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.

Title XX Social Services

Title XX Social Services PDF Author:
Publisher:
ISBN:
Category : Family violence
Languages : en
Pages : 40

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Book Description


Prescription for Profit

Prescription for Profit PDF Author: Paul Jesilow
Publisher: University of California Presson Demand
ISBN: 9780520076143
Category : Medical
Languages : en
Pages : 247

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Book Description
"A sound, well written, and highly interesting examination of how Medicaid . . . has given far too many physicians an opportunity to 'mop up' fraudulently, for their own financial gain, some of the $61 billion annual cost of the program."--Marshall B. Clinard, author of "The Abuse of Corporate Power" "A searching analysis of a problem that is of enormous concern to every nation. It is a lively, insightful treatment of the Medicaid malady, using the best diagnostics available to contemporary criminology."--John Braithwaite, Australian National University

Phantom Billing, Fake Prescriptions, and the High Cost of Medicine

Phantom Billing, Fake Prescriptions, and the High Cost of Medicine PDF 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.

The Medicare Handbook

The Medicare Handbook PDF Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 44

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Book Description


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.

A Health Care Quality Improvement System for Medicaid Managed Care

A Health Care Quality Improvement System for Medicaid Managed Care PDF Author:
Publisher:
ISBN:
Category : Government publications
Languages : en
Pages : 114

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Book Description


Statistics and Health Care Fraud

Statistics and Health Care Fraud PDF Author: Tahir Ekin
Publisher: CRC Press
ISBN: 1315278243
Category : Mathematics
Languages : en
Pages : 161

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Book Description
Statistics and Health Care Fraud: How to Save Billions helps the public to become more informed citizens through discussions of real world health care examples and fraud assessment applications. The author presents statistical and analytical methods used in health care fraud audits without requiring any mathematical background. The public suffers from health care overpayments either directly as patients or indirectly as taxpayers, and fraud analytics provides ways to handle the large size and complexity of these claims. The book starts with a brief overview of global healthcare systems such as U.S. Medicare. This is followed by a discussion of medical overpayments and assessment initiatives using a variety of real world examples. The book covers subjects as: • Description and visualization of medical claims data • Prediction of fraudulent transactions • Detection of excessive billings • Revealing new fraud patterns • Challenges and opportunities with health care fraud analytics Dr. Tahir Ekin is the Brandon Dee Roberts Associate Professor of Quantitative Methods in McCoy College of Business, Texas State University. His previous work experience includes a working as a statistician on health care fraud detection. His scholarly work on health care fraud has been published in a variety of academic journals including International Statistical Review, The American Statistician, and Applied Stochastic Models in Business and Industry. He is a recipient of the Texas State University 2018 Presidential Distinction Award in Scholar Activities and the ASA/NISS y-Bis 2016 Best Paper Awards. He has developed and taught courses in the areas of business statistics, optimization, data mining and analytics. Dr. Ekin also serves as Vice President of the International Society for Business and Industrial Statistics.

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 : Medicaid fraud
Languages : en
Pages : 32

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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.