Health Care Fraud: Hearing Before the Committee on the Judiciary, United States Senate, One Hundred Third Congress, Second Session, on Examining Federal, State, and Local Efforts to Combat Fraud and Abuse in the Health Care Industry and Related Provisions of the Proposed Health Security Act, May 25, 1994, 4. sējumsU.S. Government Printing Office, 1995 - 133 lappuses |
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activities Administration agencies AHCCCS Attorney authority beneficiaries CHAIRMAN civil monetary penalties Control Account convicted costs criminal defraud delivery system Department of Justice detection doctors dollars durable medical equipment efforts entities facilities False Claims Act Federal Government federal health fees forfeiture fraud and abuse Fraud Control Units fraud enforcement Fraud Unit fraudulent funding going health care delivery health care fraud health care offense health care programs health care providers health care reform health care system health plan Health Security Act hospital Inspector investigate and prosecute involved kickbacks law enforcement legislation MANGANO Medicaid Fraud Control Medicaid programs Medicare and Medicaid ment MFCUS million National Health NHCAA nursing home patient abuse payment percent physician self-referral physicians private insurance private payers private sector problem proposal provider fraud qui tam reimbursement schemes self-referral Senator Cohen statute tion violations WATERBURY white-collar crime
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90. lappuse - A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception.
123. lappuse - ... operated by or financed in whole or in part by any Federal, State, or local government agency...
22. lappuse - Act, and false statements statutes to prosecute health care fraud and abuse. There are also criminal statutes directed specifically to prevent fraud and abuse within Federal health care programs. Such authorities include criminal penalties for false claims and statements specifically involving the Medicare and Medicaid programs, and the Medicare and Medicaid anti-kickback statute. The anti-kickback statute prohibits an individual or entity from offering, paying, soliciting, or receiving remuneration...
86. lappuse - General shall establish a program — (A) to coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to health plans, (B) to conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care in the United States...
125. lappuse - ... or person selected to be a public official, directly or indirectly, corruptly demands, seeks, receives, accepts, or agrees to receive or accept anything of value personally or for any other person or entity, in return for: (A) being influenced in the performance of any official act...
100. lappuse - In general, physicians should not refer patients to a health care facility which is outside their office practice and at which they do not directly provide care or services when they have an investment interest in that facility.
89. lappuse - Physicians may invest in and refer to an outside facility, whether or not they provide direct care or services at the facility, if there is a demonstrated need in the community for the facility and alternative financing is not available.
20. lappuse - There are several categories of fraud which we have seen in HHA operations: cost report fraud; excessive services or services not rendered; use of unlicensed or untrained staff; falsified plans of care and forged physician's signatures; kickbacks; and intermediary hopping. Since 1986, we have concluded 24 successful criminal prosecutions of HHAs and their employees.
9. lappuse - Mr. Chairman and members of the committee, thank you very much for this opportunity to appear before you and convey to you the views and concerns of the city of Denton.
51. lappuse - PL 95-142 which established the state Medicaid Fraud Control Unit Program. The objective of this legislation was to strengthen the capability of the government to detect, prosecute and punish health care fraud. In addition to investigating and prosecuting providers who defraud the Medicaid program, the mandate to...