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Showing 5 posts in Health Care Fraud and Abuse Control Program.

Annual Report Details Record Breaking Success in Health Care Fraud Prevention

The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), required the establishment of a national Health Care Fraud and Abuse Control Program (“HCFAC”). The HCFAC Program is a joint Department of Justice (“DOJ”) and Health and Human Services (“HHS”) coordination of federal, state and local law enforcement activities to combat fraud committed against all health plans, both public and private. More >

Compliance Plan – A Provider’s Defense

The Office of the Inspector General (“OIG”) has always encouraged Medicare and Medicaid providers to implement a compliance program. For 14 years, as a matter of fact, OIG has provided compliance guidance in 11 healthcare sectors (including: hospitals, nursing facilities, home healthcare, hospice and third-party billers). With the passing of the Patient Protection and Affordable Care Act (“PPACA”), compliance plans and programs are now mandatory for any provider enrolled in a Federal health care program, including Medicare. More >

Fraud, Waste and Abuse Controls Under The Affordable Care Act

The Affordable Care Act (“ACA”) strives to improve our health care system in three main areas; by expanding consumer protections, strengthening Medicare and reducing health care costs.  One key way the government hopes to achieve these goals is through tougher fraud and waste controls. Given the focus on prevention, penalty and recovery, compliance plans are of the utmost importance for all health care providers. First we examine all of the elements incorporated in the ACA that pertain to fraud, abuse and waste before we can begin to develop a compliance plan for our facilities. The new law contains a host of tools aimed at enforcing fraud and waste prevention.  Let’s review: More >

Fraud, Waste and Abuse

Posted In Health Care Fraud, Health Care Fraud and Abuse Control Program, Health Care Law, Kentucky Pharmacists Association

Lisa English Hinkle and Molly Nicol Lewis recently spoke at the Kentucky Pharmacists Association Annual Meeting on Fraud, Waste and Abuse. To view their PowerPoint presentation click the link below. More >

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