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Rose McGowan

Special Fraud Alert: Laboratory Payments to Referring Physicians - 1 views

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    I. The Anti-Kickback Statute One purpose of the anti-kickback statute is to protect patients from inappropriate medical referrals or recommendations by health care professionals who may be unduly influenced by financial incentives. Section 1128B(b) of the Social Security Act (the Act) makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce, or in return for, referrals of items or services reimbursable by a Federal health care program. When remuneration is paid purposefully to induce or reward referrals of items or services payable by a Federal health care program, the anti-kickback statute is violated. By its terms, the statute a scribes criminal liability to parties on both sides of an impermissible "kickback" transaction. Violation of the statute constitutes a felony punishable by a maximum fine of $25,000, imprisonment up to 5 years, or both. Conviction will also lead to exclusion from Federal health care programs, including Medicare and Medicaid. OIG may also initiate administrative proceedings to exclude persons from the Federal health care programs or to impose civil money penalties for fraud, kickbacks, and other prohibited activities under sections 1128(b)(7) and 1128A(a)(7) of the Act. II. Remuneration From Laboratories to Referring Physicians Arrangements between referring physicians and laboratories historically have been subject to abuse and were the topic of one of the OIG's earliest Special Fraud Alerts. 1 In that Special Fraud Alert, we stated that, "[w]henever a laboratory offers or gives to a source of referrals anything of value not paid for at fair market value, the inference may be made that the thing of value is offered to induce the referral of business.
Rose McGowan

HMO vs PPO - 1 views

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HMO vs PPO westhill healthcare consulting jakarta usa united kingdom

started by Rose McGowan on 04 Jun 15 no follow-up yet
Rose McGowan

Westhill Consulting Insurance - Saving for your ageing parents: an easy guide to where ... - 2 views

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    The needs of elderly parents can surprise even those who are prepared, but you don't have to support your family alone Adult children of older parents should prepare financially for the costs of care and travel. Photograph: Alamy We all want to age like the late Pete Seeger, who celebrated his 90th birthday performing onstage in front of thousands of adoring fans of all ages at Madison Square Garden, and went on to entertain the Newport Jazz Festival audiences a few months later. In our pragmatic moments, we know that the odds of living that long and in such good health aren't in our favor. We know we need to plan not only to live longer but perhaps to spend more time in costly nursing homes or care facilities. It's not just ourselves we have to worry about. Failing to develop a plan to help our parents in their final years could deliver a similar kind of blow to our emotional and financial wellbeing. In the last few months, I've watched three friends, ranging in age from their 40s to the early 60s, scramble to resolve non-medical problems for their parents. In all cases, that meant forking out on costly airfares to be there in person; in one case, it required money to hire a new accountant. "I've always been aware that at some point, there would be an emergency, but I had assumed it would be a stroke or something, not this," one told me, ruefully. A recent US Trust survey revealed that while about half of all Americans have planned for their own long-term care needs, on
Rose McGowan

Lapses in Insurance Coverage - 1 views

Insurance has been around since people have realized it should be. Yet sometimes, we cannot avoid not paying for our premiums especially when we encounter financial instability. These are called...

westhill consulting health Insurance USA Jakarta UK Lapses in Coverage

started by Rose McGowan on 28 Apr 15 no follow-up yet
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