It is well-settled law that entities contracting for the services of subsidiaries are legally responsible for legal and ethical improprieties committed by those subsidiaries irrespective of whether or not the contracting organization had any specific involvement in or knowledge of those actions. Accordingly, we would strongly advise that you take immediate action to rectify the situations described in the manner outlined in our recommendations below.
Recommendations
To avoid the potentially serious criminal, civil, and financial consequences arising under MWHC's respondeat superior responsibility to prevent fraud and abuse in connection with its association with subsidiaries, it is hereby recommended that MWHC immediately:
1. Instruct the subsidiary to cease and desist from offering its contracted home health agency employees compensation of any kind in connection with client durable medical equipment (DME) orders from the subsidiary.
2. Instruct the subsidiary to cease and desist from offering financial rebates to patients who use its equipment.
3. Instruct the subsidiary either to (1) expand its payment to hospital and home...
Determine whether any specific individual was responsible for deliberately altering or fabricating objective medical and terminate that individual for cause.
President George Bush proposed a two part strategy with initial implemented drug coverage to low-income beneficiaries coupled with a White House task force to develop a plan to reform Medicare (Health Policy, 2001). Under this plan beneficiaries with income 135% below the national poverty guidelines would be eligible for full prescription drug coverage and a sliding scale would be provided for those under 175% (Health Policy 2001). The most controversial
Medicaid and Medicare Fraud Describe health news story combating health care fraud Medicare Medicaid• Examine evaluate corporate structure governance, culture, focus social responsibility • Recommends Medicare and Medicaid fraud: An overview Medicare and Medicaid fraud: An overview While there is still little consensus regarding the best ways to go about enacting healthcare reform, one issue that unites both Democrats and Republicans is the need to eliminate Medicaid and Medicare waste, fraud and abuse. According
Fraudulent activities such as these resulted in violations under the act, including a fine of not more than $25,000.00 or imprisonment for not more than five years, or both. Analysis of Current Fraud legal analysis of the current fraud committed in the Medicare and Medicaid programs indicates that reforms are in place to detect this fraud, and the involvement of governmental, local and federal police and investigation authorities has increased
Medicare and Medicaid Services (CMS), previously the Health Care Financing Administration (HCFA), that by the time 2011, health care expenditure will arrive at $2.8 trillion, as well as it will bill for 17% of the Gross Domestic Product. As a result, it is no revelation that white-collar offenders observe health care deception as a rewarding effort. Certainly, the General Accounting Office ("GAO") quotes that such deception accounts for up
Fraud and Abuse Case Healthcare fraud and abuse continues to threaten the country, costing the facility billions of dollars per year. Brodeur, (2007) stated that fraud is something difficult to understand because it is a contagious issue. Healthcare fraud and abuse according to Brosman & Roper (2007) is the most profitable thing one can take part in if he/she is a crook, it avoid all channels and legal procedures, in nutshell,
Fraud and Abuse United States v. Greber -- 3rd Circuit, 1985 Facts: Dr. Greber's company, Cardio-Med, supplied Holter monitors, a device worn by patients that records heartbeats for later interpretation. Investigations showed that Cardio-Med billed Medicare and gave a portion of each payment to the prescribing physician, under the heading, "interpretation fees," even when Dr. Greber actually did the interpretation of the data. It was found that the fixed percentage paid to the