Medicare Fraud

Author : United States. Congress. Senate. Special Committee on Aging. Subcommittee on Long-Term Care
Publisher :
ISBN 13 :
Total Pages : 128 pages
Book Rating : 4.83/5 ( download)

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Download or read book Medicare and Medicaid Frauds written by United States. Congress. Senate. Special Committee on Aging. Subcommittee on Long-Term Care and published by . This book was released on 1976 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Malcolm K Sparrow
Publisher : Hachette UK
ISBN 13 : 0465010741
Total Pages : 304 pages
Book Rating : 4.45/5 ( download)

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Download or read book License To Steal written by Malcolm K Sparrow and published by Hachette UK. This book was released on 2007-12-14 with total page 304 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.

Author : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher :
ISBN 13 :
Total Pages : 120 pages
Book Rating : 4.67/5 ( download)

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Download or read book Medicare Fraud, Waste, and Abuse written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1992 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Rebecca S. Busch
Publisher : John Wiley & Sons
ISBN 13 : 1118179803
Total Pages : 374 pages
Book Rating : 4.02/5 ( download)

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Download or read book Healthcare Fraud written by Rebecca S. Busch and published by John Wiley & Sons. This book was released on 2012-05-01 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Author : United States. General Accounting Office
Publisher :
ISBN 13 :
Total Pages : 24 pages
Book Rating : 4.69/5 ( download)

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Download or read book Medicare Fraud and Abuse written by United States. General Accounting Office and published by . This book was released on 2001 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : United States. General Accounting Office
Publisher :
ISBN 13 :
Total Pages : 16 pages
Book Rating : 4.03/5 ( download)

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Download or read book Medicare Fraud and Abuse written by United States. General Accounting Office and published by . This book was released on 2000 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher :
ISBN 13 :
Total Pages : 134 pages
Book Rating : 4.76/5 ( download)

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Download or read book Medicare Fraud, Waste, and Abuse written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1992 with total page 134 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author :
Publisher :
ISBN 13 :
Total Pages : 24 pages
Book Rating : 4.76/5 ( download)

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Download or read book Medicare Fraud and Abuse written by and published by . This book was released on 2002 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Sarah F. Jaggar
Publisher :
ISBN 13 :
Total Pages : 22 pages
Book Rating : 4.30/5 ( download)

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Download or read book Fraud and Abuse written by Sarah F. Jaggar and published by . This book was released on 1995 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher :
ISBN 13 :
Total Pages : 36 pages
Book Rating : 4.22/5 ( download)

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Download or read book Fraud and Abuse in the Medicare and Medicaid Programs written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1977 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: