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Trends to Watch in Home Health Compliance

Author: Abraham, Prinny

Source: Journal of AHIMA

Publication Date: May 2001




The implementation of the Home Health Prospective Payment System (PPS) on October 1, 2001, has presented some unique compliance risks for HIM and billing managers. This article will briefly describe some of the compliance-related issues on the OIG's agenda that are of interest to HIM....

Hard-line Approach to Compliance Pays Off

Author: Morris, Lewis

Source: Journal of AHIMA

Publication Date: May 2001




While the landscape will continue to change, most observers agree that the healthcare industry finds itself in a very different environment from a decade ago. The reasons for the evolution are numerous, but a significant factor has been the growing influence of compliance initiatives....

Compliance: A Critical Yet Costly Commitment

Author: Roach, Daniel R.

Source: Journal of AHIMA

Publication Date: May 2001




In the 1970s, the defense budget consumed the largest share of the federal budget. Concerns about both the size and efficiency of the defense bureaucracy triggered a massive crackdown on federal contractors who had either intentionally or inadvertently failed to follow the Department....

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....

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....

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....

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....

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....

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