Download or read book Health Care Fraud and Abuse written by Aspen Health Law Center and published by . This book was released on 1998 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Fraud and Abuse Investigations Handbook for the Health Care Industry written by Paul W. Shaw and published by . This book was released on 2021 with total page 775 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Phantom Billing Fake Prescriptions and the High Cost of Medicine written by Terry L. Leap and published by Ilr Press. This book was released on 2011 with total page 237 pages. Available in PDF, EPUB and Kindle. Book excerpt: Confronting medical fraud and its economic, psychological, and social costs.
Download or read book What is the Anti kickback Statute written by Thomas S. Crane and published by American Bar Association. This book was released on 2015 with total page 69 pages. Available in PDF, EPUB and Kindle. Book excerpt: Learn how the Anti-Kickback Statute protects the healthcare system and beneficiaries from the influence of money on referral decisions.
Download or read book Fraud and abuse in the medicare and medicaid programs written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1977 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Health Care Quality Improvement System for Medicaid Managed Care written by and published by . This book was released on 1993 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Title XX Social Services written by and published by . This book was released on 1980 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Improving the Quality of Long Term Care written by Institute of Medicine and published by National Academies Press. This book was released on 2001-02-27 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Download or read book Healthcare Fraud written by Rebecca S. Busch and published by John Wiley & Sons. This book was released on 2012-05-01 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Fighting Fraud and Waste in Medicare and Medicaid written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 2012 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The CMS Hospital Conditions of Participation and Interpretive Guidelines written by and published by . This book was released on 2017-11-27 with total page 546 pages. Available in PDF, EPUB and Kindle. Book excerpt: In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.
Download or read book Crossing the Global Quality Chasm written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-01-27 with total page 399 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Download or read book Government Code written by Texas and published by . This book was released on 2000 with total page 556 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Civil False Claims and Qui Tam Actions written by John T. Boese and published by Aspen Publishers. This book was released on 2010-12 with total page 1970 pages. Available in PDF, EPUB and Kindle. Book excerpt: Civil False Claims and Qui Tam Actions is an essential weapon for bringing or defending a qui tam action. This Fourth Edition, two-volume treatise provides comprehensive analysis of The Civil False Claims Statute and a balanced approach to every important aspect of case preparation and litigation -- from establishing the merits of a whistleblower claim to determining the formula for arriving at the qui tam plaintiff's award. Civil False Claims and Qui Tam Actions, frequently cited by the courts, is clearly and concisely written to: walk you, step-by-step, through each phase of case preparation, from the perspective of both plaintiff-relator and whistleblower defendant spell out the unique procedural requirements in a civil false claims action -- from the applicability of statute of limitation rules to the scope of discovery under a andquot;civil investigation demandandquot; by the federal government explain how to draft a whistleblower complaint collect, organize and interpret the controlling case law direct you to the relevant statutory whistleblower provisions, rules and regulations that apply to the issues under discussion analyze the legislative history of The False Claims Act and explains why it is essential to the success of a prosecutor's or defense's cause of action and alert you to emerging trends in civil false claims and qui tam actions For the best guidance on how to bring or defend a qui tam action, consult the civil false claims specialist - John T. Boese. John T. Boese is an expert author and litigation partner in the Washington, DC law office of Fried, Frank, Harris, Shriver andamp; Jacobson. with more than 25 years of experience in civil fraud cases, both as a former DOJ attorney and as defense counsel. In a clear and straightforward manner, he offers his expert analysis of recent developments on: The Supreme Court's decision on andquot;original sourceandquot; in Rockwell The recent trend by state legislatures to enact false claims laws that mirror the federal law. The andquot;presentmentandquot; requirement Corporate liability under The Civil False Claims Act Interpreting the public disclosure bar and original source requirement Challenges to sufficiency of FCA complaints under Rule 9(b) The Civil False Claims Act has captured the attention of any organization doing business with the federal government, for very good reasons: Virtually any person that receives, spends or uses federal money may be liable under The Civil False Claims Act. Private individuals, including employees can be whistleblowers on contractor fraud by bringing a qui tam lawsuit on behalf of the federal government - and receive up to 30% of any judgment or settlement. The courts have upheld highly creative claims brought under The Civil False Claims Act. Don't get lost in the maze of changing, complicated, and confusing qui tam provisions, whistleblower rules, and civil false claims regulations!
Download or read book Conditions of Participation for Hospitals written by United States. Social Security Administration and published by . This book was released on 1966 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Affordable Care Act and Medicare in Comparative Context written by Eleanor D. Kinney and published by Cambridge University Press. This book was released on 2015-07-20 with total page 487 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive and approachable overview of Medicare under the Affordable Care Act. The author illustrates how the ACA addresses the long-term fiscal and demographic challenges facing Medicare, as well as the potential for Medicare to become a single-payer system.
Download or read book Health Care Fraud as it Affects the Aging written by United States. Congress. Senate. Special Committee on Aging and published by . This book was released on 1993 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt:
