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.

Federal False Claims Act and Qui Tam Litigation

Federal False Claims Act and Qui Tam Litigation PDF 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.

Medicare-Medicaid Anti-fraud Act

Medicare-Medicaid Anti-fraud Act PDF Author: United States. Congress. House. Committee on Interstate and Foreign Commerce. Subcommittee on Health and the Environment
Publisher:
ISBN:
Category : Medicaid fraud
Languages : en
Pages : 176

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Book Description


What is ... the Anti-kickback Statute?

What is ... the Anti-kickback Statute? PDF Author: Thomas S. Crane
Publisher: American Bar Association
ISBN: 9781627228763
Category : Law
Languages : en
Pages : 69

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Book Description
Learn how the Anti-Kickback Statute protects the healthcare system and beneficiaries from the influence of money on referral decisions.

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


Whistleblower's Handbook

Whistleblower's Handbook PDF 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.

License To Steal

License To Steal PDF 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.

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


Medicaid Eligibility Quality Control

Medicaid Eligibility Quality Control PDF Author: United States. Social and Rehabilitation Service
Publisher:
ISBN:
Category : Medicaid
Languages : en
Pages : 460

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Book Description


United States Attorneys' Manual

United States Attorneys' Manual PDF Author: United States. Department of Justice
Publisher:
ISBN:
Category : Justice, Administration of
Languages : en
Pages : 720

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Book Description