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

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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

Health Care Fraud and Abuse Compliance Manual

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Publisher : Wolters Kluwer Law & Business
ISBN 13 : 9780834208995
Total Pages : 0 pages
Book Rating : 4.2/5 (89 download)

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Book Synopsis Health Care Fraud and Abuse Compliance Manual by :

Download or read book Health Care Fraud and Abuse Compliance Manual written by and published by Wolters Kluwer Law & Business. This book was released on 1997 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: An immensely practical resource, Health Care Fraud and Abuse Compliance Manual provides a comprehensive overview of legislative and regulatory restrictions that affect the way health care providers conduct business and how they structure relationships among themselves. This treatise helps providers determine the boundaries of permissible conduct under the myriad statutes and regulations that relate to health care fraud and abuse at both the federal and state levels. Specific coverage includes: The statutory language in the Medicare/Medicaid civil money penalties and false claims statutes The Medicare/Medicaid antikickback statute The Stark andquot;self-referralandquot; law The numerous safe harbors and exceptions contained with these prohibitions And more! This authoritative resource will make you aware of your crucial obligations and options. Each chapter of the Health Care Fraud and Abuse Compliance Manual describes what the law requires, how it applies in a health care context, and what the penalties are for failure to comply. With Health Care Fraud and Abuse Compliance Manual: You'll receive coverage of all the critical laws and considerations, including: false claims and fraudulent billings, civil and criminal penalties, the antikickback statute, the safe harbor regulations, the Stark Law, and state statutes You'll get practical advice on developing a corporate compliance program that can help you stay on the right side of the law You'll learn about the structures, goals, and procedures of agencies that investigate health care fraud You'll get an in-depth understanding of what goes into a fraud and abuse investigation - and how you can respond to an investigation to best defend your organization And much, much more! Health Care Fraud and Abuse Compliance Manual has been updated to include: Updated nationwide health care fraud and abuse enforcement statistics OIG Work Plan for FY 12 (Medicaid projects) Enforcement actions involving billing for services of unlicensed personnel Enforcement actions involving billing without proper documentation Enforcement actions involving illegal inducements to beneficiaries Hospital liability for submission of false cost reports Cases involving maximum hospital liability for EMTALA violations Criminal false claims liability for unsolicited telemarketing by a DME supplier Managed care provider liability for cherry-picking, retaining overpayments, and other practices Hospice liability for providing services to ineligible patients Pharmaceutical manufacturer liability for pricing-related false claims violations Enforcement actions involving federal research grant fraud Criminal kickback liability for sham consulting arrangements Self-referral liability for office lease agreements and independent contractor relationships inconsistent with fair market value or not memorialized in writing Updated Medicaid Fraud Control Unit performance standards (MFCU) False claims laws of Massachusetts, Montana, and Nevada OIG evaluation of Massachusetts, Montana, and Nevada false claims laws

Pharmaceutical and Medical Device Compliance Manual

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Publisher :
ISBN 13 : 9781522178026
Total Pages : 319 pages
Book Rating : 4.1/5 (78 download)

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Book Synopsis Pharmaceutical and Medical Device Compliance Manual by : Ela Bochenek

Download or read book Pharmaceutical and Medical Device Compliance Manual written by Ela Bochenek and published by . This book was released on 2019 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: A robust compliance program is essential to protecting a company from running afoul of the myriad laws and regulations that have been enacted to combat fraud and waste. The second edition of the Pharmaceutical and Medical Device Compliance Manual includes guidance to help companies develop a compliance program tailored to today's complex enforcement and business environment. Study of this Manual will enable compliance professionals and lawyers to understand the government's expectations of an effective compliance program and ethical business practices, as well as: how the government discovers potential enforcement actions, its approach to pursuing such actions, what behaviors can constitute mitigating factors for a company in the event of a legal violation. Coverage includes new chapters covering:Pharmaceutical industry interactions with patient organizations Compliance 2.0: compliance analytics in the era of big dataThe art and science of health care compliance in the pharmaceutical and medical device industries The Manual will be a great tool for health and life sciences attorneys, compliance officers, and others in the pharmaceutical and medical devices industry

The Health Care Compliance Professional's Manual

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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

Managing Relationships with Industry

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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.

The Right to Die

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Publisher : John Wiley & Sons
ISBN 13 :
Total Pages : 614 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis The Right to Die by : Alan Meisel

Download or read book The Right to Die written by Alan Meisel and published by John Wiley & Sons. This book was released on 1989 with total page 614 pages. Available in PDF, EPUB and Kindle. Book excerpt: This work discusses the legal implications of the decision to withhold or withdraw medical treatment by someone other than the patient. It addresses such issues as clinical and judicial approaches to decision making, determining the decision making capacity of the patient, standards for surrogate decision makers, drafting and administering living wills and other advance directives, and other topics.

The Right to Die

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Publisher : Wolters Kluwer
ISBN 13 : 0735546657
Total Pages : 2023 pages
Book Rating : 4.7/5 (355 download)

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Book Synopsis The Right to Die by : Alan Meisel

Download or read book The Right to Die written by Alan Meisel and published by Wolters Kluwer. This book was released on 2004-01-01 with total page 2023 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Right to Die, Third Edition analyzes the statutory and case law

United States Attorneys' Manual

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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:

Health Care Fraud and Abuse

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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.

What is ... the Anti-kickback Statute?

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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.

Health Care Compliance Professional's Manual

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Publisher : Aspen Publishers
ISBN 13 : 9781543822892
Total Pages : 1654 pages
Book Rating : 4.8/5 (228 download)

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Book Synopsis Health Care Compliance Professional's Manual by : Wolters Kluwer and the American Health Law Association 

Download or read book Health Care Compliance Professional's Manual written by Wolters Kluwer and the American Health Law Association  and published by Aspen Publishers. This book was released on 2020-03-10 with total page 1654 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Health Care Compliance Professional's Manual is one of the most vital, long-standing, and best known resources in the world of health care compliance. It has all the tools you and your compliance team need to plan and execute a customized compliance program. This new edition is filled with industry best practices, sample forms, policies, procedures, and much more to save you time and comply with federal standards. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to plan and execute a customized compliance strategy that meets tough federal standards and minimizes enforcement risks Oversee physician compensation and referrals Perform risk assessments using matrixes with step-by-step instructions to pinpoint areas that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure reinforced by industry best practices Create an effective education and training program that instills in employees the importance of legal compliance Implement a privacy and security plan that ensures patient information is protected Stay up-to-date on the latest legal and state and federal regulatory requirements affecting your facility, in areas such as HIPAA, EMTALA, fraud and abuse, reimbursement, privacy, security, patient safety, and clinical research Study for CCB(R) Certification in Healthcare Compliance (CHC) Packed with tools to make your job easier and more efficient, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Examples of common risk areas and how to handle them Time savings and peace of mind from sample policies, checklists and forms from members of the American Health Law Association (AHLA) The Health Care Compliance Professional's Manual will help you protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques for conducting internal investigations 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 Previous Edition: Health Care Compliance Professional's Manual, Second Edition ISBN: 9781543813265 SKU: 10071961-7777

Model Rules of Professional Conduct

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Publisher : American Bar Association
ISBN 13 : 9781590318737
Total Pages : 216 pages
Book Rating : 4.3/5 (187 download)

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Book Synopsis Model Rules of Professional Conduct by : American Bar Association. House of Delegates

Download or read book Model Rules of Professional Conduct written by American Bar Association. House of Delegates and published by American Bar Association. This book was released on 2007 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.

Fraud and Abuse Investigations Handbook for the Health Care Industry

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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.

Risk Management Handbook for Health Care Organizations

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Publisher : John Wiley & Sons
ISBN 13 : 0470443715
Total Pages : 672 pages
Book Rating : 4.4/5 (74 download)

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Book Synopsis Risk Management Handbook for Health Care Organizations by : American Society for Healthcare Risk Management (ASHRM)

Download or read book Risk Management Handbook for Health Care Organizations written by American Society for Healthcare Risk Management (ASHRM) and published by John Wiley & Sons. This book was released on 2009-03-27 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Risk Management Handbook for Health Care Organizations, Student Edition This comprehensive textbook provides a complete introduction to risk management in health care. Risk Management Handbook, Student Edition, covers general risk management techniques; standards of health care risk management administration; federal, state and local laws; and methods for integrating patient safety and enterprise risk management into a comprehensive risk management program. The Student Edition is applicable to all health care settings including acute care hospital to hospice, and long term care. Written for students and those new to the topic, each chapter highlights key points and learning objectives, lists key terms, and offers questions for discussion. An instructor's supplement with cases and other material is also available. American Society for Healthcare Risk Management (ASHRM) is a personal membership group of the American Hospital Association with more than 5,000 members representing health care, insurance, law, and other related professions. ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking, and interactions with leading health care organizations and government agencies. ASHRM initiatives focus on developing and implementing safe and effective patient care practices, preserving financial resources, and maintaining safe working environments.

Health Care Facilities Code Handbook

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Publisher :
ISBN 13 : 9781455914876
Total Pages : 836 pages
Book Rating : 4.9/5 (148 download)

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Book Synopsis Health Care Facilities Code Handbook by : National Fire Protection Association

Download or read book Health Care Facilities Code Handbook written by National Fire Protection Association and published by . This book was released on 2017-12-22 with total page 836 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Federal Information System Controls Audit Manual (FISCAM)

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Publisher : DIANE Publishing
ISBN 13 : 1437914063
Total Pages : 601 pages
Book Rating : 4.4/5 (379 download)

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Book Synopsis Federal Information System Controls Audit Manual (FISCAM) by : Robert F. Dacey

Download or read book Federal Information System Controls Audit Manual (FISCAM) written by Robert F. Dacey and published by DIANE Publishing. This book was released on 2010-11 with total page 601 pages. Available in PDF, EPUB and Kindle. Book excerpt: FISCAM presents a methodology for performing info. system (IS) control audits of governmental entities in accordance with professional standards. FISCAM is designed to be used on financial and performance audits and attestation engagements. The methodology in the FISCAM incorp. the following: (1) A top-down, risk-based approach that considers materiality and significance in determining audit procedures; (2) Evaluation of entitywide controls and their effect on audit risk; (3) Evaluation of general controls and their pervasive impact on bus. process controls; (4) Evaluation of security mgmt. at all levels; (5) Control hierarchy to evaluate IS control weaknesses; (6) Groupings of control categories consistent with the nature of the risk. Illus.

Conditions of Participation for Home Health Agencies

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Publisher :
ISBN 13 :
Total Pages : 36 pages
Book Rating : 4.:/5 (31 download)

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Book Synopsis Conditions of Participation for Home Health Agencies by : United States. Social Security Administration

Download or read book Conditions of Participation for Home Health Agencies written by United States. Social Security Administration and published by . This book was released on 1966 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: