Waste, Fraud, Abuse, and Mismanagement: Hearings Before the Task Force on Health of the Committee on the Budget, House of Representatives, One Hundred Sixth Congress, Second Session, Hearings Held in Washington, DC, May 18, June 14, July 12, and August 9, 2000, Volume 4U.S. Government Printing Office, 2000 - 239 pages |
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additional administrative areas audits BERENSON billing billion CARLOSS carriers Chairman CHAMBLISS changes CHARROW cians claims coding Committee complex compliance concerns Congress current methodology detection develop documentation drug durable medical equipment efforts ensure Ernie Fletcher error rate example Federal fee-for-service FLETCHER fraud and abuse fraudulent going guidelines HCFA HCFA's health care hearing home health agencies hospice care hospitals identify Illinois impact implementation improper payments inpatient issue JARMON Kentucky kickbacks LMRP look MCDERMOTT measurement Medi Medicaid medical necessity medical records medical review Medicare beneficiaries Medicare contractors Medicare program Medicare regulations ment nursing home outpatient patients payment accuracy payment errors percent physi physicians policies potential fraud problems program integrity prospective payment system providers questions regulatory reimbursement rules Saxby Chambliss specific staff submit suppliers surety bond Task Force techniques testimony Thank things tion waste
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Page 192 - Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided...
Page 128 - VA'S general computer controls was performed in connection with the department's financial audit conducted under the Chief Financial Officers Act of 1990, as expanded by the Government Management Reform Act of 1994.
Page 101 - An annual effect on the economy of $100 million or more; (2) A major increase in costs or prices for consumers, individual industries, Federal, State, or local government agencies, or geographic regions; or (3) Significant adverse effects on competition, employment, investment, productivity, innovation, or on the ability of United States-based enterprises to compete with foreign-based enterprises in domestic or export markets. (c) "Director" means the Director of the Office of Management and Budget....
Page 28 - STATEMENT OF THE AMERICAN COLLEGE OF PHYSICIANS— AMERICAN SOCIETY OF INTERNAL MEDICINE The American College of Physicians-American Society of Internal Medicine (ACPASIM), representing over 115,000 physicians who specialize in internal medicine and medical students...
Page 128 - Fraud (in accordance with §455.2) means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person.
Page 101 - Major rule" means any regulation that is likely to result in: (1) An annual effect on the economy of $100 million or more; (2) A major Increase in costs or prices for consumers, individual industries, Federal, State, or local government agencies, or geographic regions; or (3) Significant adverse effects on competition, employment investment, productivity, innovation, or on the ability of United States-based enterprises to compete with foreign-based enterprises in domestic or export markets.
Page 13 - I am here today on behalf of the American Hospital Association's (AHA) nearly 5,000 hospital, health system, network, and other health care provider members. We are pleased to have the opportunity to testify on the issue of public access to the National Practitioner Data Bank.
Page 110 - Illegal remunerations ( 1 ) whoever knowingly and willfully solicits or receives any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind— (A) in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under...
Page 40 - ... in the Medicare program should not be required to purchase bonds on a continuing basis. HCFA has much greater flexibility to tailor the surety bond regulation so that it is not onerous or harmful to small businesses, and should avail itself of that flexibility when redrafting the requirements. 5. Statistical sampling methodology for post-payment review In March 1999, HCFA published an FI manual update outlining new procedures for comprehensive medical review using statistical sampling (Transmittal...
Page 102 - Minimize the burden of the collection of information on those who are to respond, including through the use of...