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An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.
Since the first edition of the Encyclopedia of White Collar and Corporate Crime was produced in 2004, the number and severity of these crimes have risen to the level of calamity, so much so that many experts attribute the near-Depression of 2008 to white-collar malfeasance, namely crimes of greed and excess by bankers and financial institutions. Whether the perpetrators were prosecuted or not, white-collar and corporate crime came near to collapsing the U.S. economy. In the 7 years since the first edition was produced we have also seen the largest Ponzi scheme in history (Maddoff), an ecological disaster caused by British Petroleum and its subcontractors (Gulf Oil Spill), and U.S. Defense Department contractors operating like vigilantes in Iraq (Blackwater). White-collar criminals have been busy, and the Second Edition of this encyclopedia captures what has been going on in the news and behind the scenes with new articles and updates to past articles.
Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.