Introduction. In Today'S Economy, Costs Are Increasing,

Physicians located within wealthier and more populous areas have slightly better access to equipment and infrastructure, but the conditions differ only slightly. Doctors are extremely rushed with a constant overflow of patients and consistently working in hot rooms with little air circulation. This is problem does not only exist in the public clinics of general physicians. Specialist physicians have a persistent flood of patients who do not need a specialist’s care, but seek the specialist because there is no general physician available.

Dr. V. and Dr. S. violated the Stark Law, initially, they did not violate the law when they decided to lease a nuclear camera. Although the Stark Law prohibits self-referrals for Medicare and Medicaid, there are exemptions; physicians may perform DHS services if they ordered the service. Under the assumption that Dr. V and Dr. S. ordered the services, they were not in violation of the Stark Law.

Federal or state authorities may investigate allegations of fraud depending on where the fraud was reported, the laws broken, and the amount of money involved. The strictness of penalties levied by state governments varies from state to state. Federal laws such as The False Claims Act, Anti-Kickback Statute, and Social Security Act are laws that address fraud and abuse. Title XI of the Social Security Act contains Medicaid program-related anti-fraud provisions, which impose civil penalties, criminal penalties, and exclusions from federal health care programs on persons who engage in certain types of misconduct (Staman, 2010). Under federal regulations, providers convicted of fraud are excluded for a minimum of five years from receiving funds from any federally

To prevent the grantors that the agency is not doing what in documentation and brochures claim.

The week four individual paper addresses the implementation of Activity Based Costing (ABC) by Super Bakery, Inc., a virtual corporation founded by Franco Harris. Specifically, management strategies, the reasoning behind an ABC system, and the alternatives of a job order cost system or a process order cost system are assessed for this enterprise.

Legally and ethically under Informed consent a patient has the right to refuse specialty treatment or referral but needs to be informed about the risks involved with delay or lack of the specific treatment recommended. Mostly, if the patient does agree to visit the specialist then, the specialist is responsible for the informed consent for the specific treatment. But is has been contested and help in courts that the primary care physician still is responsible for the patients welfare in all phases of treatment. For a provider in a busy practice it is difficult to keep track of all the referrals and at times, the specialist’s office has a different outlook on the matter.

These bold statements were completely wrong and very misinforming. The referral would also have a date attached, so a doctor would put on the referral how long the

Based upon service rates above, it is more cost effective for the physicians to see the patients.

In 1989, Congress enacted the Ethics in Patient Referrals Act. Commonly known as Stark law, Congress named it in honor of Rep. Pete Stark, a Democrat from California, and original sponsor of the bill (Sprague 2004). This law places limitations on self-referrals by physicians and prohibits physicians from referring patients to organizations in which

The Stark Law covers primary care provider referrals for specific health services and does not require prosecutors to prove intent for overpayments. However, prosecutors must prove intent for intentional violations involving punitive recovery. This law applies to civil cases and exposes violators to False Claims Act culpability. The act covers payment issued by Medicare and

Social Security Act Section 1877, known as the Physician Self-Referral law or “Stark Law” enacted first by Congress in 1989, and since amended several times over, prohibits physicians from making referrals for certain healthcare

According to the new law the OIG’s effectiveness will be detecting fraud and abuse by expanding access to and uses of data for conducting oversight and law enforcement activities, including data-matching agreements between agencies. (Gatty, 2010). The HHA will establish procedures for screening providers and suppliers participating in Medicare, Medicaid and the Children’s Health Insurances program to prevent

After establishing Medicare and Medicaid in 1965, Congress saw the need to protect the programs from fraudulent activities and practices of unscrupulous providers. The laws on health care fraud were enacted at different time during the history of the health care programs. However, the overall congressional intent has been the same, and the objective is to strengthen existing laws to protect the federal government health care programs from fraudulent activities.

Your paper should be between 1750 and 2500 words, in APA format and structured as follows:

Visiting the doctor has never been viewed as an enjoyable experience for clients. It is likely considered to be a necessary evil, something that must be done but is not pleasantly anticipated. Making the encounter between health care professional and client both helpful and therapeutic can be a challenge. This is especially true for those whose financial situation is precarious, meaning, one pay check away from being homeless. So not only does the client arrive for their scheduled appointment with the normal anxiety visiting the doctor brings; added to this is fear of a serious diagnosis, and the stress of finding the funds to pay for medical services, medications, and any follow-up visits that may be required. The extra expenses will