Wednesday, February 26, 2014

What doctors need to know about fraud and abuse laws

Here's a primer for physicians. From the article:

Physicians who accept payment from the federal health-care programs, most notably Medicare and Medicaid, face a bewildering array of requirements that grow more complex each year...
Many fraud prohibitions are clear, yet others encompass activities that might appear to be innocuous, cost-effective, or even beneficial...
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) brought major changes to fraud enforcement.1 In addition to defining new federal crimes, most notably federal Health-care Fraud, HIPAA directed more funds to the US Department of Health and Human Services (DHHS) and Department of Justice to combat health-care fraud...

Plain language summary:

The government is continually inventing crimes for doctors and spending more and more money in the process. The resulting regulatory environment lacks clarity and is next to impossible to navigate, but here's an attempt to help.

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