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Author : United States. Congress. Senate. Special Committee on Aging. Subcommittee on Long-Term Care
Publisher : Unknown
Page : 72 pages
File Size : 45,7 Mb
Release : 1976
Category : Medicaid fraud
ISBN : PURD:32754066663562
Author : United States. Congress. Senate. Special Committee on Aging
Publisher : Unknown
Page : 94 pages
File Size : 48,7 Mb
Release : 1996
Category : Medical
ISBN : STANFORD:36105045070781
Author : United States. Congress. Senate. Special Committee on Aging
Publisher : Unknown
Page : 112 pages
File Size : 51,6 Mb
Release : 2009
Category : Medicaid fraud
ISBN : PURD:32754081200358
Author : Linda A. Baumann
Publisher : Bna Books
Page : 913 pages
File Size : 53,8 Mb
Release : 2007
Category : Law
ISBN : 1570186626
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.
Author : United States. Congress. Senate. Special Committee on Aging. Subcommittee on Long-Term Care
Publisher : Unknown
Page : 62 pages
File Size : 41,8 Mb
Release : 1977
Category : Medicaid fraud
ISBN : PURD:32754066663612
Author : United States. Congress. Senate. Special Committee on Aging
Publisher : Unknown
Page : 216 pages
File Size : 41,7 Mb
Release : 1995
Category : Business & Economics
ISBN : STANFORD:36105020994658
Author : Anton Ferilli
Publisher : Nova Science Publishers
Page : 0 pages
File Size : 51,5 Mb
Release : 2013-04-09
Category : Health care reform
ISBN : 1624176585
The Government Accountability Office (GAO) has designated Medicare and Medicaid as high-risk programs, in part due to their susceptibility to improper payments -- estimated to be about $70 billion in fiscal year 2010. Improper payments have many causes, such as submissions of duplicate claims or fraud, waste, and abuse. As the administrator of these programs, the Centers for Medicare and Medicaid Services (CMS) is responsible for safeguarding them from loss. This book explores fraud detection and deterrence in Medicare and Medicaid, with a focus on fraud detection systems; screening providers and suppliers; and program integrity.
Author : United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies
Publisher : Unknown
Page : 64 pages
File Size : 53,7 Mb
Release : 2012
Category : Law
ISBN : MINN:31951D03556842W
Author : Paul Jesilow,Henry N. Pontell,Gilbert Geis
Publisher : Univ of California Press
Page : 366 pages
File Size : 54,9 Mb
Release : 2023-09-01
Category : Medical
ISBN : 9780520911833
In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing. How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment. The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity. Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.
Author : United States. Congress. House. Select Committee on Aging
Publisher : Unknown
Page : 46 pages
File Size : 53,7 Mb
Release : 1980
Category : Government publications
ISBN : STANFORD:36105045065138
Author : Terry L. Leap
Publisher : Cornell University Press
Page : 253 pages
File Size : 51,6 Mb
Release : 2011-04-15
Category : Medical
ISBN : 9780801461286
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.
Author : United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security
Publisher : Unknown
Page : 128 pages
File Size : 49,9 Mb
Release : 2012
Category : Business & Economics
ISBN : UCSD:31822038362620
Author : United States. Congress. House. Committee on Interstate and Foreign Commerce. Subcommittee on Health and the Environment
Publisher : Unknown
Page : 176 pages
File Size : 44,8 Mb
Release : 1976
Category : Medicaid fraud
ISBN : LOC:0018423130A
Author : United States. Congress. House. Committee on Ways and Means. Subcommittee on Oversight
Publisher : Unknown
Page : 192 pages
File Size : 51,9 Mb
Release : 1991
Category : Government publications
ISBN : PSU:000017582599
Author : United States. Congress. Senate. Committee on Finance. Subcommittee on Health
Publisher : Unknown
Page : 56 pages
File Size : 42,9 Mb
Release : 1980
Category : Medicaid fraud
ISBN : UOM:39015083087588
