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Journal Q&A (1/98)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: January 02, 1998

Q: I am employed as a coder and am concerned about my potential risk with respect to fraud and abuse charges involving coding practices. Would you advise me to obtain professional liability insurance?

A: If you work for someone else, contact your employer's legal counsel to fi....

Journal Q&A (1/98)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: January 02, 1998


Q: I am a coder in a hospital HIM department. I am being pressured to code in a manner I believe to be fraudulent in order to maximize reimbursement and improve the hospital's case mix. What should I do?

A: Always remember to exhaust all avenues for resolving the matter....

Cost of Fraud

Author:

Source: Journal of AHIMA

Publication Date: January 1999


According to the Department of Justice Health Care Fraud Report for Fiscal Year 1997, $1.2 billion was awarded or negotiated as a result of criminal fines, civil settlements, and judgments in healthcare fraud matters. And $517 million of that amount came from the settlements of three case....

Roundtable Takes on Compliance Challenges

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1999


The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) and the Health Care Compliance Association conducted a one-day joint roundtable on healthcare compliance to gain new insights into the challenges of creating effective compliance programs. The ro....

GAO Evaluates Implementation of False Claims Act Guidance

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: November 1999


With the increased attention to healthcare fraud and abuse in recent years, the Department of Justice (DOJ) has been using the False Claims Act to prosecute healthcare providers for practices that, in the past, might have been dealt with by seeking repayment. The damages and penalties....

Limitation on certain physician referrals

Author:

Source: U.S. Code

Publication Date: January 23, 2000

From the U.S. Code Online via GPO Access [wais.access.gpo.gov] [Laws in effect as of January 23, 2000] [Document not affected by Public Laws enacted between January 23, 2000 and December 4, 2001] [CITE: 42USC1395nn] TITLE 42--THE PUBLIC HEALTH AND WELFARE CHAPTER 7--SOCIAL SECURITY SUBCHAPTER XVIII....

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