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Health Care Fraud and Abuse Compliance Manual

Written for attorneys and non-attorneys alike, Health Care Fraud and Abuse Compliance Manual is a practical resourcethat provides a comprehensive overview of legislative and regulatory restrictions that affect the way health care providers conduct business and how they structure relationships among themselves. This treatise is written in an easy-to-understand, non-technical style to help providers determine the boundaries of permissible conduct under the various statutes and regulations that relate to health care fraud and abuse at both the federal and state levels. The Manual explains fraud and abuse laws in plain language, using examples to illustrate the principles. It has an overview chapter that presents a general introduction to the subject areas that are explored in greater detail in subsequent chapters. The main areas addressed by the Manual are: false claims and fraudulent billing; fraud and abuse prohibitions under the Anti-kickback Statute; federal physician self-referral prohibitions; the Stark Law; corporate compliance programs; anatomy of an investigation; and state fraud and abuse investigations and enforcement. CCH and Aspen Publishers have joined together to offer you access to all the latest information regarding Health Law. Customers have the added advantage of having Aspen’s treatise materials in an electronic format that links to primary source material in the CCH Health Care Compliance Reporter. This title is part of the Health Law & Compliance Integrated Library. For more information, simply call 1-888-224-7377 to talk to one of our sales representatives and find out how Health Care Fraud and Abuse Compliance Manual provides the expert guidance you need—Call now!

Benefits and Features

• Critical laws and considerations – false claims and fraudulent billings, civil and criminal penalties, the Anti-kickback Statute, the Safe Harbor regulations, the Stark Law, state statutes, and more.
• Practical advice on developing a corporate compliance program that can help you stay on the right side of the law
• Structure, goals, and procedures of agencies that investigate health care fraud
• What goes into a fraud and abuse investigation – and how you can respond to an investigation to best defend your organization
• Updated subsection on National Practitioner Data Bank and Health Care Integrity and Protection Data Bank providing in-depth discussion on eligible entities, reporting, and confidentiality
• Summaries of projects in Office of Inspector General Work Plan for FY 2006
• New subsection on assignment violations and drug discount card education and outreach arrangements
• Further coverage of Corporate Integrity Agreements and support for compliance programs: Sarbanes-Oxley Compliance
• Full text of state anti-kickback and self-referral laws, including: California, Maryland, New York, and Ohio

Part of the Health Law & Compliance Integrated Library, Health Care Fraud and Abuse Compliance Manual links to the primary source material in the CCH Health Care Compliance Reporter. The Library combines the latest information regarding Health Law from CCH and Aspen Publishers.

Topics Covered

• False claims and fraudulent billing
• Fraud and abuse prohibitions under the Anti-kickback Statute
• Federal physician self-referral prohibitions
• The Stark Law
• Corporate compliance programs
• Anatomy of an investigation
• State fraud and abuse investigations and enforcement