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Health Care Fraud and Abuse

Health Care Fraud and Abuse PDF Author: Aspen Health Law Center
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 156

Book Description
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.

Health Care Fraud and Abuse

Health Care Fraud and Abuse PDF Author: Aspen Health Law Center
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 156

Book Description
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.

Medicare and Medicaid Guide

Medicare and Medicaid Guide PDF Author:
Publisher:
ISBN:
Category : Medicaid
Languages : en
Pages : 1452

Book Description


Applications of Accounting Information Systems

Applications of Accounting Information Systems PDF Author: David M. Shapiro
Publisher: Business Expert Press
ISBN: 1949991598
Category : Business & Economics
Languages : en
Pages : 86

Book Description
The revolutionary effects of using accounting information systems by displacing manual information systems in the private and public sectors cannot be overstated. The benefits of this substitution of set of processes include increased mathematical accuracy, predefined fields and coding tasks, and de-emphasis of manual clerical labor in favor of labor adept in data processing. Reporting can be significantly automated, facilitating managerial power and control at a distance and the proliferation of global enterprises. The potential detriments are rarely accurately, completely, and timely addressed as information system vendors, management consultants, and corporate procurement teams race toward the popularly conceived state of the art. Systems are ballyhooed as continually improving in processing speed, functionality, and capacity. Users of these automated systems may not consider big picture effects, and they may not intelligently consider the conduct risks to their own enterprises by concentrating such global reach and influence at high levels of senior management without dedicating adequate resources to verifying the accuracy, completeness, and timeliness of the information systems. This book considers these risks.

Medicaid and the Health Care Provider

Medicaid and the Health Care Provider PDF Author:
Publisher:
ISBN:
Category : Medicaid
Languages : en
Pages : 424

Book Description


Improving the Quality of Long-Term Care

Improving the Quality of Long-Term Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132746
Category : Medical
Languages : en
Pages : 344

Book Description
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

For-Profit Enterprise in Health Care

For-Profit Enterprise in Health Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309036437
Category : Medical
Languages : en
Pages : 580

Book Description
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

Medicaid Fraud, a Case History in the Failure of State Enforcement

Medicaid Fraud, a Case History in the Failure of State Enforcement PDF Author: Val J. Halamandaris
Publisher:
ISBN:
Category : Crime prevention
Languages : en
Pages : 112

Book Description


Strengthening Forensic Science in the United States

Strengthening Forensic Science in the United States PDF Author: National Research Council
Publisher: National Academies Press
ISBN: 0309142393
Category : Law
Languages : en
Pages : 348

Book Description
Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.

Registries for Evaluating Patient Outcomes

Registries for Evaluating Patient Outcomes PDF Author: Agency for Healthcare Research and Quality/AHRQ
Publisher: Government Printing Office
ISBN: 1587634333
Category : Medical
Languages : en
Pages : 385

Book Description
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Processing of Medicaid Medical Service Payments

Processing of Medicaid Medical Service Payments PDF Author: James R. Hanson
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 108

Book Description