Understanding the fraud and abuse laws : Guidance for internists.
This paper explains the fraud and abuse laws as they are being enforced in December 1997.
The American College of Physicians recognizes the onerous burden that these laws and their enforcement have on practicing internists.
These laws have created an atmosphere in which physicians feel that almost all of their behavior is suspect.
In particular, many physicians believe that inadvertent billing and coding errors made in the context of a complex system are being treated as fraud.
For this reason, the College will work with the American Society of Internal Medicine, the American Medical Association, and other medical organizations to develop legislative and regulatory proposals that will 1) reduce unnecessary burdens for physicians who do not engage in illegal activities and 2) prevent and punish fraud.
Fraud and abuse is an umbrella term that applies to a series of statutes and regulations designed to prevent government health programs from paying excessive and inappropriate claims.
In recent years, federal and state enforcement activities have been strengthened as governments have increasingly seen reduction of health care fraud as a way to rein in spending and an opportunity to reduce « waste » in government programs.
A 1997 report from the Department of Health and Human Services Office of the Inspector General concluded that in fiscal year 1996, net overpayments by Medicare totaled about $23.2 billion. (...)
Mots-clés Pascal : Médecine, Interne(étudiant), Guide pratique, Législation, Application médicale, Homme, Enseignement
Mots-clés Pascal anglais : Medicine, Resident(student), Handbook, Legislation, Medical application, Human, Teaching
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0230197
Code Inist : 002B30A09. Création : 11/09/1998.