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The lack of well-documented, factual information on fraud, waste and corruption in the healthcare sector is an important ally for those who would seek to abuse healthcare systems for their own profit. Our lack of knowledge of the incidence, nature and extent of fraud, waste and corruption in healthcare is a threat to the establishment of effective counter-fraud strategies. It prevents those who finance healthcare provision from understanding in clear and quantifiable terms the need to invest resources into counter-fraud activities. As a consequence, fraud remains a matter of moral hazard and healthcare systems continue to suffer considerable financial damage, as well as all the associated consequences for the quality of care that patients receive. It was for these reasons that the 'European Healthcare Fraud and Corruption Network' (EHFCN) and the 'Dutch Healthcare Authority' (NZa, member of EHFCN) decided to collaborate to publish this book... --
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.
"From healthcare to workplace conduct, the federal government is taking on ever more responsibility for managing our lives. At the same time, Americans have never been more disaffected with Washington, seeing it as an intrusive, incompetent, wasteful giant. The most alarming consequence of ineffective policies, in addition to unrealized social goals, is the growing threat to the government's democratic legitimacy. Understanding why government fails so often--and how it might become more effective--is an urgent responsibility of citizenship. In this book, lawyer and political scientist Peter Schuck provides a wide range of examples and an enormous body of evidence to explain why so many domestic policies go awry--and how to right the foundering ship of state.Schuck argues that Washington's failures are due not to episodic problems or partisan bickering, but rather to deep structural flaws that undermine every administration, Democratic and Republican. These recurrent weaknesses include unrealistic goals, perverse incentives, poor and distorted information, systemic irrationality, rigidity and lack of credibility, a mediocre bureaucracy, powerful and inescapable markets, and the inherent limits of law. To counteract each of these problems, Schuck proposes numerous achievable reforms, from avoiding moral hazard in student loan, mortgage, and other subsidy programs, to empowering consumers of public services, simplifying programs and testing them for cost-effectiveness, and increasing the use of "big data." The book also examines successful policies--including the G.I. Bill, the Voting Rights Act, the Earned Income Tax Credit, and airline deregulation--to highlight the factors that made them work.An urgent call for reform, Why Government Fails So Often is essential reading for anyone curious about why government is in such disrepute and how it can do better"--
Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers' Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government.
Publication defines and discusses fraud, waste and abuse in the public sector in Australia. Topics include prevention, investigation and sanctioning activities.
Audits provide essential accountability and transparency over government programs. Given the current challenges facing governments and their programs, the oversight provided through auditing is more critical than ever. Government auditing provides the objective analysis and information needed to make the decisions necessary to help create a better future. The professional standards presented in this 2018 revision of Government Auditing Standards (known as the Yellow Book) provide a framework for performing high-quality audit work with competence, integrity, objectivity, and independence to provide accountability and to help improve government operations and services. These standards, commonly referred to as generally accepted government auditing standards (GAGAS), provide the foundation for government auditors to lead by example in the areas of independence, transparency, accountability, and quality through the audit process. This revision contains major changes from, and supersedes, the 2011 revision.
The Standards of Conduct Office of the Department of Defense General Counsel's Office has assembled an "encyclopedia" of cases of ethical failure for use as a training tool. These are real examples of Federal employees who have intentionally or unwittingly violated standards of conduct. Some cases are humorous, some sad, and all are real. Some will anger you as a Federal employee and some will anger you as an American taxpayer. Note the multiple jail and probation sentences, fines, employment terminations and other sanctions that were taken as a result of these ethical failures. Violations of many ethical standards involve criminal statutes. This updated (end of 2009) edition is organized by type of violations, including conflicts of interest, misuse of Government equipment, violations of post-employment restrictions, and travel.