Healthcare Fraud Prevention Best Practices

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Preventing Health Care Fraud and Abuse - AAP

(7 days ago) WEBThe best way to protect your workplace from fraud and abuse is to have a compliance program. Large health care organizations have had these in place for years and physician employees should be aware of their responsibilities in the program. With …

https://www.aap.org/en/practice-management/liability-and-regulation/preventing-health-care-fraud-and-abuse/

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What Should Health Care Organizations Do to Reduce …

(4 days ago) WEBIn 2016, the Centers for Medicare and Medicaid Services (CMS) spent $1.1 trillion on health coverage for 145 million Americans, $95 billion of …

https://journalofethics.ama-assn.org/article/what-should-health-care-organizations-do-reduce-billing-fraud-and-abuse/2020-03

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The Health Care Fraud and Abuse Control Program Protects - CMS

(1 days ago) WEBHealth Care Fraud Prevention Partnership (HFPP): The Obama Administration has joined with private insurers, states, and associations in the HFPP to …

https://www.cms.gov/newsroom/fact-sheets/health-care-fraud-and-abuse-control-program-protects-consumers-and-taxpayers-combating-health-care-0

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Fraud, Waste, and Abuse - Centers for Medicare & Medicaid …

(5 days ago) WEBThe Healthcare Fraud Prevention Partnership (HFPP) is a voluntary, public-private partnership between the federal government, state and local and abuse schemes and …

https://www.cms.gov/files/document/hfpp-white-paper-healthcare-fraud-waste-and-abuse-context-covid-19.pdf

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Recommendations to protect patients and health care practices …

(3 days ago) WEBTypes of fraud. There is no standard in how fraud is classified. 17 CMS describes 10 different types of Medicaid fraud, whereas Thornton et al 17 describe 18 …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323645/

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Recommendations to protect patients and health care practices …

(Just Now) WEBFraud is defined as knowingly submitting, or causing to be submitted, false claims or making misrepresentations of a fact to obtain a federal health care payment …

https://www.japha.org/article/S1544-3191(20)30247-8/fulltext

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Best Practices for Employers Mitigating Health Care …

(4 days ago) WEBThe National Health Care Anti-Fraud Association (NHCAA) estimates health care fraud impacts the United States about $68 billion annually, or 3% of health care spending. Other estimates range as high …

https://www.mossadams.com/articles/2021/10/tips-to-fight-health-care-fraud

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Fact Sheet: The Health Care Fraud and Abuse Control Program …

(8 days ago) WEBHealth Care Fraud Prevention Partnership (HFPP): The Obama Administration has joined with private insurers, states, and associations in the HFPP to …

https://www.justice.gov/opa/pr/fact-sheet-health-care-fraud-and-abuse-control-program-protects-conusmers-and-taxpayers

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AI and machine learning – an intelligent approach to healthcare …

(9 days ago) WEBThe National Health Care Anti-Fraud Association estimated (on a conservative basis) that healthcare fraud costs the U.S. about $68 billion annually — …

https://www.hfma.org/cost-effectiveness-of-health/ai-and-machine-learning-an-intelligent-approach-to-healthcare-fraud-prevention/

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How Providers Can Detect, Prevent Healthcare Fraud and Abuse

(1 days ago) WEBTo prevent an organization from participating in healthcare fraud and abuse activities, providers should understand key healthcare fraud laws, implement a …

https://revcycleintelligence.com/features/how-providers-can-detect-prevent-healthcare-fraud-and-abuse

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Combating Health Care Fraud and Abuse: Conceptualization and

(3 days ago) WEBAlthough several companies are exploring blockchain to enhance health care reimbursement and revenue cycle management, few have explicitly assessed …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516680/

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The Health Care Fraud and Abuse Control Program Protects - CMS

(9 days ago) WEBHealth Care Fraud Prevention Partnership (HFPP): The Obama Administration has joined with private insurers, states, and associations in the HFPP to …

https://www.cms.gov/newsroom/fact-sheets/health-care-fraud-and-abuse-control-program-protects-consumers-and-taxpayers-combating-health-care

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Current Trends and Real-World Best Practices in Healthcare Fraud

(2 days ago) WEBRhett DeHart, Of Counsel, Womble Bond Dickinson. The penalties for non-compliance are severe. Under the FCA, any person who knowingly presents a false …

https://www.womblebonddickinson.com/us/insights/articles-and-briefings/current-trends-and-real-world-best-practices-healthcare-fraud

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Medicare Fraud & Abuse: Prevent, Detect, Report - Centers …

(1 days ago) WEBIn 2010, HHS and CMS launched the Fraud Prevention System (FPS), a state-of-the-art predictive analytics technology that runs predictive algorithms and other analytics …

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Fraud-Abuse-MLN4649244.pdf

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To Fight Fraud, Waste and Abuse, Healthcare - The Protiviti View

(7 days ago) WEBProtiviti recently hosted a webinar, Healthcare Payer Fraud, Waste and Abuse — How to Prevent, Detect and Respond, devoted to this topic and invited a …

https://blog.protiviti.com/2021/09/17/to-fight-fraud-waste-and-abuse-healthcare-providers-should-elevate-their-technology-game/

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HEAT: A Year of Tackling Health Care Fraud

(8 days ago) WEBDOJ’s Civil Division and U.S. Attorneys’ Offices have recovered more than $3.6 billion in health care fraud matters pursued under the False Claims Act and Food, …

https://www.justice.gov/archives/opa/blog/heat-year-tackling-health-care-fraud

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Federal Agencies Launch Portal for Public Reporting of …

(2 days ago) WEBThat’s why we are working to tackle anticompetitive practices in the health care markets,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration …

https://www.ftc.gov/news-events/news/press-releases/2024/04/federal-agencies-launch-portal-public-reporting-anticompetitive-practices-health-care-sector

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Best Practices for Reducing Health Care Fraud Risk

(5 days ago) WEBHealthCap® and the American Health Care Association are hosting a free webinar on Tuesday, August 24 at 2 p.m. EDT highlighting best practices for reducing …

https://www.ahcancal.org/News-and-Communications/Blog/Pages/Best-Practices-for-Reducing-Health-Care-Fraud-Risk.aspx

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Healthcare Fraud Data Mining Methods: A Look Back and Look …

(3 days ago) WEBFraud Actors, Types, and Facts. Healthcare fraud takes many forms. Some of the more prevalent forms 12, 13 are traditional fraud schemes implemented by shell …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013219/

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EXPLORING FRAUD, WASTE, AND ABUSE WITHINTELEHEALTH

(7 days ago) WEBTELEHEALTH. A white paper by the Healthcare Fraud Prevention Partnership (HFPP) Learn about evolving fraud, waste, and abuse schemes associated with the delivery of …

https://www.cms.gov/files/document/hfpp-information-sheet-exploring-fraud-waste-abuse-within-telehealth.pdf

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Strengthening Healthcare Practices: Preventing Billing Fraud

(9 days ago) WEBThis open environment acts as a deterrent against fraudulent practices. Leveraging Technology: Advanced billing software with built-in fraud detection can significantly …

https://www.revprohealthcare.com/strengthening-healthcare-practices-a-blueprint-for-preventing-billing-fraud/

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Consumer advocates support federal review of air industry’s data

(4 days ago) WEBPBPA Commends HHS Funding to Support Maternal and Infant Health. The Preterm Birth Prevention Alliance (PBPA), a coalition of maternal and women’s health …

https://nclnet.org/consumer-advocates-support-federal-review-of-air-industrys-data-collection-practices/

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Healthcare Fraud, Waste, and Abuse Context of COVID-19

(1 days ago) WEBA white paper by the Prevention Partnership. Learn about concerns surrounding fraud, waste, and abuse schemes related to the delivery of care for COVID-19, as well as …

https://www.cms.gov/files/document/hfpp-information-sheet-healthcare-fraud-waste-and-abuse-context-covid-19.pdf

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Long-Term Care Educational Opportunities Now Available Texas …

(5 days ago) WEBThis partnership includes updating eight web-based courses delivering best practices education to providers of long-term care in Texas nursing homes. The first …

https://www.hhs.texas.gov/provider-news/2024/04/24/long-term-care-educational-opportunities-now-available

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