Literature DB >> 24008955

Kickbacks, self-referrals, and false claims: the hazy boundaries of health-care fraud.

Joan H Krause1.   

Abstract

The fraud and abuse laws that govern conduct related to the federal health-care programs, such as Medicare and Medicaid, impose broad and complex limitations on billing practices and financial relationships among providers. Given the potential consequences of engaging in fraudulent behavior, it is crucial that physicians appreciate the types of activities that may run afoul of these laws. This article summarizes the major aspects of the fraud laws that are most likely to have a daily impact on physician practice: the Civil False Claims Act, the Medicare and Medicaid Anti-Kickback Statute, and the so-called Stark Law prohibition on physician self-referrals.

Mesh:

Year:  2013        PMID: 24008955     DOI: 10.1378/chest.12-2889

Source DB:  PubMed          Journal:  Chest        ISSN: 0012-3692            Impact factor:   9.410


  2 in total

1.  Recommendations to protect patients and health care practices from Medicare and Medicaid fraud.

Authors:  Zhen Xing Chen; Lindsey Hohmann; Bidur Banjara; Yi Zhao; Kavon Diggs; Salisa C Westrick
Journal:  J Am Pharm Assoc (2003)       Date:  2020-06-29

2.  Research on the Formation Mechanism of Health Insurance Fraud in China: From the Perspective of the Tripartite Evolutionary Game.

Authors:  Yun Fei; Yi Fu; Dong-Xiao Yang; Chang-Hao Hu
Journal:  Front Public Health       Date:  2022-06-23
  2 in total

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