Medicare fraud and abuse laws

Every year billions of dollars lost to fraud in the State and federal health care programs. Every dollar is lost not to worry about one at home for the elderly, or research into HIV and other treatments. This is money, be dedicated to the immunization of children, or one to find effective treatments for cancer and other diseases. Amounted to certain rules of healthcare has directly threaten the lives of patients. Governments have adopted to combat this terrible crime, laws, the laws and regulations aimed at punishing those who use the system. Types of insurance fraud and AbuseSome include practices of fraud and abuse billing for services never rendered, billing for products that are never sent increase unbundling or misrepresentation concerning services, unnecessary medical billing duplicate service billing, who are paid by fake reports, bribery and StatuteIn like.Bribery prices may 2000, the Supreme Court determines if an act of corruption in cases of fraud can be used to the health care providers health insurance units directly influence. The law stipulates a fine or a term of 10 years imprisonment, or both, may request the condemned of this law. Organizations, Medicare payments should now more fraud aware of this law that Government can. Does a service provider not insured as a form of payment, the supplier must remain aware because the acceptance of any federal funds could be reason for calling this law in the fraud.Stark statue: hikers natural self ProhibitionAccording stark status of each entity that provides health care services it is forbidden, submit a patient claims Medicare wENN the patient was referred by a doctor that entity health has inappropriate fiscal relationship. Congress has concluded that these are financial InappropriéPS compromise or whether it safe or effective professional medical judgment is when it comes to deciding whether a service is medically necessary. Studies have shown that doctors used financial relations with individual medical services providers or hospitals, services these providers more frequently than doctors who have the same financial relations. The stark statute was designed to reduce financial losses that such relationship created.Stark and dubious practices, I and II was stark Act adopted, in three parts which combined are as "stark status." I Flynn was adopted in 1989 and has prevented that doctors, that reference improper financial relations with clinical laboratories patients in the clinical laboratory services had. Congress, this in 1993 with stark II changed. This change prevents doctors the same only top 10 additional health care providers do include: physiotherapy; Radiology; Hospital and outpatient services. sustainable medical equipment and supplies; Occupational therapy; Radiotherapy; Prostheses, orthoses and prostheses and deliveries; enteral and parenteral nutrients. Home care services. and outpatient prescription drugs. Anti-pot-de-vin StatuteThe kick back status is found in § 1128B of the Social Security Act (42 u.s.c. § 1320a-7). It stipulates that it deliberately and knowingly provide a criminal offence, solicit, numbers or remuneration of reward or induce an erneuteKonferenzen for services or items that are accommodation by the federal health care programs. Both parties are assigned to criminal liability if a violation of this GEsit anti kickback and two penalties including unpaid claims received, are excluded from the Medicare program, having to pay penalties, responsible for the presentation of false statements to the Government and possibly fines or imprisonment.