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Fraud And Abuse
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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.
Book Synopsis Fraud and Abuse in Nonprofit Organizations by : Gerard M. Zack
Download or read book Fraud and Abuse in Nonprofit Organizations written by Gerard M. Zack and published by John Wiley & Sons. This book was released on 2003-06-19 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: Table of contents
Book Synopsis Occupational Fraud and Abuse by : Joseph T. Wells
Download or read book Occupational Fraud and Abuse written by Joseph T. Wells and published by . This book was released on 1997-01-01 with total page 564 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Health Care Fraud and Abuse by : Linda A. Baumann
Download or read book Health Care Fraud and Abuse written by Linda A. Baumann and published by Bureau of National Affairs (BNA). This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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.
Book Synopsis Healthcare Crime by : Kelly M. Pyrek
Download or read book Healthcare Crime written by Kelly M. Pyrek and published by CRC Press. This book was released on 2011-01-19 with total page 326 pages. Available in PDF, EPUB and Kindle. Book excerpt: Crime perpetrated by healthcare professionals is increasingly pervasive in today‘s hospitals and other healthcare settings. Patients, coworkers, and employers are vulnerable to exploitation, fraud, abuse, and even murder. Investigative journalist Kelly M. Pyrek interviews experts who provide accounts concerning the range of criminality lurking in t
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.
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:
Book Synopsis License To Steal by : Malcolm K Sparrow
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.
Book Synopsis Government Abuse by : William Sims Curry
Download or read book Government Abuse written by William Sims Curry and published by Routledge. This book was released on 2017-07-28 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: Government contracting is plagued by nefarious, amateurish, and criminal behavior. By awarding government contracts to corporations as compensation for lavish gifts and personal favors, the United States government fails to serve the public interest effectively and honestly. William Sims Curry identifies and categorizes multiple deficiencies in how government contractors are selected, and proposes how reforms can be instituted.This book is based on extensive research. Curry sifted through two years worth of contractor claims maintained by the Government Accountability Office (GAO) regarding improper behavior of federal government agencies during the contract award process. He identified additional government contracting failures through review of media stories, inspector general reports, court cases, and press releases by government investigatory agencies.Much of this abuse originates from the mandated but ineffective practice of color coding rating proposals and a subjective ratings system. Curry proposes replacing the current practice with a scoring system that weighs contractor selection criteria according to the government's needs. This, along with the other procurement reforms Curry recommends, offers promise for an alternative to the fraud, waste, and incompetence currently rampant in government contracting.
Book Synopsis Tackling Wasteful Spending on Health by : OECD
Download or read book Tackling Wasteful Spending on Health written by OECD and published by OECD Publishing. This book was released on 2017-01-10 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: Countries could potentially spend significantly less on health care with no impact on health system performance, or on health outcomes. This report reviews strategies put in place by countries to limit ineffective spending and waste.
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.
Book Synopsis A Fresh Look at Fraud by : Yaniv Hanoch
Download or read book A Fresh Look at Fraud written by Yaniv Hanoch and published by Routledge. This book was released on 2022-05-09 with total page 189 pages. Available in PDF, EPUB and Kindle. Book excerpt: A Fresh Look at Fraud features psychologists, criminologists, and computer scientists to address the state-of-the-art research on the rising problem of fraud, scams, and financial abuse, stimulating a cross-disciplinary exchange of ideas, theories, methods, and practices. In this timely volume, Yaniv Hanoch and Stacey Wood bring together leading international researchers to discuss and review state-of-the-art research in fraud research, adopting diverse methodologies (from experimental to neuroimaging), perspectives, and questions. The book addresses topics such as mass marketing fraud, financial exploitation, ageing and cyber fraud, risk factors associated with becoming a fraud victim and online/cryptocurrency fraud. It offers a holistic picture of emerging trends and issues in fraud research and also includes discussion of the ‘Next Frontiers’ in research and important insights on how to create solutions. This book will be a crucial read for practitioners and researchers engaged in fraud research and other fields such as Forensic Psychology, Social Psychology, Criminal Behavior, and Criminology, as well as for postgraduates training in these fields.
Download or read book Cybercrime written by Charles Doyle and published by DIANE Publishing. This book was released on 2011-04 with total page 97 pages. Available in PDF, EPUB and Kindle. Book excerpt: The federal computer fraud and abuse statute, 18 U.S.C. 1030, outlaws conduct that victimizes computer systems. It is a cyber security law which protects federal computers, bank computers, and computers connected to the Internet. It shields them from trespassing, threats, damage, espionage, and from being corruptly used as instruments of fraud. It is not a comprehensive provision, but instead it fills cracks and gaps in the protection afforded by other federal criminal laws. This report provides a brief sketch of Section 1030 and some of its federal statutory companions, including the amendments found in the Identity Theft Enforcement and Restitution Act, P.L. 110-326. Extensive appendices. This is a print on demand publication.
Book Synopsis Healthcare Fraud, Corruption and Waste in Europe by : Misja Mikkers
Download or read book Healthcare Fraud, Corruption and Waste in Europe written by Misja Mikkers and published by . This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The lack of well-documented, factual information on fraud, waste and corruption in the healthcare sector is an important ally for those who would seek to abuse healthcare systems for their own profit. Our lack of knowledge of the incidence, nature and extent of fraud, waste and corruption in healthcare is a threat to the establishment of effective counter-fraud strategies. It prevents those who finance healthcare provision from understanding in clear and quantifiable terms the need to invest resources into counter-fraud activities. As a consequence, fraud remains a matter of moral hazard and healthcare systems continue to suffer considerable financial damage, as well as all the associated consequences for the quality of care that patients receive. It was for these reasons that the 'European Healthcare Fraud and Corruption Network' (EHFCN) and the 'Dutch Healthcare Authority' (NZa, member of EHFCN) decided to collaborate to publish this book... --
Book Synopsis Fighting Fraud and Corruption in the Humanitarian and Global Development Sector by : Oliver May
Download or read book Fighting Fraud and Corruption in the Humanitarian and Global Development Sector written by Oliver May and published by Routledge. This book was released on 2016-05-12 with total page 354 pages. Available in PDF, EPUB and Kindle. Book excerpt: There are an estimated 40,000 international Non-Government Organisations (NGOs), working in an enormous global aid industry; official development assistance alone reached £90bn in 2014. This is supplemented by huge voluntary giving – the UK public, for example, give around £1bn a year to overseas causes. These organisations face a unique challenge from fraud and corruption. Operating in the world’s most under-developed and fragile environments, with minimal infrastructure and trust-based cultures, the risk is high. And, being wholly reliant on donors and supporters for income, so are the stakes. Researchers make different estimates of the scale of the problem facing the sector. Some research implies that losses to the global aid budget caused by occupational fraud and abuse may be in the billions of pounds, while those to the British public's voluntary overseas donations could be in the tens of millions. For many sector professionals working in the developing world, these estimates are readily believable. Fighting Fraud and Corruption in the Humanitarian and Global Development Sector by Oliver May is a timely, accessible and relevant how-to guide, which explores the scale and nature of the threat, debunks pervasive myths, and shows readers how to help their NGOs to better deter, prevent, detect and respond to fraud and corruption.
Book Synopsis Corporate Fraud Handbook by : Joseph T. Wells
Download or read book Corporate Fraud Handbook written by Joseph T. Wells and published by John Wiley & Sons. This book was released on 2017-05-01 with total page 436 pages. Available in PDF, EPUB and Kindle. Book excerpt: Delve into the mind of a fraudster to beat them at their own game Corporate Fraud Handbook details the many forms of fraud to help you identify red flags and prevent fraud before it occurs. Written by the founder and chairman of the Association of Certified Fraud Examiners (ACFE), this book provides indispensable guidance for auditors, examiners, managers, and criminal investigators: from asset misappropriation, to corruption, to financial statement fraud, the most common schemes are dissected to show you where to look and what to look for. This new fifth edition includes the all-new statistics from the ACFE 2016 Report to the Nations on Occupational Fraud and Abuse, providing a current look at the impact of and trends in fraud. Real-world case studies submitted to the ACFE by actual fraud examiners show how different scenarios play out in practice, to help you build an effective anti-fraud program within your own organization. This systematic examination into the mind of a fraudster is backed by practical guidance for before, during, and after fraud has been committed; you'll learn how to stop various schemes in their tracks, where to find evidence, and how to quantify financial losses after the fact. Fraud continues to be a serious problem for businesses and government agencies, and can manifest in myriad ways. This book walks you through detection, prevention, and aftermath to help you shore up your defenses and effectively manage fraud risk. Understand the most common fraud schemes and identify red flags Learn from illustrative case studies submitted by anti-fraud professionals Ensure compliance with Sarbanes-Oxley and other regulations Develop and implement effective anti-fraud measures at multiple levels Fraud can be committed by anyone at any level—employees, managers, owners, and executives—and no organization is immune. Anti-fraud regulations are continually evolving, but the magnitude of fraud's impact has yet to be fully realized. Corporate Fraud Handbook provides exceptional coverage of schemes and effective defense to help you keep your organization secure.
