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.

Health Care Fraud and Abuse

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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.

License To Steal

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Publisher : Basic Books
ISBN 13 : 0465010741
Total Pages : 306 pages
Book Rating : 4.4/5 (65 download)

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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.

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

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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.

The Medicare Handbook

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Publisher :
ISBN 13 :
Total Pages : 44 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis The Medicare Handbook by :

Download or read book The Medicare Handbook written by and published by . This book was released on 1988 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Title XX Social Services

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Publisher :
ISBN 13 :
Total Pages : 40 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Title XX Social Services by :

Download or read book Title XX Social Services written by and published by . This book was released on 1980 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Prescription for Profit

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Publisher : University of California Presson Demand
ISBN 13 : 9780520076143
Total Pages : 247 pages
Book Rating : 4.0/5 (761 download)

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Book Synopsis Prescription for Profit by : Paul Jesilow

Download or read book Prescription for Profit written by Paul Jesilow and published by University of California Presson Demand. This book was released on 1993 with total page 247 pages. Available in PDF, EPUB and Kindle. Book excerpt: "A sound, well written, and highly interesting examination of how Medicaid . . . has given far too many physicians an opportunity to 'mop up' fraudulently, for their own financial gain, some of the $61 billion annual cost of the program."--Marshall B. Clinard, author of "The Abuse of Corporate Power" "A searching analysis of a problem that is of enormous concern to every nation. It is a lively, insightful treatment of the Medicaid malady, using the best diagnostics available to contemporary criminology."--John Braithwaite, Australian National University

A Health Care Quality Improvement System for Medicaid Managed Care

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Publisher :
ISBN 13 :
Total Pages : 114 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis A Health Care Quality Improvement System for Medicaid Managed Care by :

Download or read book A Health Care Quality Improvement System for Medicaid Managed Care written by and published by . This book was released on 1993 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Federal False Claims Act and Qui Tam Litigation

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Publisher : Law Journal Seminars Press
ISBN 13 : 9781588521330
Total Pages : pages
Book Rating : 4.5/5 (213 download)

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Book Synopsis Federal False Claims Act and Qui Tam Litigation by : Joel M. Androphy

Download or read book Federal False Claims Act and Qui Tam Litigation written by Joel M. Androphy and published by Law Journal Seminars Press. This book was released on 2005 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers the merits of a potential action; determining whether the relator would be barred or restricted from any recovery for retaliation and more.

The Law of Medicare and Medicaid Fraud and Abuse

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Publisher :
ISBN 13 :
Total Pages : 601 pages
Book Rating : 4.:/5 (492 download)

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Book Synopsis The Law of Medicare and Medicaid Fraud and Abuse by : Timothy S. Jost

Download or read book The Law of Medicare and Medicaid Fraud and Abuse written by Timothy S. Jost and published by . This book was released on 2002 with total page 601 pages. Available in PDF, EPUB and Kindle. Book excerpt:

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.

Understanding Telehealth

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Publisher : McGraw Hill Professional
ISBN 13 : 1259837416
Total Pages : 337 pages
Book Rating : 4.2/5 (598 download)

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Book Synopsis Understanding Telehealth by : Karen Schulder Rheuban

Download or read book Understanding Telehealth written by Karen Schulder Rheuban and published by McGraw Hill Professional. This book was released on 2017-12-22 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first complete guide to the rapidly expanding field of telehealth From email to videoconferencing, telehealth puts real-time healthcare solutions at patients’ and clinicians’ fingertips. Every year, the field continues to evolve, enhancing access to healthcare, supporting clinicians, and improving the patient experience. However, since telehealth is in its infancy, no text has offered a comprehensive, definitive survey of this up-and-coming field—until now. Written by past presidents of the American Telemedicine Association, Understanding Telehealth explains how clinical applications leveraging telehealth technology are optimizing healthcare delivery. In addition, this timely resource examines the bedrock principles of telehealth and highlights the safety standards involved in the diagnosis and treatment of patients through digital communications. Logically organized and supported by high-yield clinical vignettes, the book begins with essential background information, including a look at telehealth history, definitions and roles, and rural health. It then provides an overview of clinical services for adults, from telestroke to telepsychiatry. The third section addresses pediatric clinical services, encompassing pediatric emergency and critical care, telecardiology, and more. A groundbreaking resource: •Chapters cover a broad spectrum of technologies, evidence-based guidelines, and application of telehealth across the healthcare continuum •Ideal for medical staff, public healthcare executives, hospitals, clinics, payors, healthcare advocates, and researchers alike •Incisive coverage of the legal and regulatory environment underpinning telehealth practice

Medicaid Third-party Liability

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ISBN 13 :
Total Pages : 31 pages
Book Rating : 4.:/5 (77 download)

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Book Synopsis Medicaid Third-party Liability by : United States. Government Accountability Office

Download or read book Medicaid Third-party Liability written by United States. Government Accountability Office and published by . This book was released on 2006 with total page 31 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Medicare and Medicaid Guide

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (79 download)

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Book Synopsis Medicare and Medicaid Guide by : Commerce Clearing House

Download or read book Medicare and Medicaid Guide written by Commerce Clearing House and published by . This book was released on 1995 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Medicaid Integrity Program

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Publisher :
ISBN 13 :
Total Pages : 46 pages
Book Rating : 4.:/5 (826 download)

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Book Synopsis Medicaid Integrity Program by : United States. Government Accountability Office

Download or read book Medicaid Integrity Program written by United States. Government Accountability Office and published by . This book was released on 2012 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Medicare and Medicaid Fraud and Abuse

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Publisher :
ISBN 13 : 9780314952523
Total Pages : pages
Book Rating : 4.9/5 (525 download)

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Book Synopsis Medicare and Medicaid Fraud and Abuse by : Alice G. Gosfield

Download or read book Medicare and Medicaid Fraud and Abuse written by Alice G. Gosfield and published by . This book was released on 2005 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

The Fraud and Abuse Provisions in H.R. 3600, the "Health Security Act"

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Publisher :
ISBN 13 :
Total Pages : 266 pages
Book Rating : 4.:/5 (327 download)

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Book Synopsis The Fraud and Abuse Provisions in H.R. 3600, the "Health Security Act" by : United States. Congress. House. Committee on Government Operations. Legislation and National Security Subcommittee

Download or read book The Fraud and Abuse Provisions in H.R. 3600, the "Health Security Act" written by United States. Congress. House. Committee on Government Operations. Legislation and National Security Subcommittee and published by . This book was released on 1995 with total page 266 pages. Available in PDF, EPUB and Kindle. Book excerpt: