Healthcare Fraud
Healthcare Fraud

Author: Rebecca S. Busch

Publisher: John Wiley & Sons

Published: 2012-05-01

Total Pages: 374

ISBN-13: 1118179803

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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.

Health Care Fraud and Abuse
Health Care Fraud and Abuse

Author: Aspen Health Law Center

Publisher:

Published: 1998

Total Pages: 156

ISBN-13:

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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.

Section 1557 of the Affordable Care Act
Section 1557 of the Affordable Care Act

Author: American Dental Association

Publisher: American Dental Association

Published: 2017-05-24

Total Pages: 60

ISBN-13: 1941807712

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Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.

Managing Legal Compliance in the Health Care Industry
Managing Legal Compliance in the Health Care Industry

Author: George B. Moseley III

Publisher: Jones & Bartlett Publishers

Published: 2013-09-20

Total Pages: 598

ISBN-13: 1449639658

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Managing Legal Compliance in the Health Care Industry is a comprehensive text that prepares students for this increasingly critical field in health care administration. In three sections, this unique title first examines all the key laws and regulations that health care organizations must comply with. In section two, it explores in detail the seven essential ingredients for a good compliance program. In the final section, the book explains how the compliance program must be adapted to the special needs of different types of health care organizations. Designed for graduate level students in programs of public health, health administration, and law, the text is filled with highly practical information about the ways that legal violations occur and how good compliance programs function. Key Features: - Examines in detail the current laws and regulations with which all types of health care organizations must comply - Explore the seven essential ingredients for a good compliance program - Looks at compliance programs within twelve different types of health care organizations - References real world cases of fraud and abuse - Includes Study Questions and Learning Experiences in each chapter that are designed to encourage critical thinking

2010 ADA Standards for Accessible Design
2010 ADA Standards for Accessible Design

Author: Department Justice

Publisher: Createspace Independent Publishing Platform

Published: 2014-10-09

Total Pages: 0

ISBN-13: 9781500783945

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(a) Design and construction. (1) Each facility or part of a facility constructed by, on behalf of, or for the use of a public entity shall be designed and constructed in such manner that the facility or part of the facility is readily accessible to and usable by individuals with disabilities, if the construction was commenced after January 26, 1992. (2) Exception for structural impracticability. (i) Full compliance with the requirements of this section is not required where a public entity can demonstrate that it is structurally impracticable to meet the requirements. Full compliance will be considered structurally impracticable only in those rare circumstances when the unique characteristics of terrain prevent the incorporation of accessibility features. (ii) If full compliance with this section would be structurally impracticable, compliance with this section is required to the extent that it is not structurally impracticable. In that case, any portion of the facility that can be made accessible shall be made accessible to the extent that it is not structurally impracticable. (iii) If providing accessibility in conformance with this section to individuals with certain disabilities (e.g., those who use wheelchairs) would be structurally impracticable, accessibility shall nonetheless be ensured to persons with other types of disabilities, (e.g., those who use crutches or who have sight, hearing, or mental impairments) in accordance with this section.

Health Care Fraud and Abuse Control Program
Health Care Fraud and Abuse Control Program

Author: Daniel R. Levinson

Publisher: DIANE Publishing

Published: 2010-10

Total Pages: 71

ISBN-13: 1437935176

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During FY 2009, the Fed. Gov¿t. won or negotiated approx. $1.63 billion in judgments and settlements, and it attained additional admin. impositions in health care fraud cases and proceedings. The Medicare Trust Fund received transfers of approx. $2.51 billion during this period as a result of these efforts, as well as those of preceding years, in addition to over $441 million in Fed. Medicaid money similarly transferred separately to the Treasury as a result of these efforts. The Health Care Fraud and Abuse Control Program account has returned over $15.6 billion to the Medicare Trust Fund since the inception of the Program in 1997. In FY 2009, U.S. Attorneys' Offices opened 1,014 new criminal health care fraud investigations involving 1,786 defendants. Illus.

Accountable
Accountable

Author: MD, MMM, FAAFP, Carl Couch

Publisher: CRC Press

Published: 2015-12-14

Total Pages: 131

ISBN-13: 1040181066

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While many health care organizations need to improve health care quality and lower costs, most lack specific strategies and tactics for implementing these changes. Baylor Scott & White Health has established and continues to develop an accountable care organization (ACO) called the Baylor Scott & White Quality Alliance (BSWQA) to improve th