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Final Stark II Regulations

Author: Bergeson, Donna; Butler, Jennifer

Source: AHIMA Convention

Publication Date: October 10, 2001


Introduction

The Stark Law1is designed to prohibit physician referrals for certain services when the referring physician has a financial relationship with the facility providing the service. This paper will summarize the history of the Stark Law and provide a brief discussion of the fu....

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....

Governmental Audit Toolkit

Author: AHIMA

Source: AHIMA toolkit

Publication Date: December 02, 2011

This toolkit is designed to provide guidance to HIM professionals on how to prepare for and ensure compliance in managing governmental audits.

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....

Is the FCA Effectively Fighting Healthcare Fraud?

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: May 2002


How effective has the False Claims Act (FCA) been in reducing healthcare fraud? A recent six-month study conducted by New Directions for Policy for Taxpayers Against Fraud sought to determine just that.1 What the study found is that the FCA is very effective in fighting fraud and should not be....

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....

Journal Q&A (4/03)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: April 02, 2003

Q: An attorney recently told our facility that we need to retain records for at least 10 years to comply with the False Claims Act (FCA). Our state law only requires seven years. Which takes precedence?

A: The FCA (31 USC§3729–3733) applies to actions, jurisdiction, and procedu....

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