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 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 License To Steal written by Malcolm K Sparrow and published by Basic Books. This book was released on 2007-12-14 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Medicaid Drug Fraud written by Timothy D. Crowe and published by DIANE Publishing. This book was released on 1994 with total page 62 pages. Available in PDF, EPUB and Kindle. Book excerpt: A pill millÓ operates when physicians, clinic owners, & pharmacists collect to defraud Medicaid by prescribing & distributing drugs mainly to obtain reimbursement. Patients are often knowing participants in these schemes, allowing use of their Medicaid recipient numbers for billing purposes in exchange for cash, drugs, or other inducements. This report assesses the extent of the drug diversion problem, the reasons it persists, & what actions are being taken to bring it under control. Charts & tables.
Download or read book The Medicare Handbook written by and published by . This book was released on 1988 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book How Increased Competition from Generic Drugs Has Affected Prices and Returns in the Pharmaceutical Industry written by and published by U.S. Government Printing Office. This book was released on 1998 with total page 94 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicaid Drug Fraud Medical Malpractice and Reliability of Claims Processing for Medicare written by DIANE Publishing Company and published by DIANE Publishing. This book was released on 1994-06 with total page 105 pages. Available in PDF, EPUB and Kindle. Book excerpt: Assesses the extent of the drug diversion problem, the reason it persists, & what actions are being taken to bring it under control. Compares the incidence & outcomes of malpractice litigation involving Medicare & Medicaid patients to that of the general population & analyzes aggregate hospital data on malpractice losses for Medicare, Medicaid, & other hospital patients. Assesses the methods being used to approve or deny Medicare Part B claims. Describes the characteristics of claims denials that are appealed & of those that are reversed. Illustrated.
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 Medicaid Drug Fraud written by United States. General Accounting Office and published by . This book was released on 1993 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Federal False Claims Act and Qui Tam Litigation written by Joel M. Androphy and published by Law Journal Seminars Press. This book was released on 2005 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
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 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 Emerging Fraud written by Kiymet Tunca Caliyurt and published by Springer Science & Business Media. This book was released on 2012-03-31 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Pharmaceuticals Corporate Crime and Public Health written by Graham Dukes and published by Edward Elgar Publishing. This book was released on 2014-06-27 with total page 419 pages. Available in PDF, EPUB and Kindle. Book excerpt: The pharmaceutical industry exists to serve the community, but over the years it has engaged massively in corporate crime, with the public footing the bill. This readable study by experts in medicine, law, criminology and public health documents the pr
Download or read book Michigan Court Rules written by Kelly Stephen Searl and published by . This book was released on 1922 with total page 520 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicaid Fraud prescription Drug Diversion written by United States. Congress. House. Committee on Government Operations. Human Resources and Intergovernmental Relations Subcommittee and published by . This book was released on 1995 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: Distributed to some depository libraries in microfiche.
Download or read book Understanding Telehealth written by Karen Schulder Rheuban and published by McGraw Hill Professional. This book was released on 2017-12-22 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first complete guide to the rapidly expanding field of telehealth From email to videoconferencing, telehealth puts real-time healthcare solutions at patients’ and clinicians’ fingertips. Every year, the field continues to evolve, enhancing access to healthcare, supporting clinicians, and improving the patient experience. However, since telehealth is in its infancy, no text has offered a comprehensive, definitive survey of this up-and-coming field—until now. Written by past presidents of the American Telemedicine Association, Understanding Telehealth explains how clinical applications leveraging telehealth technology are optimizing healthcare delivery. In addition, this timely resource examines the bedrock principles of telehealth and highlights the safety standards involved in the diagnosis and treatment of patients through digital communications. Logically organized and supported by high-yield clinical vignettes, the book begins with essential background information, including a look at telehealth history, definitions and roles, and rural health. It then provides an overview of clinical services for adults, from telestroke to telepsychiatry. The third section addresses pediatric clinical services, encompassing pediatric emergency and critical care, telecardiology, and more. A groundbreaking resource: •Chapters cover a broad spectrum of technologies, evidence-based guidelines, and application of telehealth across the healthcare continuum •Ideal for medical staff, public healthcare executives, hospitals, clinics, payors, healthcare advocates, and researchers alike •Incisive coverage of the legal and regulatory environment underpinning telehealth practice
