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Feb 26, 2016 · Health Care Fraud Prevention Partnership (HFPP): The Obama Administration has joined with private insurers, states, and associations in the HFPP to prevent health care fraud on a national scale. To detect and prevent payment of fraudulent billings, HFPP participants exchange information and best practices across the public and private sectors.
Feb 26, 2016 · Since its inception, the Medicare Fraud Strike Force has maintained a conviction rate of approximately 95 percent and an average term of incarceration of more than four years. Another powerful tool in the effort to combat health care fraud is the federal False Claims Act.
Jan 18, 2017 · CMS continued to conduct Medicare and Medicaid fraud investigations and provider audits, as well as state program integrity reviews. In FY 2016, CMS continued its use of the Affordable Care Act authority to suspend Medicare payments to providers during an investigation of a credible allegation of fraud.
Although not all improper payments are fraudulent, most fraud cases violate 1 or more of these 3 statutes: the False Claims Act (FCA) of 1863, Anti-Kickback Statute (AKS) of 1972, or the Stark Law of 1989. 16 Because Medicare and Medicaid rely on health professionals’ judgment to treat patients with medically necessary services and to submit accurate claims for health care items and services ...
May 26, 2011 · The Affordable Care Act ("ACA"), the health reform legislation passed in 2010, contains fraud, waste and abuse provisions to aid the federal government in combating improper payments in Medicare, Medicaid and the Children's Health Insurance Program ("CHIP"). The ACA increases screening requirements for providers that want to participate in Medicare, Medicaid, and CHIP; enhances penalties for ...
In spite of government efforts recovering $10.7 billion in fraud, waste and abuse since 2008, the Patient Protection and Affordable Care Act of 2010 (ACA) has provided an additional $350 million to enhance fraud fighting efforts. Additionally, the ACA of 2010 has provided impositions for stricter rules and sentences for fraudulent activities ...
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Nov 13, 2017 · The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. Methodology: the methodology for this qualitative study was a literature review.
