While fraud is typically discussed in financial terms, some health care industry frauds have an element that is absent in most other industries, i.e., individuals' health and lives may be affected. This paper provides a definitional understanding of health care fraud, defines specific frauds, ...
"Health care fraud shows no sign of abating," said Dr. Joseph T. Wells, CFE, CPA, founder and chairman of the ACFE, during his keynote message at the 23rd Annual ACFE Fraud Conference & Exhibition. "Don't expect a downturn anytime soon."Because health care fraud affects everybody, ...
Federal health care programs, including Medicare and Medicaid, are under attack by dishonest people who lie to the government and exploit its programs to steal taxpayers' money. The full extent of health care fraud cannot be measured precisely. However, the Federal Bureau of Investigation (FBI) ...
White-collar crimeis an umbrella term that encompasses a large number of different crimes and crime types. Connotatively, white-collar crimes are likely to be thought of as crimes that are primarily financial in nature. For example, crimes likeembezzlement, insider trading, Ponzi schemes, or bank...
A large public entity or other organization may have its own ombudsman—an example being the California Department of Health Care Services. Depending on the appointment, an ombudsman may investigate specific complaints about the services or other interaction a consumer has had with the entity concerned...
In an era ofaccountable care organizations,health caresystems need to be redesigned to care for the chronically ill. Diabetes is a great example of a chronic disease that could be partly prevented, but more important most of its complications that are costly and burdensome could be prevented. ...
Spain's Supreme Court has confirmed on Wednesday Lionel Messi's fraud sentence upholding the 21-month jail term for the FC Barcelona player and a two-million euro fine, judicial sources reported. Mediterranean to strengthen its appeal for Chinese Tourists:Maltese Minister Maltese Tourism Minister Edw...
For example, an experiment that created stem cells in an acid bath was questioned shortly after being published and retracted within months.5,6 A number of articles reporting nutritional research on food preferences have been corrected and at least 1 has been retracted.7 A published analysis of ...
‘positive’ health achievement. One can imagine other such positive health achievements, for example, athleticism or living a healthy lifestyle. Furthermore, certain aspects of health such as physique, physical strength, or endurance, can today be enhanced through various drugs and procedures – ...
The AHRQ is a federal agency tasked with improving the quality, safety, efficiency, and effectiveness of healthcare in the United States. The AHRQ hosts the USPSTF. The PPS is a reimbursement strategy of paying for an episode of care. DRGs are an example of a PPS. The PHAB is a not-fo...