Health Care Fraud and Abuse Compliance Manual

ISBN-10: 0834208997
ISBN-13: 9780834208995
Category: Health & Fitness
Pages: 388
Language: English
Published: 1997-01
Publisher: Aspen Pub
Author: Aspen Health Law Center

Description

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 "self-referral" 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

Get the book

Similar books

ADHD is Not a Four Letter Word: Drug Free Strategies for Managing the Gift that is ADHD
By Karen Ryan
... John F. Kennedy Justin Timberlake Karina Smirnoff Kurt Cobain Liv Tyler Magic Johnson Malcolm Forbes Melissa Joan Hart Michael Phelps Michelle Rodriguez ...
Breastfeeding and Human Lactation
By Karen Wambach, Becky Spencer
Although the gifts might be smaller, these practices are still in use by formula companies today ( Fortin, 2007; Tanovic, 2014). In the United States, ...
Freedom from Obesity: Unlock Your Combination to a Healthy Weight
By Karen Warren Locklear
If you've lost sight of the dream of ultimate health and wellness, and you never again want to experience the dieting roller coaster, this book will empower you to understand that being lean and fit starts from the beauty within your mind.
Encyclopedia of Herbal Medicine
By Andrew Chevallier
With its jargon-free text, fantastic photography, and focus on safety, this guide enables ease of understanding no matter what your level of herbal expertise.
Clean House Clean Planet
By Karen Logan
Casey Kitty's Litter Box Deodorizer Casey the Kitty is my daughter Sophie's favorite cat; she belongs to our neighbor, Laurie. We can't have cats because Sophie's daddy is allergic to them. Casey is a most friendly cat and willingly ...
Nutrition Research: Concepts & Applications
By Karen Eich Drummond, Alison Murphy-Reyes
by S.M. Robson, S.C. Couch, J.L. Peugh, K. Glanz, C. Zhou, J.F. Sallis, and B.E. Saelens, 2016, Journal of the Academy of Nutrition and Dietetics, 116,988. Reprinted with permission of the Academy of Nutrition and Dietetics. 6.
Therapy and the Postpartum Woman: Notes on Healing Postpartum Depression for Clinicians and the Women Who Seek Their Help
By Karen Kleiman
At least 10–20% of mothers will suf- fer from postpartum depression (Kumar & Robson, 1984), defined officially as a major depressive episode that has an onset within 4 weeks postpartum, according to the fourth edition of the Diagnos- ...
Nutrition for Brain Health: Fighting Dementia, Second Edition
By Laura Town, Karen Hoffman
... L., Smith, M., & Segal, R. (2020). Stress management. HelpGuide. Retrieved from https://www.helpguide.org/articles/stress/stress-management.htm Robson, D. (2015). Dos and don'ts to preserve your brainpower. BBC Future.
Breastfeeding and Human Lactation
By Karen Wambach, Becky Spencer
Another group of studies report that breastfeeding does not appear to influence resumption of coitus, coital frequency, and other indices of sexuality (Grudzinskas & Atkinson, 1984; Knodel & Chayovan, 1991; Robson et al., 1981) What do ...
Backbone: Living with Chronic Pain without Turning into One
By Karen Duffy
Buff's dog Gibson was a Golden Labrador Retriever puppy, a hair-raising furball of energy who was inflicted on our family for a year. Gibson went through a chewing phase that lasted ...