Subject(s)
Behavioral Medicine/organization & administration , Confidentiality/legislation & jurisprudence , Health Insurance Portability and Accountability Act/legislation & jurisprudence , Security Measures/legislation & jurisprudence , Behavioral Medicine/legislation & jurisprudence , Guideline Adherence , Humans , Medical Records/legislation & jurisprudence , Planning Techniques , Professional Staff Committees , Risk Assessment , United StatesABSTRACT
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) significantly changed the federal laws prohibiting Medicare fraud and abuse. It helps health care providers by requiring the Secretary of Health and Human Services to issue advisory opinions on transactions that may violate the fraud and abuse laws. But, overall, the changes greatly expand the government's ability to prosecute violations of the fraud and abuse laws. This article provides an overview of the fraud and abuse laws, discusses the changes made by the HIPAA, and concludes by suggesting the need for an effective plan to ensure compliance with these laws.
Subject(s)
Fraud/legislation & jurisprudence , Health Insurance Portability and Accountability Act/legislation & jurisprudence , Medicare/legislation & jurisprudence , Social Responsibility , Humans , Physician Self-Referral/legislation & jurisprudence , United StatesSubject(s)
Contract Services/legislation & jurisprudence , Medical Records Systems, Computerized/legislation & jurisprudence , Patient Credit and Collection/legislation & jurisprudence , Consumer Behavior/legislation & jurisprudence , Humans , Office Automation/legislation & jurisprudence , United StatesABSTRACT
Today's healthcare financial managers are faced with the challenge of controlling costs and providing quality care while maintaining the necessary records to comply with government requirements and observe sound business practices.
