Author : United States. Congress
Publisher : Createspace Independent Publishing Platform
Page : 306 pages
File Size : 23,8 MB
Release : 2017-12-14
Category :
ISBN : 9781981684502
Examining options to combat healthcare waste, fraud, and abuse : hearing before the Subcommittee on Health of the Committee on Energy and Commerce, House of Representatives, One Hundred Twelfth Congress, second session, November 28, 2012.
Author : United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health
Publisher :
Page : pages
File Size : 46,33 MB
Release : 2013
Category :
ISBN :
Author :
Publisher :
Page : pages
File Size : 17,62 MB
Release : 2014
Category :
ISBN :
Author : United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health
Publisher :
Page : 302 pages
File Size : 28,96 MB
Release : 2013
Category : Insurance crimes
ISBN :
Author : U.s. Government Accountability Office
Publisher : Createspace Independent Publishing Platform
Page : 26 pages
File Size : 21,86 MB
Release : 2017-07-27
Category :
ISBN : 9781973956716
" GAO has designated Medicare as a high-risk program, in part because the program's size and complexity make it vulnerable to fraud, waste, and abuse. In 2013, Medicare financed health care services for approximately 51 million individuals at a cost of about $604 billion. The deceptive nature of fraud makes its extent in the Medicare program difficult to measure in a reliable way, but it is clear that fraud contributes to Medicare's fiscal problems. More broadly, in fiscal year 2013, CMS estimated that improper payments-some of which may be fraudulent-were almost $50 billion. This statement focuses on the progress made and important steps to be taken by CMS and its program integrity contractors to reduce fraud in Medicare. These contractors perform functions such as screening and enrolling providers, detecting and investigating potential fraud, and identifying improper payments and vulnerabilities that could lead to payment errors. This statement is based on relevant GAO products and recommendations issued from 2004 through 2014 using a variety of methodologies. In April 2014, GAO also received updated information from CMS on its actions related to the laws, regulations, and guidance discussed in this statement. Additionally, GAO updated information by examining public documents and relevant policies"
Author : Aspen Health Law Center
Publisher :
Page : 156 pages
File Size : 44,88 MB
Release : 1998
Category : Business & Economics
ISBN :
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.
Author : Rebecca S. Busch
Publisher : John Wiley & Sons
Page : 374 pages
File Size : 20,50 MB
Release : 2012-05-01
Category : Business & Economics
ISBN : 1118179803
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 : M. Tunley
Publisher : Springer
Page : 229 pages
File Size : 49,30 MB
Release : 2014-04-25
Category : Social Science
ISBN : 1137406283
This project examines the concept of fraud loss measurement by critiquing existing measurement methodologies, and argues for the mandating of fraud loss measurement by enforced self regulation, the creation of a British Standard of fraud loss measurement, and the establishment of an information exchange matrix to develop best practice.
Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
Page : 399 pages
File Size : 34,71 MB
Release : 2019-01-27
Category : Medical
ISBN : 0309477891
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Author : United States. Congress. House. Committee on Energy and Commerce
Publisher :
Page : 72 pages
File Size : 10,56 MB
Release : 2011
Category : Energy policy
ISBN :
