When Congress enacted the Medicaid and Medicare statutes in 1965, the laws filled 70 pages. For years, Congress has been adding to and changing those rules, so that regulations now cover thousands of pages. Health Care Fraud and Abuse: A Guide to Federal Sanctions helps lawyers and health-care professionals understand and apply federal law providing for health-care related sanctions.
To help deal with the myriad complex laws, the book is arranged so that practitioners can find information quickly through the use of tabs for easy organization. The chapters arrange sanctions in sequence as they appear in the statutes. Each section heading describes the activity or obligation to which a sanction may apply. Beginning each section is a summary of statutory provisions, followed by extracts of relevant statutes. The reader is then specifically directed to relevant regulations directly on point. Extensive cross references to other sections in the text are also provided.
Five chapters direct readers to the sanctions in the Medicare and Medicaid statutes. Title Xl of the Social Security Act, and the Health Care Quality Improvement Act, as well as describing those persons and entities subject to sanctions under the Medicare and Medicaid statutes. Six appendices set forth the most pertinent sections of the United State Code related to health-care fraud and abuse, including the False Claims Act, the Program Fraud Civil Remedies Act, and the Major Fraud Act of 1 988.
To help readers find material relevant to their interests, guides are located at the beginning of the book. Guides are provided for hospitals, nursing homes, physicians, peer review organizations, risk-sharing organizations, insurance companies, civil money penalties, and exclusion authorities.
For more information, contact Clark Boardman Co, 375 Hudson Street, New York, NY 1 001 4; 21 2-929-7500.