general and permanent laws of the United States of America. The Code was first published in 1926, and a new edition of the code has been published every six years since 1934. The 2012 edition of the Code incorporates laws enacted through the One Hundred Twelfth Congress, Second Session, the last of which was signed by the President on January 15, 2013. It does not include laws of the One Hundred Thirteenth Congress, First Session, enacted between January 2, 2013, the date it convened, and January 15, 2013. By statutory authority this edition may be cited "U.S.C. 2012 ed." As adopted in 1926, the Code established prima facie the general and permanent laws of the United States. The underlying statutes reprinted in the Code remained in effect and controlled over the Code in case of any discrepancy. In 1947, Congress began enacting individual titles of the Code into positive law. When a title is enacted into positive law, the underlying statutes are repealed and the title then becomes legal evidence of the law. Currently, 26 of the 51 titles in the Code have been so enacted. These are identified in the table of titles near the beginning of each volume. The Law Revision Counsel of the House of Representatives continues to prepare legislation pursuant to 2 U.S.C. 285b to enact the remainder of the Code, on a title-by-title basis, into positive law. The 2012 edition of the Code was prepared and published under the supervision of Ralph V. Seep, Law Revision Counsel. Grateful acknowledgment is made of the contributions by all who helped in this work, particularly the staffs of the Office of the Law Revision Counsel and the Government Printing Office"--Preface.
Author: Rebecca S. Busch
Publisher: John Wiley & Sons
ISBN: 1118179803
Category : Business & Economics
Languages : en
Pages : 374
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Book Description
An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.
