Complying With Health Care Fraud And Abuse Laws

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Health Care Fraud and Abuse

Author : Aspen Health Law Center
Publisher :
ISBN 13 :
Total Pages : 156 pages
Book Rating : 4.0/5 ( download)

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Book Synopsis Health Care Fraud and Abuse by : Aspen Health Law Center

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.

AHLA Health Care Compliance Legal Issues Manual (Non-members)

Author : American Health Lawyers Association
Publisher :
ISBN 13 : 9781522173441
Total Pages : pages
Book Rating : 4.1/5 (734 download)

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Book Synopsis AHLA Health Care Compliance Legal Issues Manual (Non-members) by : American Health Lawyers Association

Download or read book AHLA Health Care Compliance Legal Issues Manual (Non-members) written by American Health Lawyers Association and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Authored by experts with years of health care compliance experience, this new edition integrates changes in regulation, trends in enforcement, and the reasoning of the courts to help you navigate emerging and unsettled areas of compliance risk, such as self-disclosure obligations, risks associated with opioid use, and the impact of statistical sampling.Highlights of this edition include:All new glossary of health care compliance terms, including key statutes, acronyms, governing agencies, and moreExpanded civil monetary penalty and exclusion authorities under 2017 final rulesDiscussion of core elements of compliance programs for Medicare Advantage Plans and Part D Plans as established by federal regulationsExpanded whistleblower protections under federal and state law, false claims based on lack of medical necessity, materiality after Escobar, and recent enforcement activityExpanded discussion of determinations of medical necessity, CMS review of medical necessity terminations, consequences, and appeals processesRecent health information privacy and security developments, including new guidance, risks associated with innovative technologies, and trends in Health Insurance Portability and Accountability Act (HIPAA) enforcement activityNew chapters:Chapter 1, Glossary of Key TermsChapter 10, The Relationship between Enforcement and ComplianceChapter 17, Health Care Civil Rights and Nondiscrimination Under Section 1557 of the Affordable Care ActChapter 19, Behavioral Health

Managing Legal Compliance in the Health Care Industry

Author : George B. Moseley III
Publisher : Jones & Bartlett Publishers
ISBN 13 : 1449639658
Total Pages : 598 pages
Book Rating : 4.4/5 (496 download)

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Book Synopsis Managing Legal Compliance in the Health Care Industry by : George B. Moseley III

Download or read book Managing Legal Compliance in the Health Care Industry written by George B. Moseley III and published by Jones & Bartlett Publishers. This book was released on 2013-09-20 with total page 598 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managing Legal Compliance in the Health Care Industry is a comprehensive text that prepares students for this increasingly critical field in health care administration. In three sections, this unique title first examines all the key laws and regulations that health care organizations must comply with. In section two, it explores in detail the seven essential ingredients for a good compliance program. In the final section, the book explains how the compliance program must be adapted to the special needs of different types of health care organizations. Designed for graduate level students in programs of public health, health administration, and law, the text is filled with highly practical information about the ways that legal violations occur and how good compliance programs function. Key Features: - Examines in detail the current laws and regulations with which all types of health care organizations must comply - Explore the seven essential ingredients for a good compliance program - Looks at compliance programs within twelve different types of health care organizations - References real world cases of fraud and abuse - Includes Study Questions and Learning Experiences in each chapter that are designed to encourage critical thinking

What is ... the Anti-kickback Statute?

Author : Thomas S. Crane
Publisher : American Bar Association
ISBN 13 : 9781627228763
Total Pages : 69 pages
Book Rating : 4.2/5 (287 download)

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Book Synopsis What is ... the Anti-kickback Statute? by : Thomas S. Crane

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.

The Health Care Compliance Professional's Manual

Author : Hcca
Publisher : Aspen Publishers
ISBN 13 : 9780735570382
Total Pages : 1080 pages
Book Rating : 4.5/5 (73 download)

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Book Synopsis The Health Care Compliance Professional's Manual by : Hcca

Download or read book The Health Care Compliance Professional's Manual written by Hcca and published by Aspen Publishers. This book was released on 2007 with total page 1080 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Health Care Compliance Professional's Manual gives you all the tools you need to plan and execute a customized compliance program that meets federal standards. It walks you through the entire process, start to finish, showing you how to draft compliance policies, build a strong compliance infrastructure in your organization, document your efforts, apply self-assessment techniques, create an effective education program, pinpoint areas of risk, conduct internal probes and much more. The Health Care Compliance Professional's Manual is used by the Health Care Compliance Association (HCCA) as the basic text for its Compliance Academy - the program that prepares compliance professionals for the CHC (Certificate in Healthcare Compliance) certification exam. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to help plan and execute a customized compliance strategy that meets tough federal standards Perform risk assessment to pinpoint areas within your company that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure for compliance to work, including hiring the right personnel Create an effective education and training program that instills in employees the value of legal compliance Conduct internal probes that uncover legal violations before the federal government does - and mitigate possible penalties Stay up-to-date on all the latest legal and regulatory requirements affecting your facility, including HIPAA, EMTALA, fraud and abuse reimbursement, privacy, security, patient safety and much more! Packed with tools to make your job easier, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Document efforts and apply self assessment techniques Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Time-saving sample compliance policies, forms, checklists, and chart The Health Care Compliance Professional's Manual will protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques Discover how to successfully follow the OIG's voluntary disclosure program to resolve overpayment problems and avoid exclusion from Medicare Find out how to enter into a corporate integrity agreement to settle with the federal government and mitigate FCA-related penalties Document your compliance efforts so you leave a protective paper trail that shields you from liability And much more

Healthcare Fraud

Author : Rebecca S. Busch
Publisher : John Wiley & Sons
ISBN 13 : 1118179803
Total Pages : 374 pages
Book Rating : 4.1/5 (181 download)

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Book Synopsis Healthcare Fraud by : Rebecca S. Busch

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.

Dietary Supplements

Author : United States. Federal Trade Commission. Bureau of Consumer Protection
Publisher :
ISBN 13 :
Total Pages : 32 pages
Book Rating : 4.:/5 (31 download)

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Book Synopsis Dietary Supplements by : United States. Federal Trade Commission. Bureau of Consumer Protection

Download or read book Dietary Supplements written by United States. Federal Trade Commission. Bureau of Consumer Protection and published by . This book was released on 1998 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:

United States Attorneys' Manual

Author : United States. Department of Justice
Publisher :
ISBN 13 :
Total Pages : 720 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis United States Attorneys' Manual by : United States. Department of Justice

Download or read book United States Attorneys' Manual written by United States. Department of Justice and published by . This book was released on 1985 with total page 720 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Fraud and Abuse Investigations Handbook for the Health Care Industry

Author : Paul W. Shaw
Publisher :
ISBN 13 : 9781663315007
Total Pages : 775 pages
Book Rating : 4.3/5 (15 download)

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Book Synopsis Fraud and Abuse Investigations Handbook for the Health Care Industry by : Paul W. Shaw

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.

Improving the Quality of Long-Term Care

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309132746
Total Pages : 344 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Improving the Quality of Long-Term Care by : Institute of Medicine

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.

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

Author : Terry L. Leap
Publisher : Ilr Press
ISBN 13 : 9780801449796
Total Pages : 237 pages
Book Rating : 4.4/5 (497 download)

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Book Synopsis Phantom Billing, Fake Prescriptions, and the High Cost of Medicine by : Terry L. Leap

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.

False Claims Act & the Healthcare Industry

Author : Robert S. Salcido
Publisher :
ISBN 13 : 9781663386311
Total Pages : 0 pages
Book Rating : 4.3/5 (863 download)

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Book Synopsis False Claims Act & the Healthcare Industry by : Robert S. Salcido

Download or read book False Claims Act & the Healthcare Industry written by Robert S. Salcido and published by . This book was released on 2024 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Fundamentals of Health Law

Author : Barry D. Alexander
Publisher :
ISBN 13 : 9781422489611
Total Pages : 564 pages
Book Rating : 4.4/5 (896 download)

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Book Synopsis Fundamentals of Health Law by : Barry D. Alexander

Download or read book Fundamentals of Health Law written by Barry D. Alexander and published by . This book was released on 2011-01-01 with total page 564 pages. Available in PDF, EPUB and Kindle. Book excerpt: This specialized and complex field of health law requires a thorough grounding in the basics, and Fundamentals of Health Law, 5th Edition, provides that grounding like no other book on the market does. This new edition has been thoroughly revised and made current to cover the basic issues of health law practice, from patient to facility issues, from permits and regulation issues to compliance and investigation issues, and includes issues raised by new laws, regulations and guidelines promulgated since the fourth edition in 2008, including the Affordable Care Act (ACA). This publication covers fundamental legal principles and issues to assist: * New Practitioners or experienced attorneys entering their first years of health-law practice; * Professors of health law searching for a comprehensive text for their students; and * Users of any law library looking for answers on the health law resource shelf.

Managing Relationships with Industry

Author : Steven C. Schachter
Publisher : Academic Press
ISBN 13 : 9780123736536
Total Pages : 288 pages
Book Rating : 4.7/5 (365 download)

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Book Synopsis Managing Relationships with Industry by : Steven C. Schachter

Download or read book Managing Relationships with Industry written by Steven C. Schachter and published by Academic Press. This book was released on 2008 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: An indispensable resource for doctors, community hospitals, and group practices struggling to understand the law and ethical standards on interactions with pharmaceutical and device companies, this title is the first summary of the law and ethics on physician relationships with industry.

AHLA The Stark Law (Non-Members)

Author : Charles B. Oppenheim
Publisher :
ISBN 13 : 9781522170341
Total Pages : pages
Book Rating : 4.1/5 (73 download)

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Book Synopsis AHLA The Stark Law (Non-Members) by : Charles B. Oppenheim

Download or read book AHLA The Stark Law (Non-Members) written by Charles B. Oppenheim and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: More than a summary of the law, this new edition of an essential monograph offers in-depth critical analysis of this risky, complex area, as well as a wealth of practice pointers and advice for advising clients. Written by leading experts in the interpretation and application of Stark Law, the latest edition of The Stark Law: Comprehensive Analysis + Practical Guide offers up to date information on the following topics:The definition of entitySplit/shared evaluation and management servicesTimeshare agreementsValuing goodwill in physician practice acquisitionsJoint marketingFair market value assessments"Stand in The Shoes" when contracting with a groupWhen A collection of documents can constitute a written agreementDevelopments on the signature RequirementRevisiting fair market value over the course of a termLiability under The False Claims Act with respect to MedicaidBankruptcy trustees and Stark LawUpdates to the self-referral disclosure protocol

Legal Issues in Health Care Fraud and Abuse

Author : David E. Matyas
Publisher :
ISBN 13 : 9781422434369
Total Pages : 495 pages
Book Rating : 4.4/5 (343 download)

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Book Synopsis Legal Issues in Health Care Fraud and Abuse by : David E. Matyas

Download or read book Legal Issues in Health Care Fraud and Abuse written by David E. Matyas and published by . This book was released on 2006 with total page 495 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Health Care Mergers and Acquisitions Answer Book

Author : Andrew L. Bab
Publisher :
ISBN 13 : 9781402426322
Total Pages : 0 pages
Book Rating : 4.4/5 (263 download)

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Book Synopsis Health Care Mergers and Acquisitions Answer Book by : Andrew L. Bab

Download or read book Health Care Mergers and Acquisitions Answer Book written by Andrew L. Bab and published by . This book was released on 2016-10-07 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: M&A activity in the health care industry is at its highest level since the 1980s. Organized into four parts, this guide includes practical advice on how to address the various industry-specific issues arising in health care acquisitions.