Combating Medicare Fraud and Abuse

Fraud & abuse: DOJ and Medicare and Medicaid model compliance programs.

16. Colo. Rev. Stat. § 10-16-121(l)(b) (1996). 27. Id. at § 10-16-121(l)(a). 28. Wash. Rev. Code Ann. § 48.43.075(l)-(2) (West 1996). 29. See M. Conklin, '"Gag" Order Sparks Uproar: AMA Says Contract that Prevents Doctors from t)iscussing How They're Paid is Illegal," Rocky Mountain News, Mar. 24, 1997, at IB. 30. See "Denver Doctors: Protest Disclosure Clause in Contract," Health Line, Mar. 25...

The role of the states in combating managed care fraud and abuse.

Professor Krause describes the weapons available to state regulators to address managed care fraud. Although many commentators have focused on recent federal anti-fraud efforts, Professor Krause argues that the states, through the use of a number of existing legal theories, have the most flexibility to combat fraudulent managed care practices. By using these targeted state-based efforts (in con...

Medicare and State health care programs: fraud and abuse; OIG anti-kickback provisions--HHS. Final rule.

This final rule implements section 14 of Public Law 100-93, the Medicare and Medicaid Patient and Program Protection Act of 1987, by specifying various payment practices which, although potentially capable of inducing referrals of business under Medicare or a State health care program, will be protected from criminal prosecution or civil sanctions under the anti-kickback provisions of the statute.

Self disclosure. How to manage the risk of Medicare fraud and abuse.

When you discover an incident of noncompliance with Medicare/Medicaid regulations, step forward and notify the authorities before the government or a whistleblower takes the problem out of your hands.

Curing the health care industry: government response to Medicare fraud and abuse.