Responding To Health Care Fraud And Abuse Investigations

Author : Aspatore Books Staff
Publisher : Aspatore Books
ISBN 13 : 9780314202376
Total Pages : 336 pages
Book Rating : 4.74/5 ( download)

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Download or read book Responding to Health Care Fraud and Abuse Investigations written by Aspatore Books Staff and published by Aspatore Books. This book was released on 2008 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt: Responding to Health Care Fraud and Abuse Investigations is an authoritative, insiders perspective on representing and advising health care organizations facing criminal and/or civil fraud and abuse investigations. Featuring partners from some of the nations leading law firms, these experts guide the reader through the different phases of an investigation and the key considerations for each phase. These top lawyers reveal their advice on how to understand the scope allegations, how to develop an initial response, and how to coordinate an internal investigation and evaluate a clients position, including managing documents and communications with knowledgeable individuals at the organization. From weighing self-disclosure and interacting with government agencies to auditing remedial actions and negotiating settlements, these authors outline steps that can be taken to manage liability during the latter stages of an investigation. Additionally, these leaders discuss recent changes in the regulatory landscape, describe the types of actions that often trigger investigations, and offer best practices for mitigating risk through the implementation of effective compliance programs. The different niches represented and the breadth of perspectives presented enable readers to get inside some of the great legal minds today, as these experienced lawyers offer up their thoughts around the keys to success within this ever-evolving field.

Author : Edward P. Richards
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834216037
Total Pages : 538 pages
Book Rating : 4.35/5 ( download)

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Download or read book Medical Care Law written by Edward P. Richards and published by Jones & Bartlett Learning. This book was released on 1999 with total page 538 pages. Available in PDF, EPUB and Kindle. Book excerpt: A legal reference for practicing physicians is a necessary adjunct to their professional practice library in today's highly regulated and litigious world. Medical Care Law was written to help practicing physicians avoid legal conflicts, and to prevent legal problems rather than treat them. Written with the practicing physician in mind, this book is also valuable to a variety of health professionals, including physician executives, medical directors, nurse administrators, advanced practice nurses, case managers, risk managers, legal nurse consultants, health care administrators, public health professionals, and attorneys. In addition To The traditional legal issues affecting medical practitioners, Medical Care Law addresses the legal pitfalls in today's volatile health care landscape, including managed care, health care fraud and abuse, compliance plans, and working with non-physician providers.

Author :
Publisher :
ISBN 13 : 9780769865652
Total Pages : pages
Book Rating : 4.58/5 ( download)

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Download or read book AHLA Fraud and Abuse Investigations Handbook for the Healthcare Industry (AHLA Members) written by and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Understanding the powers, procedures and remedies available to the government during a health care fraud and abuse investigation, and acquiring a basic understanding of the issues and practical steps to employ during an audit or investigation, are keys to surviving the investigation and achieving a favorable outcome.This new Handbook will arm health care administrators, executives, medical directors, office managers, physicians, and medical practice managers with a broad understanding of this industry-specific area of government enforcement. The resource is complete with:Clear and concise explanations of the lawSample government documents, affidavits, and subpoenas accompanying each chapterIllustrative pleadings and memoranda prepared by prosecutors and defense attorneysThe authors detail the nuts and bolts of a fraud and abuse investigation, from an overview of the various federal and state enforcement agencies to the potential of settling a case. Learn what to expect and how to respond with coverage of:Requests to examine books and records dealing with an organization's programs and operationsInterviews of employees by the OIG or the FBIThe power of HIPAA administrative subpoenas and the broad authority granted under this statuteSteps that should be taken in responding to the government's requestDealing with on-site demands for records and accessInternal audits and investigationsVoluntary disclosuresAffirmative actions to try and fend off an investigation, plea agreements, and deferred prosecution

Author : Robert A. Griffith
Publisher :
ISBN 13 : 9780769865720
Total Pages : 774 pages
Book Rating : 4.20/5 ( download)

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Download or read book Ahla Fraud and Abuse Investigations Handbook for the Healthcare Industry written by Robert A. Griffith and published by . This book was released on 2014 with total page 774 pages. Available in PDF, EPUB and Kindle. Book excerpt: If you are not an AHLA member and would like to purchase this title, click here. Understanding the powers, procedures and remedies available to the government during a health care fraud and abuse investigation, and acquiring a basic understanding of the issues and practical steps to employ during an audit or investigation, are keys to surviving the investigation and achieving a favorable outcome. This new Handbook will arm health care administrators, executives, medical directors, office managers, physicians, and medical practice managers with a broad understanding of this industry- specific area of government enforcement. The resource is complete with: * Clear and concise explanations of the law * Sample government documents, affidavits, and subpoenas accompanying each chapter * Illustrative pleadings and memoranda prepared by prosecutors and defense attorneys The authors detail the nuts and bolts of a fraud and abuse investigation, from an overview of the various federal and state enforcement agencies to the potential of settling a case. Learn what to expect and how to respond with coverage of: * Requests to examine books and records dealing with an organization's programs and operations * Interviews of employees by the OIG or the FBI * The power of HIPAA administrative subpoenas and the broad authority granted under this statute * Steps that should be taken in responding to the government's request * Dealing with on-site demands for records and access * Internal audits and investigations * Voluntary disclosures * Affirmative actions to try and fend off an investigation, plea agreements, and deferred prosecution

Author : United States. Congress. House. Committee on Commerce. Subcommittee on Oversight and Investigations
Publisher :
ISBN 13 :
Total Pages : 96 pages
Book Rating : 4.28/5 ( download)

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Download or read book Medicaid Fraud and Abuse written by United States. Congress. House. Committee on Commerce. Subcommittee on Oversight and Investigations and published by . This book was released on 1999 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Paul W. Shaw
Publisher :
ISBN 13 : 9781663315007
Total Pages : 775 pages
Book Rating : 4.00/5 ( download)

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Download or read book Fraud and Abuse Investigations Handbook for the Health Care Industry written by Paul W. Shaw and published by . This book was released on 2021 with total page 775 pages. Available in PDF, EPUB and Kindle. Book excerpt: The authors examine each stage of a fraud and abuse investigation, beginning with an overview of federal and state enforcement agencies, and concluding with a discussion of the potential collateral consequences of an investigation. They have supplemented their analysis extensively with sample documents, including indictments, requests for records, subpoenas, internal response memoranda, and responses to auditors, prosecutors, and more. Taken together, the materials in this book provide a true Handbook for anyone who needs to quickly and thoroughly understand the complex nature of a government fraud and abuse investigation.-Preface.

Author : Aspen Health Law Center
Publisher : Aspen Pub
ISBN 13 : 9780834208995
Total Pages : 388 pages
Book Rating : 4.97/5 ( download)

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Download or read book Health Care Fraud and Abuse Compliance Manual written by Aspen Health Law Center and published by Aspen Pub. This book was released on 1997-01 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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

Author : Martha Dale Nathanson
Publisher :
ISBN 13 :
Total Pages : 506 pages
Book Rating : 4.63/5 ( download)

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Download or read book Home Care Fraud and Abuse written by Martha Dale Nathanson and published by . This book was released on 1999 with total page 506 pages. Available in PDF, EPUB and Kindle. Book excerpt: Due to many changes in medical care and hospital discharge patterns, home health care is experiencing its share of fraud and abuse. In response, the government has increased its legislation efforts to crack down on abuse and fraud. This text will keep agencies advised on all the changes in legislation and regulations facing the home care industry in an easy-to-follow question & answer format.

Author : Robert A. Griffith
Publisher :
ISBN 13 : 9780918945433
Total Pages : 424 pages
Book Rating : 4.37/5 ( download)

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Download or read book Fraud and Abuse Investigations Handbook for the Healthcare Industry written by Robert A. Griffith and published by . This book was released on 2000 with total page 424 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations
Publisher :
ISBN 13 :
Total Pages : 236 pages
Book Rating : 4.71/5 ( download)

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Download or read book Health Care Fraud and Waste written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations and published by . This book was released on 1992 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: