Week+4++Laws+and+Regulations+Executive+Summary
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School
University of Phoenix *
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Course
430
Subject
Health Science
Date
Dec 6, 2023
Type
Pages
6
Uploaded by Quiensala32
1
Title of Paper
Quiensala Hamilton
Universito of Phoenix
HCS/430
Jennifer Noren
12/25/2023 Extension
2
False Claim Laws and Regulations
This paper will go over various subject associated with the False Claims Act in the health
sector, Laws of the False Claim Act, the entity that oversees and enforces the law, The impact
that DOJ has on the health care industry, reason to comply with DOJ, requirements to stay in
compliance with DOJ and the penalties for breaking the law or ethics,
In 1863, the False Claim Act was passed to safeguard the governments programs such as
Medicaid and Medicare and other government funded programs. President Lincoln asked for its
implementation because of the unethical fraud that occurred during the American Civil War. The
False Claim Act amended during this period, significantly increasing the amount of funding the
government provided to the armed forces. The false claim act were implemented with the
intention of encouraging people who were aware of false claims to report them. Whistleblower
and qui tam, which translate to "come forward," were two of the means through which people
could come forward
.
After the false claim was implemented, it was modified in 1943, eliminating
compensation for individuals who reported false claims and imposing penalties on those who
made false claims. Once they saw that the number of false claims was beginning to rise once
more, they made the decision to reinstate payment to those who had reported false claims. People
that come forward they are protected by this law to prevent retaliation.
Law or Regulation Overseer and Enforcer
3
Entities that overseas and is responsible for enforcing False Claims are the following:
Department of Justice
Federal Bureau of Investigation
Inspector General of the Department of Health &
human Services
The Department of justice which is a federal executive department of the United States
government enforces federal laws and administration of the justice in the Untied States. In the
fiscal year of 2022, the DOJ recovered more than 2.2 billion in settlement involving fraud and
fraud claims that was against the government.
The Inspector General of the Department of Health & Human Services works with other
government entities to improves the efficiency of Medicare and Medicaid systemic changes,
enhanced compliance, effective enforcement measures, and the recovery of misused money.
The federal Bureau of Investigation also know as the White -Collar Crime is the main
organization that investigates health care fraud for both the public and private insurance
programs such as medicate and Medicare.
Impact of the False Claim Act on Healthcare
When physicians makes claims to the federal government it is important for them to
ensure that they are keeping fraud and abuse under control. Fraud claims could be costlyand can
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