Download or read book AHLA Legal Issues in Health Care Fraud and Abuse AHLA Members written by Laura F. Laemmle-Weidenfeld and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This completely updated fifth edition offers broad coverage of the full range of U.S. fraud and abuse prohibitions, with practical application for your work in health care today. Completely updated to address the latest trends in investigation, enforcement, and interpretations of the law, this edition of Legal Issues in Health Care Fraud and Abuse addresses the sweeping changes seen in the health care industry since the previous edition, with over 600 pages of expert explanations and fully referenced real-world examples.With in-depth coverage of the Anti-Kickback Law, Stark Law, False Claims Act, and more, this book is a necessity for anyone who needs to understand the intricacies of how fraud and abuse laws are structured and enforced in the health care context, providing a foundation for your work in health law:How health care is regulated in the United StatesHow fraud and abuse laws are enforced by federal and state entitiesPractical advice on assessing and addressing riskGuidance on navigating relationships with the agencies and individuals enforcing the law's prohibitionsAs health care and society evolve, so too does fraud and abuse law and governmental enforcement activity. Since the previous edition of this book, the risks relating to fraud and abuse have evolved significantly, for reasons ranging from the proliferation of health care data, to the expansion of the use of technology in health care, to changes in the regulatory scheme resulting from the shift toward value-based payment. Every chapter analyzes the impact of these changes.
Download or read book AHLA Healthcare Compliance Legal Issues Manual Non Members written by and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: As the world of health care compliance continues to evolve, so do the potential ramifications for everyone in the healthcare arena. State and federal governmental agencies continue to pursue large recoveries through litigation and settlements against those who don't have effective compliance plans. In fact, the Federal Government announced it had recovered over $4 billion from healthcare providers for Medicare and Medicaid fraud in 2010 alone.This new edition of Health Care Compliance Legal Issues Manual provides a comprehensive overview of the legal issues that create the foundation for healthcare compliance programs, and affect every aspect of these programs. The Manual addresses important topics such as what a compliance program is, how to conduct internal investigations, audit basics, what to consider prior to deciding on repayments and disclosures, substantive overviews of the false claims act, the Stark and Anti-kickback laws, HIPAA privacy and security, issues in life sciences entities, tax compliance, and many othersHighlights of this new edition include:A discussion of the Sunshine Act's reporting requirements for drug and device companiesHHS' Healthy People 2020 initiativeAnalysis of the fraud and abuse provisions in the Patient Protection and Affordable Care Act (ACA)Compliance program requirements for all providers and suppliers as a condition of enrollment in MedicareChanges to the Federal Sentencing GuidelinesNew HIPAA security and privacy enforcement measuresSarbanes-Oxley compliance standards
Download or read book AHLA False Claims Act The Healthcare Industry Non Members written by and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Significant events have occurred regarding the government's enforcement and administration of the False Claims Act (FCA) in the last few years. The government has continued to negotiate major settlements against healthcare entities, and the courts have issued numerous decisions that impact the manner in which healthcare businesses are organized and operated. In 2012, the Department of Justice announced that $3 billion of the $5 billion recovered under the FCA was health-related. With these recent developments in FCA litigation and the rapidly developing case law, you will need the Second Edition of False Claims Act & the Healthcare Industry and the 2014 Cumulative SupplementThis authoritative treatise will keep you up-to-date on the latest FCA developments so that you can more effectively advise your client on how to assess their company's potential exposure to liability, evaluate the exposure of companies that they may acquire, and reform company practices to reduce the risk of potential FCA liability.EXPERT ANALYSIS: THE ELEMENTS THAT CREATE LIABILITY UNDER THE FCAWhat does it mean to "Present or Cause to Present" a false claim?How do courts determine whether a claim is "False or Fraudulent"?How does one "know" under the FCA, that a claim is "False"?When is a claim "Material" to the government's determination to pay?LEADING DEFENSES THAT RESULT IN THE DISMISSAL OF QUI TAM ACTIONSWhen are lawsuits barred under the FCA public disclosure bar?What must the whistleblower prove to show that she qualifies as an "original source"?Under what circumstances do courts dismiss actions for failure to state fraud with specificity under Fed.R.Civ.P.9(b)?Under what circumstances does a plaintiff fail to show that defendant submitted a "false" claim or statement under the FCA?Under what circumstances does a plaintiff fail to establish that the defendant "knew" that a claim wa false or fraudulent?FCA DAMAGESHow do courts compute FCA damages in Healthcare upcoding cases and in cases alleging a violation of the FCA because of a violation of the Anti-Kickback or Stark Law?What are the limits courts may impose on the government's or whistleblower's ability to recover FCA damages?FCA STATUTE OF LIMITATIONSHow do courts compute the FCA statute of limitations?VOLUNTARY DISCLOSURES TO THE OIGUnder what circumstances should a company consider submitting a voluntary disclosure?What is the process underlying the submission of a voluntary disclosure?What are the potential benefits and risks associated with submitting a voluntary disclosure?THE FCA WHISTLEBLOWER RETALIATION PROVISIONWhat does a retaliated against "whistleblower" need to prove to obtain damages from the employer?The eBook versions of this title feature links to Lexis Advance for further legal research options.
Download or read book AHLA Stark Final Regulations written by Charles B. Oppenheim and published by . This book was released on 2005-06-01 with total page 53 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book AHLA PDF Homecare V Medshares written by American Health Lawyers Association and published by . This book was released on 2006-09-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book AHLA Healthcare Compliance Legal Issues Manual AHLA Members written by and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: As the world of health care compliance continues to evolve, so do the potential ramifications for everyone in the healthcare arena. State and federal governmental agencies continue to pursue large recoveries through litigation and settlements against those who don't have effective compliance plans. In fact, the Federal Government announced it had recovered over $4 billion from healthcare providers for Medicare and Medicaid fraud in 2010 alone.This new edition of Health Care Compliance Legal Issues Manual provides a comprehensive overview of the legal issues that create the foundation for healthcare compliance programs, and affect every aspect of these programs. The Manual addresses important topics such as what a compliance program is, how to conduct internal investigations, audit basics, what to consider prior to deciding on repayments and disclosures, substantive overviews of the false claims act, the Stark and Anti-kickback laws, HIPAA privacy and security, issues in life sciences entities, tax compliance, and many othersHighlights of this new edition include:A discussion of the Sunshine Act's reporting requirements for drug and device companiesHHS' Healthy People 2020 initiativeAnalysis of the fraud and abuse provisions in the Patient Protection and Affordable Care Act (ACA)Compliance program requirements for all providers and suppliers as a condition of enrollment in MedicareChanges to the Federal Sentencing GuidelinesNew HIPAA security and privacy enforcement measuresSarbanes-Oxley compliance standards
Download or read book Fraud and Abuse Investigations Handbook for the Healthcare Industry written by Robert A. Griffith and published by . This book was released on 2000 with total page 424 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Fraud and Abuse written by Linda A. Baumann and published by Bna Books. This book was released on 2007 with total page 913 pages. Available in PDF, EPUB and Kindle. Book excerpt: Baumann (of Arent Fox LLP in Washington, DC) presents a general information reference resource for attorneys working in the field of health law that has been revised so as to be current through May 2007, although some material has been updated past that date in order to cover significant new developments, such as the new Stark III regulations issued in September 2007. Following the introduction, nine chapters address federal physician self-referral restrictions; application of the substantive, qui tam, and voluntary disclosure provisions of the False Claims Act in health care prosecutions; practical considerations for defending health care fraud and abuse cases; legal issues surrounding hospital and physician relationships; risk areas in managed care fraud and abuse for government program participants; corporate compliance programs; potential liabilities for directors and officers of health care organizations; disclosure of qui tam suits and investigations; and control of fraud, waste, and abuse in the Medicare Part D Program.
Download or read book AHLA Stark Final Regulations written by American Health Lawyers Association and published by . This book was released on 2005-06-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Compliance Legal Issues Manual written by Harry R. Silver and published by . This book was released on 2011 with total page 455 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Ahla Fraud and Abuse Investigations Handbook for the Healthcare Industry written by Robert A. Griffith and published by . This book was released on 2014 with total page 774 pages. Available in PDF, EPUB and Kindle. Book excerpt: If you are not an AHLA member and would like to purchase this title, click here. Understanding the powers, procedures and remedies available to the government during a health care fraud and abuse investigation, and acquiring a basic understanding of the issues and practical steps to employ during an audit or investigation, are keys to surviving the investigation and achieving a favorable outcome. This new Handbook will arm health care administrators, executives, medical directors, office managers, physicians, and medical practice managers with a broad understanding of this industry- specific area of government enforcement. The resource is complete with: * Clear and concise explanations of the law * Sample government documents, affidavits, and subpoenas accompanying each chapter * Illustrative pleadings and memoranda prepared by prosecutors and defense attorneys The authors detail the nuts and bolts of a fraud and abuse investigation, from an overview of the various federal and state enforcement agencies to the potential of settling a case. Learn what to expect and how to respond with coverage of: * Requests to examine books and records dealing with an organization's programs and operations * Interviews of employees by the OIG or the FBI * The power of HIPAA administrative subpoenas and the broad authority granted under this statute * Steps that should be taken in responding to the government's request * Dealing with on-site demands for records and access * Internal audits and investigations * Voluntary disclosures * Affirmative actions to try and fend off an investigation, plea agreements, and deferred prosecution
Download or read book False Claims Act the Healthcare Industry written by Robert S. Salcido and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Significant events have occurred regarding the government's enforcement and administration of the False Claims Act (FCA) in the last few years. The government has continued to negotiate major settlements against healthcare entities, and the courts have issued numerous decisions that impact the manner in which healthcare businesses are organized and operated. In 2012, the Department of Justice announced that $3 billion of the $5 billion recovered under the FCA was health-related. With these recent developments in FCA litigation and the rapidly developing case law, you will need the Second Edition of False Claims Act & the Healthcare Industry and the 2014 Cumulative SupplementThis authoritative treatise will keep you up-to-date on the latest FCA developments so that you can more effectively advise your client on how to assess their company's potential exposure to liability, evaluate the exposure of companies that they may acquire, and reform company practices to reduce the risk of potential FCA liability.EXPERT ANALYSIS: THE ELEMENTS THAT CREATE LIABILITY UNDER THE FCAWhat does it mean to "Present or Cause to Present" a false claim?How do courts determine whether a claim is "False or Fraudulent"?How does one "know" under the FCA, that a claim is "False"?When is a claim "Material" to the government's determination to pay?LEADING DEFENSES THAT RESULT IN THE DISMISSAL OF QUI TAM ACTIONSWhen are lawsuits barred under the FCA public disclosure bar?What must the whistleblower prove to show that she qualifies as an "original source"?Under what circumstances do courts dismiss actions for failure to state fraud with specificity under Fed.R.Civ.P.9(b)?Under what circumstances does a plaintiff fail to show that defendant submitted a "false" claim or statement under the FCA?Under what circumstances does a plaintiff fail to establish that the defendant "knew" that a claim wa false or fraudulent?FCA DAMAGESHow do courts compute FCA damages in Healthcare upcoding cases and in cases alleging a violation of the FCA because of a violation of the Anti-Kickback or Stark Law?What are the limits courts may impose on the government's or whistleblower's ability to recover FCA damages?FCA STATUTE OF LIMITATIONSHow do courts compute the FCA statute of limitations?VOLUNTARY DISCLOSURES TO THE OIGUnder what circumstances should a company consider submitting a voluntary disclosure?What is the process underlying the submission of a voluntary disclosure?What are the potential benefits and risks associated with submitting a voluntary disclosure?THE FCA WHISTLEBLOWER RETALIATION PROVISIONWhat does a retaliated against "whistleblower" need to prove to obtain damages from the employer?The eBook versions of this title feature links to Lexis Advance for further legal research options.
Download or read book Vaccine Vaccination and Immunization Law written by Brian Dean Abramson and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Pharmaceutical and Medical Device Compliance Manual written by Ela Bochenek and published by . This book was released on 2019 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: A robust compliance program is essential to protecting a company from running afoul of the myriad laws and regulations that have been enacted to combat fraud and waste. The second edition of the Pharmaceutical and Medical Device Compliance Manual includes guidance to help companies develop a compliance program tailored to today's complex enforcement and business environment. Study of this Manual will enable compliance professionals and lawyers to understand the government's expectations of an effective compliance program and ethical business practices, as well as: how the government discovers potential enforcement actions, its approach to pursuing such actions, what behaviors can constitute mitigating factors for a company in the event of a legal violation. Coverage includes new chapters covering:Pharmaceutical industry interactions with patient organizations Compliance 2.0: compliance analytics in the era of big dataThe art and science of health care compliance in the pharmaceutical and medical device industries The Manual will be a great tool for health and life sciences attorneys, compliance officers, and others in the pharmaceutical and medical devices industry
Download or read book The Cambridge Handbook of the Law of the Sharing Economy written by Nestor M. Davidson and published by Cambridge University Press. This book was released on 2018-11-22 with total page 952 pages. Available in PDF, EPUB and Kindle. Book excerpt: This Handbook grapples conceptually and practically with what the sharing economy - which includes entities ranging from large for-profit firms like Airbnb, Uber, Lyft, Taskrabbit, and Upwork to smaller, non-profit collaborative initiatives - means for law, and how law, in turn, is shaping critical aspects of the sharing economy. Featuring a diverse set of contributors from many academic disciplines and countries, the book compiles the most important, up-to-date research on the regulation of the sharing economy. The first part surveys the nature of the sharing economy, explores the central challenge of balancing innovation and regulatory concerns, and examines the institutions confronting these regulatory challenges, and the second part turns to a series of specific regulatory domains, including labor and employment law, consumer protection, tax, and civil rights. This groundbreaking work should be read by anyone interested in the dynamic relationship between law and the sharing economy.
Download or read book Risk Management Handbook for Health Care Organizations written by American Society for Healthcare Risk Management (ASHRM) and published by John Wiley & Sons. This book was released on 2009-04-27 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Risk Management Handbook for Health Care Organizations, Student Edition This comprehensive textbook provides a complete introduction to risk management in health care. Risk Management Handbook, Student Edition, covers general risk management techniques; standards of health care risk management administration; federal, state and local laws; and methods for integrating patient safety and enterprise risk management into a comprehensive risk management program. The Student Edition is applicable to all health care settings including acute care hospital to hospice, and long term care. Written for students and those new to the topic, each chapter highlights key points and learning objectives, lists key terms, and offers questions for discussion. An instructor's supplement with cases and other material is also available. American Society for Healthcare Risk Management (ASHRM) is a personal membership group of the American Hospital Association with more than 5,000 members representing health care, insurance, law, and other related professions. ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking, and interactions with leading health care organizations and government agencies. ASHRM initiatives focus on developing and implementing safe and effective patient care practices, preserving financial resources, and maintaining safe working environments.
Download or read book Food and Beverage Management written by Bernard Davis and published by Routledge. This book was released on 2013-01-11 with total page 412 pages. Available in PDF, EPUB and Kindle. Book excerpt: This introductory textbook provides a thorough guide to the management of food and beverage outlets, from their day-to-day running through to the wider concerns of the hospitality industry. It explores the broad range of subject areas that encompass the food and beverage market and its five main sectors – fast food and popular catering, hotels and quality restaurants and functional, industrial, and welfare catering. New to this edition are case studies covering the latest industry developments, and coverage of contemporary environmental concerns, such as sourcing, sustainability and responsible farming. It is illustrated in full colour and contains end-of-chapter summaries and revision questions to test your knowledge as you progress. Written by authors with many years of industry practice and teaching experience, this book is the ideal guide to the subject for hospitality students and industry practitioners alike.
