Week+4++Laws+and+Regulations+Executive+Summary

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University of Phoenix *

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430

Subject

Health Science

Date

Dec 6, 2023

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pdf

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6

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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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