Proprietary education dates back to the late nineteenth century where institutions focused on professional training in teaching, medicine, and law (Breneman, Pusser, & Turner, S., 2000). The 1972 Higher Education Reauthorization Act included for-profit institutions in federal financial aid programs and changed the vernacular of higher education to postsecondary education (2000). This piece of legislation along with new technologies along with increased demand for higher education and prompted a resurgence
Off-label promotion: profitable health jeopardizing act of defiance or costly freedom of speech? INTRODUCTION Over the years there is the discussion on the nature of off-label promotion. Promotion for an unapproved by the Food and Drug Administration usage of a drug, medical device or biologic is prohibited by the 1938 Food, Drug and Cosmetics Act, and subjects the product to the misbranding provisions. On the other hand, off-label promotion is deemed to be a constitutional right protected by the
Labor Law Whistle Blowing Dillema Labor relations today, are quite different from those that existed in England during the eighteenth and nineteenth centuries when employment relationships were considered of very little importance in the eyes of the law. Industrialization and commerce grew bringing with it the birth of modem day labor law. America was in no way exempt from the pain of progress. Employer and employee relationships were strained from the very beginning of labor, and it
filing claims. This issue is very important to address considering your healthcare staff could be filing claims illegally to the Center for Medicaid and Medicare (CMS), and be subjected to the False Claims Act (FCA). Administrators need to make sure claims are filed correctly and not for the benefit of the doctors own pocket. Healthcare providers need to take caution and be aware of this situation occurring in their own hospital, as all healthcare organizations could be subjected to the False Claims
specifically target health care fraud. Example of the laws that the government direct at inappropriate health care activities includes the “Medicare and Medicaid Anti-Kickback Statute and Ethics in Patient Referrals Act (EPRA).” 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
five elements pertaining to the establishment of a false claim under the False Claims Act are the government must establish that the claim submitted is false and that it was submitted knowingly, the government must establish that the person submitted the claim with actual knowledge, in deliberate ignorance, or with reckless disregard for the claim’s truth or falsity, the claim was against a department or agency of the United States and if the claim was material. Privacy Standards were designed to
In my role with Liberty Mutual, I drove adoption of Medicare reimbursement models through public affairs involvement with multiple state workers' compensation committees seeking to update their reimbursement schedules in response to the implementation of ICD-10 coding requirements in October of 2015. With the state workers’ compensation authorities seeking to adopt CMS reimbursement type models, my involvement was directed at securing the inclusion of specific CMS rules governing correct coding and
When a person feels that something illegal or ethically wrong is happening in their place of work, what can they do? That person has the right to go to their administration about the acts that are occurring. (GAP) This action would be called whistle-blowing. Furthermore, whistle-blowers would be protected by law from repercussions from coming forward about the ethical or illegal issue. (Hallman, 2012) The organization that protects accountants and other financial professionals within the field of
Introduction 3 1.2 Policies and Procedures 4 1.3 Duties of the Employee 4 2 Essential Guidelines of the Compliance Plan 2.1 Assuring Quality 5 2.2 Patients’ Rights 5 2.3 Anti-Kickback and Self-Referral Laws 6 2.4 False Claim Act 7 3 Compliance Plan Establishment 3.1 Director of Compliance Role 7 3.2 Education and Training 8 3.3 Ongoing Oversight 8
In March of 2014, the New York Federal Court awarded Keith Edwards, a former employee of J.P. Morgan, $64 million dollars for his part in the Whistleblowing of a case that defrauded the U.S. government. J.P. Morgan Chase & Co., were submitting false claims to U.S. government to insure flawed home loans (Stempel, 2014). For more than a decade, JP Morgan Chase & Co. submitted thousands of mortgages for insurance by the Federal Housing Administration or the Department of Veterans Affairs that did not