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Healthcare Fraud And Abuse Introduction
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Book Synopsis Healthcare Fraud and Abuse Introduction by : Daniel Farb
Download or read book Healthcare Fraud and Abuse Introduction written by Daniel Farb and published by University of Health Care. This book was released on 2004 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare Fraud and Abuse Introduction should be used for two purposes: informing one's organization about fraud and abuse and for documenting their training as part of a compliance program.
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 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 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 Cornell University Press. This book was released on 2011-04-15 with total page 253 pages. Available in PDF, EPUB and Kindle. Book excerpt: U.S. health care is a $2.5 trillion system that accounts for more than 17 percent of the nation’s GDP. It is also highly susceptible to fraud. Estimates vary, but some observers believe that as much as 10 percent of all medical billing involves some type of fraud. In 2009, New York’s Medicaid fraud office recovered $283 million and obtained 148 criminal convictions. In July 2010, the U.S. Justice Department charged nearly 100 patients, doctors, and health care executives in five states of bilking the Medicare system out of more than $251 million through false claims for services that were medically unnecessary or never provided. These cases only hint at the scope of the problem. In Phantom Billing, Fake Prescriptions, and the High Cost of Medicine, Terry L. Leap takes on medical fraud and its economic, psychological, and social costs. Illustrated throughout with dozens of specific and often fascinating cases, this book covers a wide variety of crimes: kickbacks, illicit referrals, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill schemes, insurance scams, short-pilling, off-label marketing of pharmaceuticals, and rebate fraud, as well as criminal acts that enable this fraud (mail and wire fraud, conspiracy, and money laundering). After assessing the effectiveness of the federal laws designed to fight health care fraud and abuse—the antikickback statute, the Stark Law, the False Claims Act, HIPAA, and the food and drug laws—Leap suggests a number of ways that health care providers, consumers, insurers, and federal and state officials can bring health care fraud and abuse under control, thereby reducing the overall cost of medical care in America.
Book Synopsis Healthcare Fraud and Abuse Introduction 100 Users by : Daniel Farb
Download or read book Healthcare Fraud and Abuse Introduction 100 Users written by Daniel Farb and published by Universityofhealthcare. This book was released on 2005-02-04 with total page 125 pages. Available in PDF, EPUB and Kindle. Book excerpt: Offers healthcare billing compliance training and planning for small practices to hospitals and health systems.
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 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.
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 Healthcare Fraud and Abuse Introduction Manual by : Daniel Farb
Download or read book Healthcare Fraud and Abuse Introduction Manual written by Daniel Farb and published by University of Health Care. This book was released on 2004 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Useful for Doctors, Nurses, Dentists, Therapists, Podiatrists, Osteopaths, Physicians Assistants, Practice Administrators, Compliance Officers, and all Allied Health Professionals, for Medicare, Medicaid, and Private Insurance.
Book Synopsis CRIME IN THE HOME HEALTH CARE FIELD by : Brian K. Payne
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 :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)
Book Synopsis Crossing the Global Quality Chasm by : National Academies of Sciences, Engineering, and Medicine
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.
Book Synopsis License To Steal by : Malcolm K Sparrow
Download or read book License To Steal written by Malcolm K Sparrow and published by Hachette UK. This book was released on 2007-12-14 with total page 304 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 Health Care Fraud and Abuse by : Hoyt W. Torras
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.
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 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 . This book was released on 2005 with total page 654 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Introduction to Health Care Management by : Sharon Bell Buchbinder
Download or read book Introduction to Health Care Management written by Sharon Bell Buchbinder and published by Jones & Bartlett Learning. This book was released on 2007 with total page 499 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Introduction to Health Care Management is a concise, reader-friendly, introductory healthcare management book that covers a wide variety of healthcare settings, from hospitals to nursing homes and clinics. It is the perfect resource for students of healthcare management, nursing, allied health, business administration, pharmacology, occupational therapy, public administration, and public health."--Jacket.
Book Synopsis Introduction to Health Care Management by : Sharon Buchbinder
Download or read book Introduction to Health Care Management written by Sharon Buchbinder and published by Jones & Bartlett Publishers. This book was released on 2011-07-22 with total page 525 pages. Available in PDF, EPUB and Kindle. Book excerpt: Instructor Resources: Tranisition Guide, Instructor's Manual, PowerPoint Slides, Case Studies, TestBank, Traditional Syllabus, and an 8-week online course Syllabus
Book Synopsis Introduction to Health Care Management by : Sharon B. Buchbinder
Download or read book Introduction to Health Care Management written by Sharon B. Buchbinder and published by Jones & Bartlett Publishers. This book was released on 2011-07-19 with total page 525 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction to Health Care Management is a concise, reader-friendly, introductory healthcare management book that covers a wide variety of healthcare settings, from hospitals to nursing homes and clinics. Filled with examples to engage the reader’s imagination, the important issues in healthcare management, such as ethics, cost management, strategic planning and marketing, information technology, and human resources, are all thoroughly covered. Guidelines and rubrics along with numerous case studies make this text both student-friendly and teacher friendly. It is the perfect resource for students of healthcare management, nursing, allied health, business administration, pharmacy, occupational therapy, public administration, and public health. “Drs. Buchbinder and Shanks have done a masterful job in selecting topics and authors and putting them together in a meaningful and coherent manner. Each chapter of the book is designed to give the student the core content that must become part of the repertoire of each and every healthcare manager, whether entry level or senior executive. Each of the chapters and accompanying cases serve to bring to life what it means to be a truly competent healthcare manager.” —Leonard H. Friedman, PhD, MPA, MPH, Professor, Dept of Health Services Management and Leadership, and Director of the Master of Health Services Administration program, George Washington University, School of Public Health and Health Services “I am very happy with Health Care Management and will be adopting it for a new course that I will be teaching. This is probably the best management text I have seen so far. I was thrilled to receive it.” —Sally K. Fauchald, PhD, RN, Assistant Professor of Nursing, The College of St. Scholastica “A solid text that covers a wide range of management topics.” —Michael H. Sullivan, Director HCA Program, Methodist University, Fayetteville, North Carolina
