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Author : Linda A. Baumann
Publisher : Bureau of National Affairs (BNA)
ISBN 13 : 9781617463013
Total Pages : 0 pages
Book Rating : 4.4/5 (63 download)
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:
Author : Hoyt W. Torras
Publisher : American Medical Association Press
ISBN 13 :
Total Pages : 452 pages
Book Rating : 4.3/5 (91 download)
Download or read book Health Care Fraud and Abuse written by Hoyt W. Torras and published by American Medical Association Press. This book was released on 2003 with total page 452 pages. Available in PDF, EPUB and Kindle. Book excerpt: A guide for physicians covering the legal aspects of health insurance and offers ways to design an effective billing, coding, and accounts receivable process.
Author : Rebecca S. Busch
Publisher : John Wiley & Sons
ISBN 13 : 1118179803
Total Pages : 374 pages
Book Rating : 4.1/5 (181 download)
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.
Author : David E. Matyas
Publisher :
ISBN 13 : 9781422434369
Total Pages : 495 pages
Book Rating : 4.4/5 (343 download)
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:
Author : Aspen Health Law Center
Publisher :
ISBN 13 :
Total Pages : 156 pages
Book Rating : 4.0/5 ( download)
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.
Author : Linda A. Baumann
Publisher : Bna Books
ISBN 13 : 9781570186622
Total Pages : 913 pages
Book Rating : 4.1/5 (866 download)
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.
Author : Malcolm K Sparrow
Publisher : Basic Books
ISBN 13 : 0465010741
Total Pages : 306 pages
Book Rating : 4.4/5 (65 download)
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.
Author : Paul W. Shaw
Publisher :
ISBN 13 : 9781663315007
Total Pages : 775 pages
Book Rating : 4.3/5 (15 download)
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.
Author : Kelly M. Pyrek
Publisher : CRC Press
ISBN 13 : 1439820341
Total Pages : 326 pages
Book Rating : 4.4/5 (398 download)
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
Author : Brian K. Payne
Publisher : Charles C Thomas Publisher
ISBN 13 : 0398083541
Total Pages : 193 pages
Book Rating : 4.3/5 (98 download)
Download or read book CRIME IN THE HOME HEALTH CARE FIELD written by Brian K. Payne and published by Charles C Thomas Publisher. This book was released on 2003-01-01 with total page 193 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the past couple of decades, individuals have come to rely more on home health care visits for their health care needs. While there have been decreases in hospital stays and in the percentage of older persons living in nursing homes the consequence has been the emergence of a new type of occupational crime: home health care abuse. In considering offending in the home health care industry, it is important to focus on crimes by and against home health care professionals. This book is one of the first to fully address abuses occurring in the home health care industry. Its intent is not to suggest that home health care is a dangerous field for workers and consumers; rather, the intent is to shed some light on the types of misconduct found in home health care. Each chapter will include a wealth of examples to illustrate that these incidents actually are real, devastating, and significant. At the end of each chapter the reader will find a series of discussion questions designed to encourage the reader to reflect back on the content of the chapter through the eyes of those involved in the response to home health care fraud. Also included are Web site addresses where readers can learn more about the offenses and other resources to help demonstrate ways to deal with the problem. It is intended for criminal justice officials, health care professionals, academics, and researchers who want to better understand the nature of offending in the home health care industry. It is also intended for use in criminal justice, sociology, and white-collar crime courses exploring crime in the workplace as well as courses examining the home health care field. Chapters include: Home, Home on the Range: Where Health Care is Provided and Crimes are Committed; Home Health Care Professionals as Victims and Witnesses; Crimes by Home Health Professionals: Violence, Theft, and Deception; Responding to Crime in the Home Health Care Field: Strategies, Obstacles, and Issues; and Preventing Home Health Care Misconduct.
Author : United States. Congress. House. Committee on Government Operations. Human Resources and Intergovernmental Relations Subcommittee
Publisher :
ISBN 13 :
Total Pages : 180 pages
Book Rating : 4.F/5 ( download)
Download or read book Health Care Fraud and Abuse written by United States. Congress. House. Committee on Government Operations. Human Resources and Intergovernmental Relations Subcommittee and published by . This book was released on 1993 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 0309477891
Total Pages : 399 pages
Book Rating : 4.3/5 (94 download)
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.
Author : Robert Fabrikant
Publisher : Law Journal Press
ISBN 13 : 9781588520739
Total Pages : 1308 pages
Book Rating : 4.5/5 (27 download)
Download or read book Health Care Fraud written by Robert Fabrikant and published by Law Journal Press. This book was released on 2023-12-28 with total page 1308 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Care Fraud: Enforcement and Compliance focuses on fraud and abuse issues involving health care providers as well as application of the laws governing fraud and abuse to manufacturers of drugs and medical devices and other non-providers such as medical researchers.
Author : Terry L. Leap
Publisher : Ilr Press
ISBN 13 : 9780801449796
Total Pages : 237 pages
Book Rating : 4.4/5 (497 download)
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.
Author : Curtis Wood
Publisher : Nova Science Publishers
ISBN 13 : 9781634636933
Total Pages : 0 pages
Book Rating : 4.6/5 (369 download)
Download or read book The Health Care Fraud and Abuse Control Program written by Curtis Wood and published by Nova Science Publishers. This book was released on 2015-02 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In fiscal year 2012, the Department of Health and Human Services (HHS), HHS Office of Inspector General (HHS-OIG), and the Department of Justice (DOJ) obligated approximately $583.6 million to fund Health Care Fraud and Abuse Control (HCFAC) program activities. This book describes how HHS and DOJ obligated funds for the HCFAC program; examines how HHS and DOJ assess HCFAC activities and whether key program outputs have changed over time; and examines what is known about the effectiveness of the HCFAC program in reducing health care fraud and abuse.
Download or read book Health Care Fraud and Abuse Control Program :. written by and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : United States. Congress. House. Committee on Government Reform and Oversight. Subcommittee on Human Resources and Intergovernmental Relations
Publisher :
ISBN 13 :
Total Pages : 274 pages
Book Rating : 4.F/5 ( download)
Download or read book Health Care Fraud and Abuse written by United States. Congress. House. Committee on Government Reform and Oversight. Subcommittee on Human Resources and Intergovernmental Relations and published by . This book was released on 1997 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt:
