Health Care Fraud and Abuse

Health Care Fraud and Abuse PDF 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.

Health Care Fraud and Abuse

Health Care Fraud and Abuse PDF Author: Aspen Health Law Center
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 156

Get Book Here

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.

Fraud and Abuse Investigations Handbook for the Health Care Industry

Fraud and Abuse Investigations Handbook for the Health Care Industry PDF 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.

The Health Care Fraud and Abuse Control Program

The Health Care Fraud and Abuse Control Program PDF Author: Curtis Wood
Publisher: Nova Science Publishers
ISBN: 9781634637107
Category : SOCIAL SCIENCE
Languages : en
Pages : 169

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Book Description
In fiscal year 2012, the Department of Health and Human Services (HHS), HHS Office of Inspector General (HHS-OIG), and the Department of Justice (DOJ) obligated approximately $583.6 million to fund Health Care Fraud and Abuse Control (HCFAC) program activities. This book describes how HHS and DOJ obligated funds for the HCFAC program; examines how HHS and DOJ assess HCFAC activities and whether key program outputs have changed over time; and examines what is known about the effectiveness of the HCFAC program in reducing health care fraud and abuse.

Health Care Fraud and Abuse Control Program

Health Care Fraud and Abuse Control Program PDF Author: United States. Government Accountability Office
Publisher: DIANE Publishing
ISBN: 1428931074
Category : Medicare fraud
Languages : en
Pages : 41

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Book Description


Prescription for Profit

Prescription for Profit PDF Author: Paul Jesilow
Publisher: Univ of California Press
ISBN: 0520911830
Category : Medical
Languages : en
Pages : 366

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Book Description
In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing. How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment. The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity. Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.

The Role of the Office of the Inspector General

The Role of the Office of the Inspector General PDF Author: United States. Social Security Administration. Office of the Inspector General
Publisher:
ISBN:
Category : Fraud
Languages : en
Pages : 2

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Book Description


Standards for Internal Control in the Federal Government

Standards for Internal Control in the Federal Government PDF Author: United States Government Accountability Office
Publisher: Lulu.com
ISBN: 0359541828
Category : Reference
Languages : en
Pages : 88

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Book Description
Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers' Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government.

Health Care Fraud and Abuse Control Program

Health Care Fraud and Abuse Control Program PDF Author: Daniel R. Levinson
Publisher: DIANE Publishing
ISBN: 1437935176
Category : Medical
Languages : en
Pages : 71

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Book Description
During FY 2009, the Fed. Gov¿t. won or negotiated approx. $1.63 billion in judgments and settlements, and it attained additional admin. impositions in health care fraud cases and proceedings. The Medicare Trust Fund received transfers of approx. $2.51 billion during this period as a result of these efforts, as well as those of preceding years, in addition to over $441 million in Fed. Medicaid money similarly transferred separately to the Treasury as a result of these efforts. The Health Care Fraud and Abuse Control Program account has returned over $15.6 billion to the Medicare Trust Fund since the inception of the Program in 1997. In FY 2009, U.S. Attorneys' Offices opened 1,014 new criminal health care fraud investigations involving 1,786 defendants. Illus.

Fraud and Abuse in the Medicare and Medicaid Programs

Fraud and Abuse in the Medicare and Medicaid Programs PDF Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
ISBN:
Category : Fraud
Languages : en
Pages : 36

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Book Description


Emerging Fraud

Emerging Fraud PDF Author: Kiymet Tunca Caliyurt
Publisher: Springer Science & Business Media
ISBN: 3642208258
Category : Business & Economics
Languages : en
Pages : 200

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Book Description
Fraud has become a challenging phenomena affecting economies worldwide. Anti-fraud measures are an integral part of today’s management practices and have found their way into business education. Yet in developing countries these topics have long been neglected and only limited research has been conducted in this area. This book fills an essential gap by analyzing the impact of fraud on developing economies, describing successful anti-fraud methods and featuring cases that exemplify the measures described. The book features contributions by outstanding experts in the field and is intended for academic readers with a special interest in fraud research.